Minor Injuries Overview

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Presentation transcript:

Minor Injuries Overview Julia Gamston Consultant Nurse in Emergency and Urgent Care

Learning Outcomes An head to toe brief overview of minor injuries Management in GP practice When to send to ED/UCC When to refer to specialism

Head/facial injuries

When to refer ? Fall ? Collapse Significant MOI LOC, period of amnesia ,vomiting Neck pain Wound management ?FB Facial bony tenderness Septal haematoma ?draining Past Medical history, drug history

Management in GP Practice Head injury instructions- verbal and written Paediatric and Adult Red flags Accompanied home/support at home Nose injury review ?ENT referral

Structure for examination for limb injuries

Upper limb

When to refer Bony tenderness Deformity ?dislocation Wound ? FB Complex Wound ? Tendon/nerve injury (ED/UCC with plastics) ?Contaminated

Management in GP Practice Rest, Ice, compression, elevation RICE Bandage, tubigrip, sling Analgesia (?NSAIDS) Gentle mobilisation Wound care ? photo

Lower limb

Ottawa ankle rules

When to refer Ottawa Rules for knee and ankle for x-ray Weightbearing (paed/older adult) Wound +/- FB higher incidence of infection

Management in GP Practice Analgesia RICE Gentle mobilisation Physio

Wounds/Burns

When to refer Full thickness burns or unable to assess Inhalation, electrical, chemical burns Facial, hands, genitals, feet, joints, scalp, ears or circumferential burns Safe guarding concerns Gaping bleeding wounds requiring closure Possible FB ? Contaminated Complex wounds, tendon/nerve involvement

Management in GP Practice Analgesia Immunisation Wound review Wound care advice Photograph

References and resources 1. Bachmann LM, Kolb E, Koller MT et-al. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ. 2003;326 (7386): 417. doi:10.1136/bmj.326.7386.417 2. Atkinson P, Boyle A, Chisholm E. X-ray requesting patterns before and after introduction of the Ottawa Knee Rules in a UK emergency department. Eur J Emerg Med. 2004;11 (4): 204-7. NICE head injury guidelines National Institute for Health and Care Excellence. Head injury: triage, assessment, investigation and early management of head injury in infants, children and adults. (Clinical guideline 176.) 2014. www.nice.org.uk/ CG176.