Pink Pulseless Hand
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You are the member of orthopedic team of a large hospital. It is the team’s Job to make decision and treat all trauma brought to it. You are on duty on alternate days and on duty days you are supposed to take decisions, operate and seek help on behalf of the team. You received an emergency call at 12 midnight to attend a case.
General Information about the case:
A 7 year old girl had a fall on out-stretched hand. She has got a pink pulse less hand (left) and a swollen elbow. The emergency physician has Splinted the limb.
Details about the case:
Glades is a 7 year old girl. She fell from a small tree, with her left outstretched hand, at around 7:30pm. She had no other injuries and she was conscious. Parents Immediately took her to a nearby hospital. X-ray of the left elbow was taken and the CMO told them that there is a fracture of the elbow and as the orthopedic Surgeon us out of station, he referred her to your hospital.
The emergency medicine Consultant had noticed that, though the O2 saturation of the left upper limb was 99% and the Capillary filling was not delayed, she could not palpate the radial & ulnar artery pulsation. You reached the Emergency department at 12:15AM.
1) What will you do Immediately?
2) What will you look for in the ✗ ray?
3) Are you aware of any classification for the most common paediatric elbow fracture? Describe the classification and how it will guide you for the treatment decision making?
4) Considering the absence of pulse what actions will you take?
5) Will you operate in the middle of the night, as emergent or urgent?
6) What are the Immediate and late complications of this injury?
7) Which guideline will you follow for the treatment of this injury? Describe the Same using a flow chart.