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Pediatric emergency medicine trisk 3424 3424

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fractures within a safe time period Referral for outpatient orthopedic follow-up after initial ED management is recommended for (1) most nondisplaced Salter– Harris type I fractures, (2) nondisplaced upper extremity, foot, and phalangeal fractures, (3) incomplete, nondisplaced fractures of the lower extremity long bones, and (4) reassessment of reduced routine dislocations of the minor joints and shoulder ( Table 111.1 ) Disposition Open fractures, those associated with neurovascular compromise, those at high risk for the development of compartment syndrome, or fractures requiring intravenous medication for pain control should be admitted to the hospital for further orthopedic management Non-/minimally displaced fractures, wellreduced fractures, as well as successfully reduced dislocations of the minor joints and shoulder, may be discharged home after immobilization Discharge instructions should include guidelines for pain control such as elevation and ice/cold pack application to the injured extremity and the use of medications at home, including oral narcotics if necessary In addition, written instructions should review signs and symptoms of neurovascular compromise, infection, compartment syndrome, and other emergent reasons to return to medical attention

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