Alright, now that that bit of nastiness is out of the way . . .
Football is not usually a dangerous sport. Some of the tackles may look a bit violent, but serious injuries are fortunately rare. However, considering the commonness of the game, I get plenty of football players in my trauma bay. Most of them have collided violently with another player and thankfully suffer no more than a concussion and some bumps and bruises at worst. But I do see the odd tibia fracture from someone getting kicked in the shin (usually during a "friendly" game where shin pads aren't being worn), but they are few and far between. So recently when my pager told me I was getting another football player in 10 minutes, I figured it would be another quick workup, another minor injury, and I could get back to reading A Game of Thrones.
I didn't know just how right I would be.
Morris (not his real name©) was playing a friendly game of football (striker, if you're curious) when he was kicked in the thigh. He immediately fell to the ground in agony, and emergency services was called. They felt he had an "obvious femur fracture" (so they told us over the box before they arrived), so they placed a traction device to stabilise his leg and help his pain. When he arrived, his thigh looked . . . completely normal. He wasn't in that much pain; in fact, he looked rather comfortable. Actually, he didn't have a scratch on him, despite the pre-hospital report, so I started wondering why the medics had seen fit to deem him a trauma patient. And then things went directly from "Strange" to "What the ever-loving fuck" when I asked him what happened to him and he started his story with "Well, six weeks ago . . ."
Wait, wait wait . . . six weeks ago? "No sir," I said, "not six weeks ago. What happened to you today?"
"I was getting to that, doc. So six weeks ago I was playing football, and I got kicked in my right thigh. It really hurt, but I played through the pain. I took some pain medicine and it got better and it's been feeling ok since, until this morning when it started hurting a bit again. But I decided to play through the pain again. Then I got kicked in the thigh again during our match today. It really hurt again, so here I am."
This seemed utterly ridiculous. He hadn't struck his head, he hadn't lost consciousness, he had no lacerations or abrasions or ANY other injuries, and was an otherwise healthy young man. Why did the medics designate him a trauma?
I had no idea, and by the time I realised I wanted to ask the medics what the fuck they were thinking, they had left. In a bit of a hurry, I would say. I had even less of an idea when I saw his completely normal femur X-ray.
"Yeah, I didn't think it was broken either, doc," he told me. "But they said it looked bad so I should get it checked out."
Fifteen minutes after he arrived, he walked out of the hospital with a prescription for ibuprofen and instructions to avoid football for a while.
I'm used to caring for people with life-threatening injuries. I take care of shattered spleens and lacerated bowels and eviscerations and gunshot wounds to the heart. These are the injuries that I typically deal with. So I should have been glad he wasn't seriously hurt. I should have been happy he didn't need surgery. But instead I was merely annoyed that the medics brought this kid to me unnecessarily and thoroughly wasted his time. And mine.
For a bruise.
For a bruise.
My kid tore his menicus playing your brand of football. But then he cracked his thumb swatting a fly with a science book. Probably just my kid.ReplyDelete
we call it football, because it is played on foot, instead of in a motor vehicle, of course. but I accept you are talking of the competitive diving exhibitions that the rest of the world calls football - which got its name because the reaction to any physical contact between players resembles the reaction one would normally associate with having a foot forcefully delivered to one's genitalia.ReplyDelete
ritual kidding aside.
I've seen a broken femur before. it is usually pretty readily identifiable by the fact that the thigh is no longer straight and the patient is minimally responsive at best - mainly because they are very busily hyperventilating. I've also seen the result of a strike to the hip that is hard enough to temporarily incapacitate the recipient, but not hard enough to break the bone. it is quite colorful - I have a photograph somewhere. which all leaves me wondering - how did he manage to get kicked in the thigh that hard?
The ball is a foot long. That's whyReplyDelete
Because the Brits used to call the two sports "Rugby Football" and "Association Football" then shortened it to "Assoccer" to eventually "Soccer".ReplyDelete
Really, it's just another example of Britain saying "Hey this is cool!" America going "Yeah, this IS cool!" and Britain throwing a fit going "Don't copy me!".
Basically, this: http://dobrador.com/wp-content/uploads/2012/12/6896205650405549_sIWm8J9e_f.jpg
I would have thought the "can you stand" test would have been a good place to start in this case! I'm not a medic but I'm pretty sure broken femurs are not compatible with standing upright!ReplyDelete
I was once running full-pelt through an alleyway at night (no I hadn't just snatched a handbag) and neglected to see the sturdy metal chain that someone had kindly hung between two concrete bollards. I was genuinely incapacitated by the pain of that one and had the links of the chain outlined by the bruises on my thighs for a couple of weeks after. I really expected to see jagged pieces of femur sticking through my jeans but amazingly I did no serious damage and was able to stagger on after only a few minutes recovery.
Femurs are pretty damn strong.
asking a person with a possible broken bone in their leg to stand is generally frowned upon in emergency services circles.Delete
To be fair when i brokr my wrist/arm bones the first question i was asked upon seeing some sort of medical professional was "can you move it"Delete
Oddly, I was not being entirely serious in suggesting that he be asked to stand right away. However, he didn't himself think it was broken so some brief investigation into what movement he could make without too much discomfort might perhaps have revealed a lack of extra knee.Delete
right - sometimes listening to the patient's self-assessment can save a world of trouble.Delete
Having a real problem with the medics' inability to properly assess this one. I have a very vivid memory of an actual living, breathing patient who had an actual, nasty fractured femur. There was an accidental new joint halfway between his hip and knee.ReplyDelete
I remember because as I was inserting a foley into what I thought was an unconscious trauma patient (donorcycle accident), the man tried to get off the table and moved enough to get the lower part of that broken leg off the table. The screams from the foley insertion were something. The screams from the leg "bending" off the side of the trauma table were even worse. My screams of "wwwwww" couldn't have helped much.
Remarkably, I still see this man up and around town, and he's done very well. I even assisted his wife with her labor and delivery of the couple's first daughter a couple of years later. One of the benefits (or curses) of working as an RN in a small community hospital and living in that small community.
my first one involved a tree about a foot in diameter and a small car. amazingly, despite having a tree print a foot deep in the door, we were able to simply open the door to remove the patient - who had a matching print in the thigh.Delete