Continuing Professional Development: Management of an isolated neck-of-femur fracture in the elderly patient

OverviewIn the UK, femoral neck fractures affect up to 75 000 elderly people per year, with up to a third of these patients dying within twelve months. While there is a paucity of research specific to the pre-hospital field, current evidence demonstrates that optimal treatments include appropriate and adequate analgesia, fluid management and correct immobilisation of the injured leg. Analgesia should be considered immediately in a stepwise approach, through the variety of options open to paramedics and should be progressive to the patients needs. Fluid management should be considered to stabilise the patient and prepare them for surgery. Transfer to the ambulance should be done in a safe manner, ensuring the patient is immobilised and remains pain free. This pre-hospital management of the patient with a femoral neck fracture ensures they receive appropriate management before initiation onto a care pathway in hospital.Learning OutcomesAfter completing this module you will be able to:• Identify there are different types of femoral neck fracture.• Recognise the importance of completing a full set of observations and taking a full history, including a pain assessment.• Demonstrate the pharmacology of analgesia appropriate for use in elderly patients in prehospital care.• Explain the importance of non-analgesic treatment in the management of femoral neck fractures, such as IV fluid therapy and immobilisation of the injured leg.

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