Hip fracture in emergency department, treatment and management

Prehospital treatment of a patient who complains of hip pain should include immobilisation on a stretcher.

• If the patient is a victim of multiple traumas, address the ABCs and immobilize the cervical spine as appropriate. – If fracture or deformity of the femur is
  obvious, apply a traction splint and place an intravenous (IV) line for hydration.
• If the patient is hypotensive or tachycardic, initiate crystalloid fluid bolus and place patient on supplemental oxygen. – Emergency Department Care
• If the patient is a victim of trauma, attend to the ABCs first and conduct a thorough search for other possible injuries. – n cases of obvious femur fracture, immobilise the patient, place 2 large-bore IV lines for hydrations and possible transfusion, restrict the patient’s oral intake to nothing by

mouth (NBM), and obtain specimens for preoperative labs if necessary.

• Orthopaedic treatment decisions vary significantly among different practitioners, thus early consultation for all hip fractures is recommended.
• Initiate appropriate parenteral analgesia as
  soon as possible. – Ultrasound-guided femoral nerve blocks may also be used to achieve adequate analgesia. – Femoral head fractures- Type 1: Orthopaedic consultation in the Emergency Department (ED) should be