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WHAT YOU SHOULD KNOW:
- A pelvic fracture is when one or more of the pelvic (hip) bones are broken. Many pelvic fractures are caused by accidents that happen at high speed, like a car accident, or falling from a great height. Some pelvic fractures are caused by minor falls or injuries. An athlete may get an avulsion fracture when a sudden movement causes the muscle to tear away a piece of hip bone. Pelvic avulsion fractures do not usually cause any other life-threatening injuries. Pelvic avulsion fractures usually can be treated with bed rest, using crutches or a walker, and pain medicine. If you have this kind of fracture, you may have to avoid putting weight on the hip bone until it heals.
- You may have life-threatening injuries if your pelvic fracture was caused by a high speed injury. Serious injuries may have happened to your chest, head, neck, kidney, and other organs inside your abdomen. You may be taken to the ER after the accident that caused your pelvic fracture. You may need many tests to find out if you have other injuries. After being treated in the ER, you may be taken to the intensive care unit, to surgery, or to another nursing unit.
CARE AGREEMENT:You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.
- You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.
- Even with treatment, you may have life long problems after a pelvic fracture. You may have long-term back or pelvic pain, differences in the length of your legs, or men may have impotence (be unable to have an erection). Even after surgery, there is a chance that your bones may not heal correctly. Call your caregiver if you are worried or have questions about your treatment or care.
WHILE YOU ARE HERE:
Fractures heal as new bone grows to fill in the gap between the broken pieces. Resting your hip as much as possible allows the bone to heal. You may need to rest in bed for a while so the pelvic bones can heal. If you are not allowed out of bed, ask caregivers if you may exercise one or both of your legs in bed. Exercise may make your legs stronger and may help stop blood clots from forming. Stop exercising if you become tired.
You may not be able to get out of bed to urinate or to have a bowel movement (BM). If you cannot get out of bed you will use a bedpan. Ask your caregivers if you need help using the bedpan.
You may use the call button when you need your caregiver. Pain, trouble breathing, or wanting to get out of bed are good reasons to call. The call button should always be close enough for you to reach it.
Deep breathing and coughing:
This will help decrease your risk for a lung infection after surgery.
- Hold a pillow tightly against your incision when you cough to help decrease pain. Take a deep breath and hold it for as long as you can. Deep breaths help open your airways. Let the air out and follow with a strong cough. Spit out any mucus you cough up. Repeat the steps 10 times every hour.
- You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece into your mouth and take a slow, deep breath. Let out your breath and cough. Repeat the steps 10 times every hour.
A Foley catheter
is a tube put into your bladder to drain urine into a bag. Keep the bag below your waist. This will prevent urine from flowing back into your bladder and causing an infection or other problems. Also, keep the tube free of kinks so the urine will drain properly. Do not pull on the catheter. This can cause pain and bleeding, and may cause the catheter to come out. Caregivers will remove the catheter as soon as possible to help prevent infection.
Intake and output:
Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.
A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
You may need one or more of the following tests to help caregivers plan your treatment.
- Arteriogram: This test may also be called arteriography. X-rays are used to take pictures of the arteries in your abdomen and pelvic area. If arteries have been injured, caregivers may be able to stop bleeding during the arteriogram. Before the X-ray, you are given dye through an IV. This dye helps the arteries show up better on the X-rays. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to any of these.
- Blood gases: This is also called an arterial blood gas, or ABG. Blood is taken from an artery (blood vessel) in your wrist, arm, or groin. Your blood is tested for the amount of oxygen and carbon dioxide in it. The results can tell caregivers how well your lungs are working.
- Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
- Bone x-rays: You may need X-rays to find fractures (broken bones). More X-rays may be taken later to watch how the bones are healing.
- Chest tap: A needle may be put between ribs to see if there is bleeding in your chest or lungs. The needle can also be used to take air out from around your lungs.
- Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
- C-spine x-rays: You may need cervical spine (c-spine) x-rays to check for broken bones or other problems in your neck. Several pictures may be taken of the bones in your neck. These neck bones are called vertebrae.
- CT scan: This test is also called a CAT scan. A special X-ray machine uses a computer to take pictures of different areas of the body, especially your chest, lungs, and abdomen. Before taking the pictures, you may be given dye through an IV in your vein. The dye helps the area show up better in the pictures. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to any of these.
- Cystoscopy: A cystoscopy allows caregivers to look for problems inside your bladder. A cystoscope is put into your bladder through your urethra. The urethra is the tube that urine flows through when you urinate. The cystoscope is a long tube with a lens and a light on the end. The scope may be hooked to a camera or monitor, and pictures may be taken. A tissue sample may also be taken during your cystoscopy. During this test, small tumors may be removed or bleeding may be stopped.
- Cystourethrogram: This special type of X-ray may be done to find out if you have any injuries to your bladder or urethra. The urethra is the tube that goes from the bladder to the outside of your body that you urinate (pass urine) through. Before taking the pictures, you may be given dye through an IV in your vein. The dye helps the area show up better in the pictures. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to any of these.
- An echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your heart.
- Telemetry is continuous monitoring of your heart rhythm. Sticky pads placed on your skin connect to an EKG machine that records your heart rhythm.
- Ultrasound: This test uses sound waves to look at different organs inside your chest, abdomen, or pelvis. Caregivers may be looking at your heart, lungs, kidneys, bladder, or uterus. The pictures show up on a TV-like screen.
- Urine sample: A sample of your urine is collected and tested for blood in your urine. This test helps tell caregivers if your bladder, urethra, or kidney have been injured. The kidney is where urine is made and the bladder is an organ where urine is kept. The urethra is the tube that goes from the bladder to the outside of your body that you urinate (pass urine) through.
- Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
Your treatment depends on how bad the pelvic fracture is and the other injuries you may have. This is often decided after you have tests. You may have some of the following treatments alone or together.
- Back board: Caregivers may lay you flat on a special board with your head strapped down. This keeps your back and neck still until tests are done to make sure that your spinal cord has not been injured.
- Blood transfusions: You may need one or more blood transfusions if you have lost a lot of blood. There are large blood vessels inside the pelvic area. These blood vessels can be damaged and bleed without being seen. Caregivers may also be able to use a machine called a cell saver. The machine collects your own blood if you are bleeding and cleans it. Then caregivers can give this blood back to you. This may help prevent or decrease the number of regular blood transfusions that you may need.
- Body cast: You may be put in a special cast from your abdomen (belly) down both legs. This is called a body cast and holds your hip bones still while they heal.
- Chest tube: A chest tube is used to remove air, blood, or fluid from around your lungs or heart. Removing fluid lets your lungs fill up with air when you breathe, and helps your heart beat normally. The chest tube is attached to a container to collect the blood or fluid. Call a caregiver right away if the tube comes apart from the container. Let the caregiver know if the tubing gets bent, twisted, or the tape comes loose. You may need more than one chest tube.
- Drains: These are thin rubber tubes put into your skin to drain fluid from around your incision. The drains are taken out when the incision stops draining.
- Ice: Ice causes blood vessels to constrict (get small) which helps decrease inflammation (swelling, pain, and redness). Caregivers will put crushed ice in a plastic bag and cover it with a towel. Put this on your hip for 15 to 20 minutes every hour as long as you need it. Do not sleep on the ice pack because you can get frostbite.
- Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
- Antinausea medicine: This medicine may be given to calm your stomach and prevent vomiting.
- Blood thinners: Blood clots often happen after a pelvic fracture. This medicine keeps clots from forming in the blood. Clots can cause strokes, heart attacks, and death. Blood thinners may make it easier to bleed or bruise. If you shave, use an electric razor. Use a soft toothbrush to brush your teeth. Doing this can keep your skin and gums from bleeding.
- Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
- Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
- Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
- Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.
- Oxygen: You may need extra oxygen for a while after the injury. It may be given through a plastic mask over your mouth and nose. It may be given through nasal prongs (short, thin tubes in your nose). Tell your caregiver if the oxygen is drying out your nose or if the nasal prongs bother you. Do not take off your oxygen without asking your caregiver. If you do, your body may not have enough oxygen.
- Pressure stockings: These are long, tight stockings that put pressure on your legs to promote blood flow and prevent clots. You may need to wear pressure stockings before or after surgery or if you have poor circulation (blood flow).
- Pneumatic boots: Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots.
- Surgery: You may need surgery to repair the pelvic fracture and other injuries.
- External fixation device: A piece of metal equipment called an external fixation device may be put on your hips to hold the broken bones together while they heal. Screws or a special clamp are used to hold it to your hipbones. Caregivers may be able to put this on while you are in the ER or you may be taken to the operating room.
- Open fixation surgery: The pieces of broken bone are put together with metal pins, screws, or plates while you are in the operating room.
- Other surgery: You may need one or more of the following surgeries to repair damaged organs or blood vessels.
- Laparotomy: Abdominal surgery that may be needed to look for injuries to your abdominal organs and to stop bleeding.
- Bladder surgery: This kind of surgery may be needed if your bladder was injured or ruptured.
- Colostomy: This kind of surgery may be needed if your intestines or rectum are torn. A colostomy is when a section of uninjured bowel is made to come out of your abdomen. Your BM comes out of this opening into a sealed bag. This allows the injured part of your intestines or rectum to be repaired and then rest while it heals.
Learn more about Pelvic Fracture (Inpatient Care)
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