Some input on a missed femur fracture.

[1EMT-P]

It can be difficult to assess patient's in the field especially if they are not fully alert and oriented. If you did a full head to toe assessment on your patient in the field, followed your protocols and treated the patient to the best of your ability then I don't think you did anything wrong.

It sounds like your colleague needs to review the HIPPA rules, before he goes discussing a patient's diagnosis or treatment in the ED.

[BushyFromOz]

Please forgive my ignorance, but what is HIPPA?

[EMT City Administrator]

HIPAA

[web:4b2075ea49]http://en.wikipedia.org/wiki/HIPAA[/web:4b2075ea49]

[MedicRN]

Please forgive my ignorance, but what is HIPPA?

Health Insurance Portability and Accountability Act

[Ridryder 911]

Actually, since he cared for the patient there is no HIPPA violation. Continuation or follow up is acceptable. As well if they do not do electronic billing, there is no HIPPA ruling.... a little loop hole.

R/r 911

[aussiephil]

Dont worry about it.

I have had an ER doc diagnose a pt with a disecting AAA as having muscular skeletal pain (non palpable in the field)

At least I had cardiovascular suspicions.

A wise man once told me always treat for the worst & hope for the best. That way yu cover all bases.

[iMac]

It can be a tought call. I have heard of story where 2 medics were called for a fall. An 85 yo female had slipped on a sidewalk curb and couldnt get up. She didnt have any complaints other than some minor leg lower leg pain, right below her knee.

From what I understood, it was a student and 2 medics. Dont know who, or where but they picked her up and a piece of femur fell down on the sidewalk. As it happend she obviously had an open femur fracture...oops :?

Personally dont know how you could miss something like that, but again I wasnt there. Some injuries can just be tricky to find. Some might not actually show obvious signs until much later.

[melangel16]

I've even heard of a doc pronoucing a pt and a nurse just for the sake of it checked a pulse and guess what??? He had one - big oops.

So missed fractured femur - won't kill him - just prolong the pain. I've missed one in the field as well, even a fractured hip - it happens (especially when the bones are still in line or hairline fracture with no obvious signs present) - pt still got treated and bones reset so all ends well. Which is the goal.

From the sounds of it you did everything you shoud have - don't fret about it.

[whit72]

Stable vitals, no deformity, no swelling. Hospitals don't diagnose FXs without X rays, they don't expect you to either.

[1EMT-P]

Rid as I understand it, every health care agency who transmits health information electronically is covered regardless of their size. It is also my understanding that a hospital ED may give a patient's billing information to an ambulance service who transported the patient to the ED, but that the hospital may not disclose any protected health information about the patient's condition or treatment to the ambulance service once the patient/provider relationship has ended without written consent from the patient.