Nerdy Nurse Tip of the Month

If you've ever had a spontaneous bloody nose, absent-mindedly scratched open a scab, or are generally accident prone like me, you've gotten blood on your clothes. Screw Martha Stewart, being in the ER, we nurses know the trick to getting it out fast. You don't have the time or the resources to pop it in the washer and even then sometimes that doesn't even do the job. The key?

Hydrogen peroxide.

As soon as you realize you'd messed up your clothes, saturate the area, dab it with a washcloth or papertowel you can throw away and poof! It's gone. Like it never even happened. HP dries quickly, doesn't smell, and doesn't leave a stain of it's own (to ensure it doesn't bleach your clothes, rinse or dab the area with cold water after you've removed the stain). Now, this will only work if it just happened - it has to be new blood - if it's dried blood or an old stain, it won't help you. If you're looking to get rid of an old stain, Miss Martha is your guru. If you catch it quick, good old H-O-O-H is your friend.

And that's the Nerdy Nurse tip of the month!

xoxo

If it ain't broke, don't fix it...on the other hand...

If it is...ouch!!

There are several ways to break a bone. I'm only going to discuss four of my favorites instead of going through them all to avoid boring the snot out of you.

Let's start with my favorite. It's my favorite because the name for it illustrates exactly what it is: the greenstick fracture.

Have you ever been building a fire or just walking through the woods and you've tried to snap a branch in two that wasn't dead, but still green inside? It just twists, breaks a little on one side, but mostly just bends, right? Children's bones, because they are still soft and pliable (bones calcify and harden with age, hence, brittle bones in the elderly) do the same thing. It's an incomplete fracture where the bone is mostly just bent. Treat it with a hot pink cast that gets lots of autographs and you're good to go! Children are so resilient!

The next fracture that I love is also visual: the burst fracture. These occur from a high-energy axial load, usually caused by falls or car accidents and involved the vertebrae, causing it to literally burst. Surgery is usually required, involving fusion, especially if the spine is unstable, but these fractures can definitely cause paralysis if they are severe enough to involve the spinal cord. So don't jump from tall buildings - even if you land on your feet you can do some serious damage.

The third fracture that I think is fascinating is called the "Hangman's Fracture." This is the severance of pars interarticularis of the axis vertebra, more commonly known as C2, named so because this is the mechanism of injury (and the resulting death) in judicial hangings. It's caused by the sudden and forceful hyperextension of the head (chin to chest), and is not only caused by the sudden drop and jerk when one is being hung, but also in motor vehicle accidents when unrestrained drivers go into the steering wheel or through the windshield head-first. So wear your seatbelts!! Your C-spine is one of your most treasured possessions, so please, please treat it with loving care!

Last, but not least, I love a good open, compound fracture. Not cutely or sensationally named, but man is it gross! Quickly shortened by us in the ER to "open [insert name of body part]", (e.g. "open tib-fib," "open ankle"), these come in as level 2 traumas on a regular basis. Very bloody, easily contaminated (with dirt, etc.), and wicked awesome, these fractures are, surprisingly, usually not particularly painful. If there is considerable nerve, tendon, ligament, muscle damage, first we'll reduce it (put it back to where it's supposed to be) under conscious sedation and then splint it, but eventually surgery is going to be the answer. Pins, rods, plates, and all kinds of bike-shop metal is gonna be placed in there to make sure you're back in one piece. I had a patient the other day with a GREAT open ankle fracture and even took a picture of it with his permission. But the damn picture wouldn't load so now we're stuck with a look-alike from Google. Just imagine way more blood! :)

Awesome! So, the moral of the story is: get your daily dose of calcium because you definitely don't want to end up in the ER with one of these because your bones are too brittle and can't handle normal wear and tear! (Also, don't try to hang yourself because a) we love you and want you to live and b) suicide attempts by hanging usually succeed because of slow, terrifying asphyxiation, not a quick C2 fracture.)

xoxo