Breaking Bad Bones

CotEcast #6 - Shownotes

*Apologies for slight noise/feedback issues in this episode - it was due to a technical issue that has now been resolved*

Title: Breaking Bad Bones

Host(s): Mark/Pete

Guest(s): Iain Wilkinson, Francis Collin

Opening Question: What is your biggest pet hate when watching medical dramas?

Main Topic: Orthogeriatrics

Discussion Points:

• Overview of orthogeriatrics (what is it, why is it needed, evidence?)
• National targets - Blue book (2007)
  • All patients with hip fracture should be admitted to an acute orthopaedic ward within 4 hours of presentation
  • All patients with hip fracture who are medically fit should have surgery within 48 hours of admission, and during normal working hours
  • All patients with hip fracture should be assessed and cared for with a view to minimising their risk of developing a pressure ulcer
  • All patients presenting with a fragility fracture should be managed on an orthopaedic ward with routine access to acute orthogeriatric medical support from the time of admission
  • All patients presenting with fragility fracture should be assessed to determine their need for antiresorptive therapy to prevent future osteoporotic fractures
  • All patients presenting with a fragility fracture following a fall should be offered multidisciplinary assessment and intervention to prevent future falls
• What would an ideal service look like?
• Biggest annoyances/areas for improvement

CotEcast commandments:

1. Treat hip fracture as a medical emergency
2. Bring the clinical team together
3. Take a proper falls history

References, Links and Resources:

• Blue Book
• National Hip Fracture Database
• Fascia Iliac Block Training (via BGS blog)
• Closure those taking issues with 'Scrubs' opening sequence (thanks to @GerisJo for the link)

Twitter Usernames:

• AEME: @ElderlyMedEd
• Mark: @garside80
• Pete: @petebrock7
• Iain: @geriatricsdoc

Email cotecast@aeme.org.uk with comments, questions, suggestions