ortho

DC Inst – Peds Fracture

DC, Peds

Male child?????????????????????????

Your son has been evaluated in the Emergency Department today for his ______ pain. His evaluation, including an x-ray of his _____, has revealed a _____ fracture. Your son’s ______ has been splinted in the ER.

Please rest, ice, and elevate your son’s ____ to control pain and inflammation.

Please give your son tylenol/motrin as directed in the attached dosing instructions for discomfort.

Please follow up with a pediatric orthopedic surgeon in about 1 week.

Return to the ER immediately if your son has any worsening or uncontrolled pain, numbness or weakness to his ____, color change to his ____, or for any other concerning symptoms.

Thank you for choosing usfor your child’s care.

Female child??????????????????????????????

Your daughter has been evaluated in the Emergency Department today for her ______ pain. Her evaluation, including an x-ray of her _____, has revealed a _____ fracture. Your daughter’s ______ has been splinted in the ER.

Please rest, ice, and elevate her ____ to control pain and inflammation.

Please give your daughter tylenol/motrin as directed in the attached dosing instructions for discomfort.

Please follow up with a pediatric orthopedic surgeon in about 1 week.

Return to the ER immediately if your daughter has any worsening or uncontrolled pain, numbness or weakness to her ____, color change to her ____, or for any other concerning symptoms.

Thank you for choosing us for your child’s care.

Pediatric Tylenol/Motrin Dosing Chart by Weight

Acetaminophen (Tylenol) Dosing Chart
May give acetaminophen dose every 4 – 6 hours:
Weight Tylenol Milligram Dosage Tylenol Infant drops 80mg/0.8ml Tylenol Children’s liquid160mg/5ml Tylenol Chewables 80mg each Tylenol Junior 160mg each
6 – 8 lbs 40 mg ½ dropper (0.4 ml) N/A N/A N/A
9 – 11 lbs 60 mg ¾ dropper (0.6 ml) N/A N/A N/A
12 – 17 lbs 80 mg 1 dropper (0.8 ml) ½ tsp (2.5 ml) N/A N/A
18 – 23 lbs 120 mg 1 ½ dropper (1.2 ml) 3/4 tsp (3.75 ml) N/A N/A
24 – 35 lbs 160 mg 2 droppers (1.6 ml) 1 tsp (5 ml) 2 tablets 1 tablet
36 – 47 lbs 240 mg 3 droppers (2.4 ml) 1 ½ tsp (7.5 ml) 3 tablets 1 ½ tablet
48 – 59 lbs 320 mg N/A 2 tsp (10 ml) 4 tablets 2 tablets
60 – 71 lbs 400 mg N/A 2 ½ tsp (12.5 ml) 5 tablets 2 ½ tablets
72 – 95 lbs 500 mg N/A 3 tsp (15 ml) 6 tablets 3 tablets
Note: Tylenol suppositories can be used if the child is vomiting or is very resistant to taking medicine by mouth. The suppositories can be cut-up to get the proper dose.

Ibuprofen (Motrin / Advil) Dosing Chart
May give ibuprofen dose every 6 – 8 hours:
Weight Motrin Milligram Dosage Motrin Infant drops 50mg/1.25ml Motrin Children’s liquid100mg/5ml Motrin Chewables 50mg each Motrin Junior100mg each
12 – 17 lbs 50 mg 1 dropper (1.25 ml) ½ tsp (2.5 ml) N/A N/A
18 – 23 lbs 75 mg 1 ½ dropper (1.875 ml) 3/4 tsp (3.75 ml) N/A N/A
24 – 35 lbs 100 mg 2 droppers (2.5 ml) 1 tsp (5 ml) 2 tablets 1 tablet
36 – 47 lbs 150 mg 3 droppers (3.75 ml) 1 ½ tsp (7.5 ml) 3 tablets 1 ½ tablet
48 – 59 lbs 200 mg N/A 2 tsp (10 ml) 4 tablets 2 tablets
60 – 71 lbs 250 mg N/A 2 ½ tsp (12.5 ml) 5 tablets 2 ½ tablets
72 – 95 lbs 300 mg N/A 3 tsp (15 ml) 6 tablets 3 tablets
Note: Motrin should NOT be given to infants less than 6 months old.

DC Inst – Back Pain

DC

You were evaluated in the Emergency Department today for your back pain. Your evaluation did not show signs of medical conditions requiring emergent intervention at this time.

We recommend you take 600mg ibuprofen every 6 hours or tylenol 650mg every 6 hours as needed for pain. If needed, you can alternate these medications so that you take one medication every 3 hours. For instance, at noon take ibuprofen, then at 3pm take tylenol, then at 6pm take ibuprofen.

***Please take your prescribed norco as directed as necessary for severe pain. Do not drive or take medications containing tylenol while taking norco.

Please schedule an appointment for follow-up with your primary care physician this week for further evaluation of your symptoms.

Return to the Emergency Department if you experience worsening back pain, difficulty walking, fevers, numbness, tingling, incontinence, or any other concerning symptoms.

Thank you for choosing us for your care.

DC Inst – Ankle Fx

DC

You have been evaluated in the Emergency Department today for ankle pain. Your evaluation showed a fracture of your ankle. We have placed your ankle in a splint today, avoid getting the splint wet.

We have provided crutches for you to use while your ankle heals. Please rest, ice, and elevate your ankle.

We recommend you take 600mg ibuprofen every 6 hours or tylenol 650mg every 6 hours as needed for pain. If needed, you can alternate these medications so that you take one medication every 3 hours. For instance, at noon take ibuprofen, then at 3pm take tylenol, then at 6pm take ibuprofen. *** Please take your prescribed norco as directed as necessary for breakthrough pain. Do not drive or take medications containing tylenol while taking norco.

***Please follow-up with an orthopedic surgeon in 1 week.

Return to the Emergency Department if you experience worsening pain, numbness, tingling, change of color in your toes, or any other concerning symptoms.

Thank you for choosing us for your care.

Back Pain – Low Risk

MDM

This patient presents with back pain most consistent with ***. Differential diagnoses includes lumbago versus musculoskeletal spasm / strain versus sciatica.*** No back pain red flags on history or physical. Presentation not consistent with malignancy (lack of history of malignancy, lack of B symptoms), fracture (no trauma, no bony tenderness to palpation), cauda equina (no bowel or urinary incontinence/retention, no saddle anesthesia, no distal weakness), AAA, viscus perforation , pulmonary embolism, renal colic, pyelonephritis (afebrile, no CVAT, no urinary symptoms). Given the clinical picture, no indication for imaging at this time.***

Plan: pain control, supportive care, reassess