Need your input.

  1. I have a longtime friend, that recently broke her leg. Now it was only a hairline fx of the tibia, but it almost turned tragic. When she was discharged from the hospital, she wasn't given any Heparin, or Coumadin to offset potential blood clots. She was medically cleared to travel to Florida which she did with a couple of friends. She made the trip okay, but was feeling sick on the plane. She went to the bathroom, threw up and then felt fine. Later that day, she went shopping. That night the 3 of them went to a restaurant, and Jane said that she was feeling bloated, and if she could go to the bathroom she would feel better. One of the others went with her, and before Jane could get to the stall, she fell over unconscious, and not breathing. My friend Miriam and restaurant staff rushed in the restroom and called 911. They turned Jane over, and opened her airway, and she sat bolt upright and started talking coherently. The squad took her to the hospital, and she spent 5 days in ICU. turns out she had 2 BLOOD CLOTS!! 1 in her lung, and 1 in her heart!!! The doc said her heart was strong enough that it flushed the one in her heart out. She's fine now, and back home, but please tell me, when she got discharged with the original leg fx, shouldn't she have had prophylactic Coumadin or Heparin at least until the les started to knit together?? I just feel that the ball was really dropped here, and my friend could have died because of it. Am I wrong??
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  2. 10 Comments

  3. by   traumaRUs
    In the ER where I work - no we would not routinely anticoagulate a tibia fx.
  4. by   warrior woman
    Okay. I was just curious. Guess I'm just wound up because it's Jane. Thanks.
  5. by   FranEMTnurse
    Quote from warrior woman
    I have a longtime friend, that recently broke her leg. Now it was only a hairline fx of the tibia, but it almost turned tragic. When she was discharged from the hospital, she wasn't given any Heparin, or Coumadin to offset potential blood clots. She was medically cleared to travel to Florida which she did with a couple of friends. She made the trip okay, but was feeling sick on the plane. She went to the bathroom, threw up and then felt fine. Later that day, she went shopping. That night the 3 of them went to a restaurant, and Jane said that she was feeling bloated, and if she could go to the bathroom she would feel better. One of the others went with her, and before Jane could get to the stall, she fell over unconscious, and not breathing. My friend Miriam and restaurant staff rushed in the restroom and called 911. They turned Jane over, and opened her airway, and she sat bolt upright and started talking coherently. The squad took her to the hospital, and she spent 5 days in ICU. turns out she had 2 BLOOD CLOTS!! 1 in her lung, and 1 in her heart!!! The doc said her heart was strong enough that it flushed the one in her heart out. She's fine now, and back home, but please tell me, when she got discharged with the original leg fx, shouldn't she have had prophylactic Coumadin or Heparin at least until the les started to knit together?? I just feel that the ball was really dropped here, and my friend could have died because of it. Am I wrong??
    And yet here in our local hospital, they do place a patient who has had a compound fracture on coumadin. My friend and neighbor had to take is last year, but her leg was fractured in 4 places.
  6. by   warrior woman
    I'm just wondering if she should have gotten a blood clot from a simple leg fx.
  7. by   VivaLasViejas
    Where I work, Coumadin is given prophylactically to our lower-extremity fracture patients of all ages (well, I don't know about peds, but all of our adult pts. receive it). Also to those w/ multiple fx and of course ortho surgeries, barring any allergies or contraindications (such as epidurals!).
  8. by   warrior woman
    So Marla did Jane's ortho doc miss the mark by not prescribing it prophylactically?? Or am I just reading too much into this??
  9. by   kids
    Generally anticoagulation is needed due to immobility. If she is able to be up, out and about I would be more inclined the clots were a result of either her flight to Florida, or the long ride if she didn't fly. Sometimes completely health people develope clots from the immobility during travel.
    Last edit by kids on Jun 22, '04
  10. by   warrior woman
    Okay. That helps to know. Thanks Kids r Fun. Any more mew pics of Dylan yet??
  11. by   VivaLasViejas
    Actually, Theresa, I don't know that the ball was dropped here, although I do NOT think she should have been cleared to take a long trip like that, at least not without being strongly cautioned about the possibility of developing clots and given information about how to prevent them. I don't know how many people I've talked to about this very thing, including my own family, and we're talking about healthy people, not those with long-bone fractures (no matter how "hairline" it is, long-bone fractures are not something to be taken lightly). DVT is so common that they even have ads on TV now advising people how to prevent it........I'm surprised that your friend wasn't told NOT to take this trip, or at the very least given a handful of information on what to do to prevent clot formation and a list of symptoms to watch for. I'm glad she's OK, though.........just goes to show it can happen to anyone. A cautionary tale, indeed.
  12. by   warrior woman
    Thanks Marla. There was a lot of praying and tears involved until it was discovered she was gonna be okay. She's home now.

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