The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and backs)

[Francis]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

Never assume

Makes an ASS out of U and ME

In the case of where I live the Good Samaritan Act is firm law.. We are protected and it has been that way for a long time.. No one has ever sued anyone for helping.

http://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/00_96172_01

 

[The Doc]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

I'm going to have to disagree with your assertion that there is no difference between ibuprofen and Celebrex or the other prescription drugs that you listed. Ibuprofen is a non-selective COX inhibitor, while the others you mentioned are COX-2 inhibitors. Which I think you were getting to with your comment about Mobic and stomach problems. By not blocking the COX-1 enzyme, it largely eliminates the possibility of stomach ulcers and the like developing with extended use. I've personally been on relatively high doses of Celebrex in the past for different pain problems, and I did notice a difference in my pain levels as opposed to simply taking high doses of ibuprofen. So, it's not the medical industry trying to make more money off of you, it's an issue where the medical industry is providing a more targeted drug for the specific purpose of anti-inflammation and pain relief without GI side effects due to the COX-1 enzyme being inhibited.

Your assertion that doctors only want to make money is rather disingenuous. An x-ray isn't an unnecessary procedure, it's a responsible one that provides the medical provider the information necessary to make an informed diagnosis. They wouldn't want to diagnose your shoulder pain as simple overuse when you actually had a separation that wasn't obvious through physical examination. It's not about making extra money, it's about providing the proper care. It is professionally irresponsible of you to suggest to people that they can simply fix issues by themselves when there could be a more severe underlying problem. Your suggestions are sound common sense solutions for basic aches and pains; but I wouldn't tell people that it is unnecessary to visit their doctor for pain they may be experiencing. Self-diagnosis and self-treatment for chronic conditions is one of the worst things people can do. I'm certain that people here more than likely exhibit proper common sense when it comes to issues like these, but other people might not... so I would caution you before telling people that they don't need to see their physician for pains they might be experiencing.

No, I'm not a medical professional, but most of my family is, has, or will be in the medical field in some way... so I've been around it for most of my life, have extensive experience taking pain killers due to chronic knee and shoulder problems that I have (not to mention various broken bones), and I worked in a physical therapy clinic as a coder, front office, and a treatment assistant. Just some things I thought I should throw out there, no offense intended.

Mobic, Ibeuprofin, Celebrex and Naproxen are all NSAIDS and do the same thing, but i did point out mobic and celebrex are used for people who have GI issues because ibeuprofin is tough on the gut. also, celebrex is contraindicated in people with heart problems.

AT no point did i say X-rays are un-neccessary. They are very much overused on obvious injuries that dont need them. When there is a suspected bone fracture, or visual disfigurement then its neccessary. If you just rolled your ankle or banged your wrist you most probly didnt break anything. If you broke something, you would know. Trust me.

Is that true even with the good samaritan laws?

I believe if you have "some" qualifications and utilize what you know to the best of your ability to help someone in need, you may be protected from lawsuits.

Good samaratin laws exist in certain places and cover certain things. Its different place to place. I dont risk it. A girl at a party when i was on leave got roofied and was drunk. I started an IV line on her of LR. The paramedics again informed I did the right thing but I can be sued.

 

[Francis]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

Good samaratin laws exist in certain places and cover certain things. Its different place to place. I dont risk it. A girl at a party when i was on leave got roofied and was drunk. I started an IV line on her of LR. The paramedics again informed I did the right thing but I can be sued.

Doc, as I posted the same time you did on the Good Samaritan Act in my area, you should also know, if you travel that there are countries and places where there is a law that requires you to ASSIST people in dire need of help.. Some make it Civil Law while other make it Criminal Law if you do not do the minimum to assist.

It's called "Duty to Rescue".

http://en.wikipedia.org/wiki/Duty_to_rescue

 

[retro]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

Mobic, Ibeuprofin, Celebrex and Naproxen are all NSAIDS and do the same thing, but i did point out mobic and celebrex are used for people who have GI issues because ibeuprofin is tough on the gut. also, celebrex is contraindicated in people with heart problems.

They are indeed all NSAIDSs, but there is a distinct difference between unbiased COX inhibitors and COX-2 inhibitors... it also goes beyond simple GI issues. I was merely clarifying though, because there is a reason why physicians would prescribe a COX-2 inhibitor over simple ibuprofen; whether it before GI issues or anything else.

AT no point did i say X-rays are un-neccessary. They are very much overused on obvious injuries that dont need them. When there is a suspected bone fracture, or visual disfigurement then its neccessary. If you just rolled your ankle or banged your wrist you most probly didnt break anything. If you broke something, you would know. Trust me.

I've broken many bones in my body, and so yes I do know what a broken bone feels like. That being said, I broke my wrist, and had no clue (because a wrist fracture and a wrist sprain can present with very similar symptoms) until I had an x-ray. In fact, my physician thought that it was a sprain, but elected to have me get x-rays, where we discovered that it was a fracture. I would much rather that my physician get a clear and accurate picture of what's going on prior to taking action. The fact that you're talking about "obvious injuries" tells me a lot... nothing in regards to physical ailments should be treated as "obvious". Every situation is different and should be thoroughly investigated prior to developing a treatment. It is incredibly reckless to just make an assumption where someone's health is concerned. If you were my medical provider, I wouldn't have ever known that I had a broken wrist, and it could have healed incorrectly as a result... at least based on your claim that x-rays are unnecessary for simply banging your wrist.

 

[The Doc]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

How it works in the Army medical command is if there is no obvious disfigurement you will use RICE therapy with NSAIDS and if the pain persists over 1 week then you get an X ray. Also, wrists and ankles have certain physical tests to determine if there is a fracture like the snuff box test with the wrist, etc...

 

[retro]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

See, and I feel like that's potentially wasting time... RICE is fine and dandy, but when you're dealing with a fracture, it's not going to help. I'd rather go downstairs from my primary to the radiology department, get my x-rays, and then go back up to the doctor to find out what's up. Or to go downstairs and have the x-rays, and come back to see the specialist the next day. That way I know exactly what is going on without potentially treating it incorrectly.

 

[The Doc]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

See, and I feel like that's potentially wasting time... RICE is fine and dandy, but when you're dealing with a fracture, it's not going to help. I'd rather go downstairs from my primary to the radiology department, get my x-rays, and then go back up to the doctor to find out what's up. Or to go downstairs and have the x-rays, and come back to see the specialist the next day. That way I know exactly what is going on without potentially treating it incorrectly.

Fracture or no fracture, they are still going to do ride therapy on you even if you full on broke the bone. The only difference is you will have a cast for compression and not an ACE

 

[purpledove]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

Not to disrespect you Doc as I acknowledge your service to our country and experience being a combat medic. However, I agree with almost everyone who have posted in this thread.

I agree that RICE and Ibuprofens are the basic treatment but in addition, it's still case to case basis depending on what type of injury, level of pain etc that needed to be considered before treatment is done. Don't forget that most civilians lack the assessment skills/training that you and some other medically trained members in this forum have. Giving advises like not taking xrays nor waiting a week to go see an MD etc I think, it's a big risk on your part. Even medical advise sites online have 'disclaimers' and state to see their PCP when symptoms worsen. These medical advise sites like WebMD etc are aware that once an advise is given to a person and those advises don't work well with that person or like a fracture or bad bone misalignment existed and it worsened or affected normal healing process after following your advise, that a probable lawsuit can be at hand. You're young and please help protect your license/certificate by being careful as to what you advise others on what to do especially without you fully assessing the situation/details on their type of injury.

Combat/war treatment is so much different from a day to day muscoloskeletal injuries of civilians. I am assuming most soldiers or athletes you deal with are medically healthy in comparison to civilians who have clotting/bone/joint problems like DVT, DJD, Osteoporosis etc. These medical conditions and others are needed to be taken into consideration b4 treatment is initiated.

Not all people are able to know when there is a broken bone esp if it's a hairline fracture. The injured needs to be seen by an MD and have an Xray to see clearly the direction of the fracture in comparison to body alignment. It's important for one to know what type of cast/sling/brace or treatment is needed. It's true that If there is 'gross' disfigurement/misalignment of a bone, one is able to know right away as one is able to see visually the protruding bone through one's skin. But keep in mind, there are different types of fractures: comminuted, hairline/stress, oblique, transverse, simple etc. Without the training of some forum people you're generally advising on, how do you propose they'll know when they have broken bones ? :unsure:

....not to brag, I am an RN with 21.5 years experience in the field (Heart and Lung transplant, cardiac bypass, OR & ER Trauma, Intensive care, long term and rehabilitative, Admission/ER Assessments & Forensics)

L0L...maybe you can spell check the medical terms you use on your post

 

[purpledove]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

Also you've added back injuries. Back injuries are not something for someone to wait for a week to see an MD. You might be aware that per each level in one's spinal cord, are connected to the brain and affecting parts of one's body. Any fracture/swelling or injuries to the back may compress the spinal cord and nerves which can later on if not managed right away by an MD can lead to paralysis or weakening of some parts of our body depending on what level the back injury is at. There are also lots of symptoms related to a back/spinal injury that one needed to take into consideration b4 someone can rely on the basics of RICE and Ibuprofens/NSAIDS.

 

[The Doc]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

Not to disrespect you Doc as I acknowledge your service to our country and experience being a combat medic. However, I agree with almost everyone who have posted in this thread.

I agree that RICE and Ibuprofens are the basic treatment but in addition, it's still case to case basis depending on what type of injury, level of pain etc that needed to be considered before treatment is done. Don't forget that most civilians lack the assessment skills/training that you and some other medically trained members in this forum have. Giving advises like not taking xrays nor waiting a week to go see an MD etc I think, it's a big risk on your part. Even medical advise sites online have 'disclaimers' and state to see their PCP when symptoms worsen. These medical advise sites like WebMD etc are aware that once an advise is given to a person and those advises don't work well with that person or like a fracture or bad bone misalignment existed and it worsened or affected normal healing process after following your advise, that a probable lawsuit can be at hand. You're young and please help protect your license/certificate by being careful as to what you advise others on what to do especially without you fully assessing the situation/details on their type of injury.

Combat/war treatment is so much different from a day to day muscoloskeletal injuries of civilians. I am assuming most soldiers or athletes you deal with are medically healthy in comparison to civilians who have clotting/bone/joint problems like DVT, DJD, Osteoporosis etc. These medical conditions and others are needed to be taken into consideration b4 treatment is initiated.

Not all people are able to know when there is a broken bone esp if it's a hairline fracture. The injured needs to be seen by an MD and have an Xray to see clearly the direction of the fracture in comparison to body alignment. It's important for one to know what type of cast/sling/brace or treatment is needed. It's true that If there is 'gross' disfigurement/misalignment of a bone, one is able to know right away as one is able to see visually the protruding bone through one's skin. But keep in mind, there are different types of fractures: comminuted, hairline/stress, oblique, transverse, simple etc. Without the training of some forum people you're generally advising on, how do you propose they'll know when they have broken bones ? :unsure:

....not to brag, I am an RN with 21.5 years experience in the field (Heart and Lung transplant, cardiac bypass, OR & ER Trauma, Intensive care, long term and rehabilitative, Admission/ER Assessments & Forensics)

L0L...maybe you can spell check the medical terms you use on your post

Again, people know their own bodies fairly well. If you have broken something, or your in severe pain your going to see a doctor. Thats a given. For the back I did state what you said, if its midline and you experience numbness or tingling in the lower extremities or lose control of bladder or stools its a spinal injury you need to see your primary care physician. This whole thread was made for regular day to day injuries that arent severe like sprained ankles and wrists, bumped knees etc..

Also, hairline fractures can not be seen in an X-ray. You would need a bonescan for stress/hairline fractures and stress reactions. Even if it was found you had a hairline or stress fracture the treatment would still be the same. Its an overuse injury. RICE therapy.

 

[purpledove]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

Again, people know their own bodies fairly well. If you have broken something, or your in severe pain your going to see a doctor. Thats a given. For the back I did state what you said, if its midline and you experience numbness or tingling in the lower extremities or lose control of bladder or stools its a spinal injury you need to see your primary care physician. This whole thread was made for regular day to day injuries that arent severe like sprained ankles and wrists, bumped knees etc..

Also, hairline fractures can not be seen in an X-ray. You would need a bonescan for stress/hairline fractures and stress reactions. Even if it was found you had a hairline or stress fracture the treatment would still be the same. Its an overuse injury. RICE therapy.

That's not what you have initially posted hence the refuting posts of other Otzers too.

I dont think I've mentioned that hairline fracture is diagnosed with an Xray. I am aware that a diagnostic procedure is via Bone scans/MRI/CT scans. But remember though that 'patellar hairline fracture's' diagnostic procedure of choice is Xray.

I was stating my point in re: to your statement to trust you that one will know when there is a broken bone hence an example of a hairline fracture which can be hard to see. Even if one knows their body well, take into consideration the psychological aspect of a person. If one is injured, the initial reaction is distraught/panic, focused more on pain. Even one who is medically trained will have their emotions come first over assessing if they have broken bones and such. Maybe not all are emotionally strong when it comes to injuries like the soldiers you dealt with. My point is that with the advise you give take into consideration all the other aspects and fully assess the injury of those you're giving advise to first.

 

[Peter Parka]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

Reparitive or aversion therapy. Consult your physician

My physician has been a doctor for 30 years and see's no illness called being homosexual. I'll respect his opinion over some young quack like you. :thumbup

 

[Tim]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

Does anyone else see the irony here?

He will walk past someone who's dying and not help because he might get sued.

I dont touch anyone who is not covered under TRICARE, even if they are dying.

But has no problem posting bad medical advice that can get him sued.

:dunno

 

[The Doc]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

Does anyone else see the irony here?

He will walk past someone who's dying and not help because he might get sued.



But has no problem posting bad medical advice that can get him sued.

:dunno

Bad medical advice? Lol go sprain your wrist or roll your ankle, guess what your doctors going to tell you todo.

 

[retro]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

Bad medical advice? Lol go sprain your wrist or roll your ankle, guess what your doctors going to tell you todo.

They're gonna have you get an x-ray to make sure there isn't anything seriously wrong with said ankle or wrist, that's for damn sure. If necessary, they'll give you something stronger or more targeted than ibuprofen. A lot of what you've said is sound common sense, but some of the more detailed advice regarding taking care of the injuries, or waiting to see the doctor, is quite simply irresponsible.

 

[Staci]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

what exactly qualifies you to give out medical advice?

 

[retro]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

what exactly qualifies you to give out medical advice?

He's an Army EMT

 

[The Doc]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

He's an Army EMT

Theres no such thing. There is no Army EMT job. The EMS system on Army posts are run by civilians.

 

[Staci]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

Theres no such thing. There is no Army EMT job. The EMS system on Army posts are run by civilians.

so my question still stands....

 

[The Doc]

Re: The Cure for most musculoskeletal injuries(Sprained ankles/wrists to knees and ba

so my question still stands....

Working in clinics, working in field hospitals, working on the line, writings scrips, going to classes. A lot of times I dont have a PA or doctor to consult. I diagnose and treat on my own, with the supervision of the senior medic. He is gone now, so I am the senior medic. Sports injuries are my forte, thats most of what I see. STD's are pretty rampant in my squadron also sadly.. but Im pretty good at getting rid of the easy ones. In terms of qualifications I dont have anything civilian instead of an EMT cert. Army wise i Have a Health-Sciences Diploma, AMEDD Certificate, have done Table 8 Re-cert, BCT-3, and many correspondence courses. Next on the list is EFMB.

In the Army, we dont have many doctors. You have 1 doctor per brigade, and 1 PA per battalion. A company sized element is generally 120 strong. You normally have 5 companies within a battalion. So you have 1 physician assistant (Usually a 1LT but sometimes a captain) per every 600 soldiers. There are 6 battalions per brigade. So 1 you have 1 doctor (usually a Major O-4) (Formally called the brigade surgeon) for 3,600 soldiers. The Brigade surgeon is at Birgade headquarters, as the PA is at battalion headquarters. Then you have 1-2 medics per platoon. So thats 1 medic per every 30 soldiers. The PA doesnt see patients unless we have something we just cant figure out, which is rare. The Doctor doesnt see patients unless a PA cant figure it out (Even more rare). the blunt of the diagnosis and treatment is on us because we are normally forward on the OP's and COP's. The best we can do is call for advice in alot of cases.

Also, all that was for injuries/sickness not trauma. If your involved with trauma you get quickly patched up by the platoon medic, then sent to the OP or COP for level 1 trauma care/packaging then sent on a helicopter to a foward trauma team or field hospital.