Introduction
PVFRAC Triage ED Paediatric # clinic referrals AND virtually manage simple, stable paediatric fractures or soft tissue injuries
The P-VFRAC service was developed out of necessity during the COVID-19 pandemic although prior to COVID-19 the paediatric fracture clinic faced significant demand pressure with service statistics indicating 6444 paediatric fracture clinic appointments were provided in 2019. The clinic was consistently overbooked, had lengthy wait times and often ran late, patients also travelled significant distances to attend the clinic. During the COVID-19 pandemic, alternative methods of providing care to paediatric patients were sought out including the option to replicate the successful Adult Virtual Fracture Care (VFRAC) service which was implemented at WH in 2017.
Monday and Thursday
T: 0435467632
Email: ChildrensFracture@wh.org.au
Inclusion
Paediatric patients discharged from a WH ED with a musculoskeletal condition (bony or soft tissue) appropriate for referral to the WH paediatric fracture clinic for management including but not limited to the following:
- Buckle fractures of the wrist
- Supracondylar Gartland 1 fracture
- Radial head/ neck fractures and occult elbow fractures
- Proximal humerus fractures
- Un-displaced midshaft clavicle fractures
- Glenohumeral dislocations
- Toe fractures/ dislocations
- Base of 5th metatarsal fractures
- Weber A fractures
- Avulsion fractures of the foot and ankle
- Soft Tissue Injuries
ED referrals only (capacity)
Exclusion
- Age older than 17 years
- Open fractures
- Documented clinical concern of neurovascular compromise
- Documented clinical concern of compartment syndrome
- Injury(s) sustained as a result of high velocity trauma:
- Motor vehicle accident >100km/h
- Fall from height of >1m or 5 stairs
- Pedestrian or bike versus motor vehicle at >30kmh
- Concern of non-accidental injury
- Parental or carer hearing impairment and/or language and/or comprehension barriers to safe telehealth management
- Parental or carer concern
- Telehealth management declined by parent or carer
- No access to telephone
- Barriers to GP access
WH PVFRAC Clinical Guidelines
Resources
https://www.rch.org.au/clinicalguide/fractures
Authorship
Ben McElwee and Bhavna Trivedy July 2024