Orthopaedics Consult 🦴
Guide for orthopaedics consultation and referral. Key information to provide, common indications, and referral scripts for NCHDs.
📋 Key Info to Have Ready
- Patient identifiers: full name, date of birth, location, and MRN
- Reason for admission: note that admission may not be for an orthopaedic reason
- Reason for consult and mechanism of injury (e.g. fall, trauma, sports injury)
- Relevant Past Medical History (e.g. osteoporosis, previous surgeries/fractures)
- Medications (e.g. anticoagulants, bisphosphonates)
- Observations and vitals, especially if systemic signs of infection or trauma
- Relevant bloods: FBC, CRP, coagulation profile if planning surgery
- Imaging: X-rays (include views and whether they’ve been reviewed), CT if applicable
- Neurovascular status of affected limb
🔎 Investigations to Know
- X-rays – confirm appropriate views taken and reviewed
- CT/MRI – if available or pending, especially in complex injuries
- Bloods – FBC, CRP, U&E, Coag profile
- ECG and Group & Save – if likely surgical candidate
📞 Example Script
- Hi, this is [Your Name], the intern from [Team Name]. I’m calling to refer a [Age]-year-old [M/F] with a [suspected fracture/dislocation/orthopaedic concern].
- They were admitted for [reason for admission], but now have an orthopaedic concern of [e.g. suspected fracture, dislocation].
- The mechanism was [e.g. fall onto outstretched hand], and imaging shows [describe fracture/dislocation].
- They have a background of [e.g. osteoporosis, previous fracture], and currently [neurovascularly intact / impaired].
- Bloods are [normal/deranged], and they’re [stable/unstable]. We’re seeking your advice on management and whether the patient may need surgical intervention.
📝 Tips
- Always check and document distal neurovascular status
- Have imaging available when calling
- Mention anticoagulation or bleeding risks early
- Clarify if the consult is for surgical review or outpatient follow-up