Injured far from the clinic? What to do first

Don’t drive hurt, and other advice from an acute-care provider

Injured far from the clinic? What to do first

Angela Dugan is a physician assistant specializing in orthopedic care in Grand Forks, North Dakota, who sees how the walk-in clinic there helps people every day.

Often the patients visiting Dugan at Sanford Health Orthopedics and Sports Medicine Grand Forks have acute injuries – that is, the injury is fresh and came suddenly.

Those who are injured might have to travel 15 or more miles to seek care and may have to tend to their own injuries until they reach the clinic.

First in that challenging scenario is to find someone who can get you to a clinic.

The next step, if you’re dealing with a strain, sprain or possible broken bone, is commonly referred to as RICE. That is: rest, ice, compression and elevation.

“The best thing you can do is to immobilize and protect the injured area,” Dugan said. “Let’s say it’s a knee, a wrist or an ankle – you want to try to limit any weight bearing. If it’s a lower or upper extremity, you might want to wrap a towel over the injury. Anything to protect it. Applying ice right away is always a good plan, too, especially if you’re going to have a car ride to the clinic.”

Reviewing RICE

RICE relieves pain, limits swelling, and speeds healing. It’s often the best treatment for soft-tissue injuries, like sprains and strains. Here’s what to do:

  • Move the injured area as little as possible to allow healing to begin.
  • Apply ice right away to reduce inflammation, which causes more pain and slows healing. Cover the injured area with an ice pack wrapped in a thin towel for about 15 to 20 minutes, three to four times a day.
  • Using a pressure bandage helps prevent or reduce swelling. Use an elastic bandage and wrap the injured area without making it so tight that it will cut off the blood supply.
  • Raise the injured area above the level of the heart. Prop up a leg or arm while resting it. You may need to lie down to get your leg above your heart level.

Find somebody to help

Dugan emphasized that avoiding operating your car after an acute injury is a crucial piece of a first-aid plan.

“For multiple reasons, you shouldn’t drive,” Dugan said. “No. 1, if it’s a lower extremity, it can be a factor in being able to drive at all. But even if it’s something else, chances are you’re in pain and your reaction time and your ability to focus will be affected.”

Dugan’s patients are not always dealing with an injury that just happened; many times, it’s an injury that happened days or weeks earlier. In those cases, knowing yourself and how to treat yourself can be very helpful.

You have to ask yourself: Do I really need to go in for this? Can I apply ice to the injured area? Can I use anti-inflammatories like ibuprofen or Aleve to help with the inflammation and pain relief?

“If you injure something and it’s not really improving, you can’t continue to ‘play through it,’” Dugan said. “You have to get it rest and allow it to settle down. If the injury is not befitting from RICE, then it’s time to follow up at the clinic and see if there is anything that can be done to treat this problem.”

When an injury is visible, like a dislocation or an open fracture, you should deal with it as an emergency. If you’re not sure, call your walk-in clinic to talk to a nurse who may help you decide.

“It’s just important to know that seeking attention for an acute injury in a timely manner is not only beneficial for the patient, but also the provider,” Dugan said. “It can help them put you in a position where your treatment can be as productive as possible.”

Walk-in clinic adds to same-day care

The Grand Forks walk-in clinic, where Dugan serves as a provider, opened in May. At a location that serves many surrounding rural communities, it can add a layer of convenience and safety that can bridge a health care gap for those who don’t have suitable options where they live.

Walk-in hours are available 8 a.m. to 4:30 p.m. Monday-Friday in Grand Forks. The clinic primarily offers acute care for muscle, bone and joint injuries. If the orthopedic walk-in clinic deems physical therapy is needed, referrals and appointments can be set up the same day.

Related: Do you need urgent care or the ER?

Dugan offered a real-life example of what the presence of a walk-in clinic can mean for a community:

“I had two patients come in with acute fractures,” she said. “We applied splints and we were able to set them up for follow-up visits, which can also take place at the clinic. Delivering care so quickly is one of the clinic’s real strengths. We’ve received a lot of positive feedback on it from patients.”

Without a walk-in clinic, the options for Dugan’s patients would be setting up an appointment with a primary care provider or showing up at the emergency room.

“It wouldn’t have been the correct use of the emergency room, and they weren’t dealing with the kind of injuries where you would have wanted to wait to see a primary provider,” Dugan said. “Instead, they were able to see an orthopedic specialist right away and were able to assess their injuries and schedule follow-ups. It’s very efficient care.”

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Posted In Grand Forks, Orthopedics, Rural Health, Sports Medicine