79 Neurovascular Status Documentation in Complex Limb Fractures: First Cycle Audit

Aim Assessing neurovascular status post-fracture is vital to detect complications and guide medical actions. Fractures can cause neurovascular problems and timely recognition prevents long-term damage. Neurovascular status should be recorded on admission to establish a baseline and identify those that need urgent surgery, and the findings should be well documented. Method Neurovascular documentation for patients with fractures of the tibia or femur was audited over the period of one year at a major trauma centre according to NICE guidelines. 885 patients met the inclusion criteria, giving a total of 959 fractures. Results Poor compliance was defined as <75% of guidelines followed. 911/959 (95%) of all fractures had a basic mention of neurovascular status in patient notes. 492/959 (51%) had gross sensation documented, 143/959 (15%) had a named nerve assessment, 71/959 (7%) had motility assessed using the MRC scale and 367/959 (38%) had a pulse assessment, with the pulses assessed documented. We recommend a pre-written template for clinicians detailing the different aspects of the neurovascular examination and documentation. This template will remind clinicians of examination and documentation, enabling ongoing monitoring, facilitating prompt detection of issues, thus improving outcomes, and reducing long-term complications. Conclusions Inadequate documentation of neurovascular status in patient records poses a risk to those requiring urgent surgery or experiencing neurovascular compromise, potentially leading to long-term complications. Ensuring an error-free documentation process is crucial and a primary goal for the trauma and orthopaedic department.