580 An Assessment of the Adequacy of Initial Photography of Open Lower Limb Injury Patients in the Emergency Department of a Major Trauma Centre

Aim As per BAPRAS/BOAST guidelines, all open lower limb injury patients should have a photograph taken of their injury as part of their initial assessment in the ED. A good photograph helps to triage the injury and can aid with operative planning. These photographs are almost always taken by medical or nursing staff with no medical imaging training and as such quality can be variable. By assessing the adequacy of these initial photographs and determining which factors are impacting this, we hope to develop helpful guidance for non-medical image trained clinical staff. Method Open lower limb injury patients identified by review of 2 months of orthopaedic operating lists on Bluespier (1st July – 31st August 2023). Initial patient images reviewed on Careflow and assessed as Adequate or Inadequate. An image is judged as inadequate if (1) the position of wound cannot be determined or (2) the whole wound cannot be seen. Results Patients identified in timeframe – 34 Limb affected Right - 23 Left - 10 Bilateral – 1 Could orientate Yes - 28 No – 6 Could see whole wound Yes - 25 No – 9 Adequate – 21 (61.8%) Inadequate – 13 (38.2%) Conclusions Further education of ED staff is required to improve initial photography of open lower limb patients. The authors’ have designed a bespoke information poster to be placed in ED, explaining the importance of adequate photography on admission. Further research will determine if this could be an effective tool.