奇美醫院急診醫學部

Extremities

Avoid heavy lifting, intense movements in the involving the waist and back area, or rapid or suddenly bending over.
Maintain good posture. Sit and stand up straight. Avoid wearing high-heeled shoes.
Bed rest as much as possible if there is any pain.
Sleep on hard flat surfaces rather than spring or foam mattresses.
Eat plenty of fruits and vegetables to avoid constipation.
Wear a corset or brace to protect the back.
Try cold packs during the first few days. Apply hot packs after 2-3 days. Alternating between cold and hot packs may help with the pain. Stretching may also help relieve root compression related discomfort.
Take medicine and pain killers as instructed and follow-up regularly at the orthopedic or neurosurgical outpatient department.
Return to the emergency department if there are the following symptoms：
1. Sudden, severe pain in your low back or leg and numbness or muscle weakness in your leg
2. Trouble controlling the bladder and bowels
3. Severe abdominal pain

Joint dislocations are improper positioning of the bones in the joint, resulting in painful immobilization of the joint. The nerves, muscles and nearby blood vessels may be compressed or damaged from the injury. Dislocations, if returned to their normal positions promptly, should return to their normal functions after adequate rest and rehabilitation. However, a small number of dislocations may lead to permanent irreversible peripheral nerve damage.
Simple dislocations may be reduced (maneuvred back into the original position) in the ER. If the dislocation cannot be successfully reduced in the ER, surgery may be required.
A light sedative and respiratory status monitoring will be provided during joint reduction at our ER.
Dislocations may cause blood vessel damage. It is essential to closely observe the blood flow of the injured extremities. When necessary, angiography or surgery may be needed to repair the injured blood vessels.
After reduction, the injured joint will be immobilized. Return to the orthopedic outpatient department for further instructions and when the sling or splint may be removed.
Patients with recent dislocations are vulnerable to re-dislocation and avascular necrosis of the joints (inadequate circulation to the bones). Please follow-up at the outpatient departments as scheduled.

During acute attacks, take an anti-inflammatory medication as soon as possible and ice and elevate the joint.
Drink lots of fluids (3-4 liter per day) if no contraindication. Avoid alcohol or sweet beverages.
Avoid foods rich in purines, such as organ meats, fatty fish, shellfish, asparagus, spinach, peas, cauliflower, mushrooms or fermented food. Eat more vegetables, whole grains, plant proteins such as nuts and legumes, and low-fat dairy. Refined carbohydrates and processed foods should be kept to a minimum.
Avoid strenuous activity and maintain a healthy weight. Relax; stress can aggravate gout.
Take medicine as prescribed and follow up in the out-patient department as scheduled.
Return to the hospital if there is persistent fever or poor response to medications.

PTA is a is a minimally invasive procedure to open up blocked arteries or dialysis fistula or tube. Most procedures can be done only under local anesthesia and the patient may return home after a few hours of observation.
Wound care：check for active wound bleeding or blood build up under skin. Try ice-packing if there is any swelling. Like any wound, keep it clean and dry. Return to the ER if there is any discharge, or local heat with severe stabbing pain.
Return to the emergency department if there are following symptoms in the finger or toes distal to the PTA wound site：
1. Turning grey or blue
2. Tingling or growing numb
3. Growing very cold

Take antibiotics as ordered and follow-up at the outpatient department as scheduled.
Change wound dressing as instructed. Keep wound dry and clean.
Elevating the infected limb can help reduce edema.
Fever is a common result of the infection. Drink lots of water. Ice pillow and ice packing over the wound if necessary.
Return to the emergency department as soon as possible if there are following symptoms：
1. Skin around wound becoming swollen, hard, and stiff
2. Stinging pain around the wound
3. Rapidly swelling or wound expansion of the wound
4. High fever with chills

Take medicines as prescribed, get adequate rest, follow-up as scheduled, and receive and continue physical therapy as suggested.
Sleep on a firm mattress. When sitting, keep the bottom pressed against the back of the chair as much as possible.
Wear appropriate supportive footwear. Avoid of soft open-toed slippers.
When performing daily activities, using larger joints in the body (e.g. shoulder, elbow) can reduce the stress on the smaller joints (e.g. finger, wrist) thus preventing joint deformities. For example, clean the floor using a mop instead of kneeling on the floor with a towel.
Maintain a balanced diet and healthy weight. Overweight patients should try and lose some weight to reduce the stress on the joints.
Visit your doctor if there’s any fever or poor response or adverse events to the drugs.