C10002059 / invoice 10000

Reason: L4 Broken Leg?TIME: 2030Presenting complaint- Jumped from floor onto owner's chest, then attempted to jump onto back of couch but missed and fell over the back, landing awkwardly with front legs appearing bent and crookedHistory- Had dinner prior to incident, was playing and jumping around furniture- Immediately yelped after fall, attempted gentle biting when touched indicating pain- Settled once picked up but still showing significant pain- Preexisting conditions: Previous left leg fracture at 4 months of age- Prophylaxis: Up to dateTriage- Demeanour: QAR, anxious- HR 160- RR 40- MM colour pink- CRT <2- T 39.3- Administered 1mg methadone IMClinical examKey findings- Suspected distal radial and ulnar fracture- Significant painAssessment / Differential diagnosis- Distal radial and ulnar fracture requiring specialist surgical repair due to poor blood supply in distal regionPlan- Hospitalisation overnight for pain management and diagnostics- General anaesthesia for radiographs to avoid painful positioning- Fentanyl CRI for continuous pain control- Fentanyl patch placement (takes 12-24 hours to become effective, provides 3-4 days analgesia)- Thick supportive bandage to immobilise limb- Surgery on Monday - Discharge planned for 9am if pain controlled, ambulatory, and eatingTreatment- Owners elected to transfer Poppy to QVS    Vital Signs    Weight: 2;