Pathway Step 4 · Build your kit

🧰 Patient Tools Kit — Hip-Fracture

The everyday tools a Certified Prepared Patient keeps within reach: the rules that decide an emergency, the order to make calls, and the trackers that keep the routine on course. Print the cards, fill in your contacts, and keep this kit where the whole household can find it.

What’s in your kit

Eight tools. The first three are the rules you must know cold — they decide when something is an emergency. The rest keep the daily partnership steady and tell you where your role begins and ends.

1 The Fall Rule 2 The Clot Rule 3 Other Red Flags 4 The Contact Ladder 5 Steps + Pain 6 Post-Fracture Meds 7 The ER Go-Bag 8 Speak Up / Trust the Team
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1 · The Post-Fracture Fall Rule

Know this cold

After a hip fracture, the risk of a second fall — and a second fracture — is dramatically higher. The home environment, the medicines, and the body all need to change.

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HIP-FRACTURE FALL RULE

Patient card
Any new fall
Even a fall without injury matters. Most second falls happen in the first 6 months. Tell the team — PT, balance work, home assessment.
Fall WITH head strike
If on blood thinners (some hip-fracture patients are), head strike = ED to rule out brain bleed. Even mild.
Cannot bear weight
Sudden inability to bear weight on the operated leg — or new severe pain — could mean hardware failure or new fracture. ED.
Your move as patient: Be the home safety officer. Remove throw rugs. Add nightlights. Install grab bars. Encourage PT exercises. Stay with you during high-risk moves (toilet, shower, stairs) in the first weeks.
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2 · The DVT / PE Rule

Know this cold

After hip surgery, blood clots in the leg (DVT) are common — if a clot travels to the lungs (PE), it can be fatal. The risk is highest in the first 90 days. Anticoagulant medicines reduce risk; symptom awareness saves lives.

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HIP-FRACTURE CLOT RULE

Patient card
One leg swelling + pain
New swelling, warmth, or calf pain on the operated leg (or any leg) = possible DVT. Call the team or ED today.
Sudden shortness of breath
New unexplained breathlessness, chest pain with breathing, or rapid pulse — could be PE. 911 immediately.
Take the blood thinner
Most patients are on a blood thinner for 4-6 weeks after surgery. Never skip. Tell every clinician.
Your move as patient: Watch the operated leg daily for swelling or color change. Help with leg exercises while sitting. Encourage early walking. Take all blood-thinner doses. Tell ED staff about recent hip surgery.
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3 · Other Red Flags — Emergencies

Know this cold

Beyond the two red rules above, these situations also mean immediate help. When in doubt, the home care plan handles ordinary days — these are not ordinary.

💨 Sudden shortness of breath

Could be PE (clot in lungs). High risk in first 90 days after hip surgery.

Call 911 now

💘 One-sided leg swelling

Could be DVT. ED to rule out clot.

ED now

🔥 Wound red or draining

Wound infection after hip surgery is serious — ED today.

ED today

🧠 New confusion

After hip surgery, especially in older adults, sudden confusion can mean infection (UTI, pneumonia), blood-thinner bleed, or medicine side effect. ED.

Call 911 now
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4 · The Contact Ladder

Fill in & print

When something is wrong, you should not be deciding who to call in the moment — only which rung you are on. Fill in the names and numbers now, while things are calm.

1
Rung 1 · The plan

You's PT plan + post-op instructions

Daily exercises, weight-bearing instructions, blood-thinner schedule, follow-up appointments.

Action plan kept: ________________________
2
Rung 2 · The specialists

Orthopedic surgeon / PT

For pain, mobility, hardware questions, suspected complications. Many ortho practices have nurse lines.

Specialty team: ________________________
3
Rung 3 · Everyday care

Primary care provider

For routine care, bone-health follow-up (DXA), vitamin D, calcium. Critical for second-fracture prevention.

Primary care: ________________________
4
Rung 4 · Emergency

911 / Emergency Department

For sudden breath, severe leg pain or swelling, wound infection, confusion, falls with injury.

Preferred ED: ________________________
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5 · Daily Recovery Tracker

Tap to log

Track total walking steps and pain (0-10). Trends across the week show recovery progress.

PT will set step goals. Pain should trend down over weeks. Sudden pain increase = call the team. Bring this log to ortho visits.

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6 · Hip-Fracture Medicine Support

Daily routine

Medicines after hip fracture do four jobs: prevent clots (blood thinner), control pain, prevent infection (early), and prevent the next fracture (bone-protective). All four matter.

Most important: the bone-protective medicines (alendronate, IV zoledronic acid, denosumab) start within weeks after fracture. Without them, the next-fracture risk doubles. Many patients miss this conversation. Ask the team if it’s been started.

Blood thinner first 4-6 wk

Enoxaparin, apixaban, rivaroxaban, or warfarin — prevents DVT/PE. Take every dose. Tell every clinician.

Pain control balance

Opioids early, transitioning to acetaminophen and ice as pain improves. Use scheduled rather than as-needed early.

Calcium + Vitamin D

Daily — usually 1200 mg calcium + 800-2000 IU vitamin D. Foundation for bone-protective medicines.

Bone medicine

Bisphosphonate or denosumab should start within 1-3 months. Ask if it has been ordered.

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7 · The ER Go-Bag

Pack once, check monthly

A crisis is not the time to gather paperwork. Pack a go-bag now and keep it by the door. Tap each item as you add it — your checklist saves on this device.

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8 · Speak Up / Trust the Team Guide

You boundary

The hardest skill in patienting is knowing when to act and when to hold back. A great patient is a reliable backup and a fierce advocate — without taking your own care away from them.

💬 Speak up when…

  • A red-flag rule is met and a clinician is dismissing it — restate the rule and the home plan calmly and clearly.
  • You are in the ED and your home plan is being ignored — ask for it to be looked at, and ask for a senior clinician if needed.
  • You are about to be given a medicine or test that wasn’t in the plan — ask why, and ask about alternatives.
  • Your symptoms are escalating between visits — call before it becomes an ER trip.
  • You feel unheard or rushed — it’s OK to say "I need a minute to ask one more question."

🤝 Trust the team when…

  • They have proposed a guideline-based treatment that fits your plan.
  • You disagree from fear rather than from new information — pause, ask one question, listen.
  • You are on a stable run that’s working — small adjustments often beat big changes.
  • Your care partner’s instinct and the team’s recommendation agree — that’s a strong signal.
  • You’ve done your part of the homework — logs, questions, honest history — and now it’s the team’s turn.
The principle: you trained to the depth your clinicians use so you could be a partner in your own care, not a passenger. Speak up for safety and accuracy; trust the team for guideline-based treatment and steady adjustment. When unsure, ask a clarifying question first: “Can you walk me through your reasoning?”
← Back to the Hip-Fracture Patient pathway · then mark Step 4 complete