Extremity Injuries: Difference between revisions

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* If distal pulses are present and neurological function intact, immobilize apparent fractures in present position, (when possible).
* If distal pulses are present and neurological function intact, immobilize apparent fractures in present position, (when possible).
* If distal pulses are diminished or absent, immobilize apparent closed fracture(s) in neutral anatomic position. Attempt to reduce severely angulated fractures with inline traction, except when a joint is involved. Note pulses distal to fracture site. Apply appropriate splinting and dressings.
* If distal pulses are diminished or absent, immobilize apparent closed fracture(s) in neutral anatomic position. Attempt to reduce severely angulated fractures with inline traction, except when a joint is involved. Note pulses distal to fracture site. Apply appropriate splinting and dressings.
* If open, (compound), fracture, cover with sterile dressings and immobilize in present position. Apply appropriate splinting and dressings.
* If open, (compound), fracture:
**cover with sterile dressings and immobilize in present position. Apply appropriate splinting and dressings.
**[[Ancef|ANCEF]] 1 gm IV/IO for adults or 50 mg/kg IV/IO up to 1 gm for pediatrics


'''DO NOT MANIPULATE OR REDUCE OPEN FRACTURES.'''
'''DO NOT MANIPULATE OR REDUCE OPEN FRACTURES.'''
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====ARTERIAL BLEED OR TRAUMATIC AMPUTATION:====
====DIFFICULT TO CONTROL BLEED OR TRAUMATIC AMPUTATION:====
* If unable to control bleeding, apply tourniquet no more than 2 inches above injury/amputation:
*If unable to easily control bleeding, consider the following procedures:
* Note time tourniquet applied. '''DO NOT RELEASE ONCE IT IS APPLIED.'''
**Hemostatic dressing
* If amputation incomplete, attempt to stabilize with bulky pressure dressing.
**[[Combat Application Tourniquet|Combat Action Tourniquet]] if extremity
* Apply a hemostatic (chitosan based) dressing to help stop bleeding if available.
**[[ITClamp Hemorrhage Control System|iTClamp]] – not usable on trunk of body
* Splint in line with associated extremity.
*For amputations:
* Refer to [[Analgesia and Sedation|ANALGESIA /SEDATION PRACTICE PARAMETERS]] (2.04).
**Splint in line with associated extremity.  
* Cleanse amputated part with sterile saline. Wrap in a sterile saline soaked dressing. Place in plastic bag. Attempt to cool with cold pack during transport.
**If amputation incomplete, attempt to stabilize with bulky pressure dressing.  
* '''DO NOT APPLY DIRECTLY TO ICE'''
**Cleanse amputated part with sterile saline. Wrap in a sterile saline soaked dressing. Place in plastic bag. Attempt to cool with cold pack during transport.  
**DO NOT APPLY DIRECTLY TO ICE  
*Refer to [[Analgesia and Sedation|ANALGESIA /SEDATION PRACTICE PARAMETERS]] (2.04).
 


[[Category:Trauma]]
[[Category:Trauma|0606]]

Latest revision as of 13:56, 31 January 2024

Section 6 - TRAUMA

6.06 EXTREMITY INJURIES

INITIAL TRAUMA CARE, (2.02)

SUSPECTED FRACTURE:

  • Splint suspected fracture sites in most appropriate fashion:
    • Fractures may be immobilized with padded board splints, ladder splints or air splints.
    • Femur fractures may be immobilized with a traction splint or inflated MAST.
  • Place cold pack on suspected fracture sites.
  • If distal pulses are present and neurological function intact, immobilize apparent fractures in present position, (when possible).
  • If distal pulses are diminished or absent, immobilize apparent closed fracture(s) in neutral anatomic position. Attempt to reduce severely angulated fractures with inline traction, except when a joint is involved. Note pulses distal to fracture site. Apply appropriate splinting and dressings.
  • If open, (compound), fracture:
    • cover with sterile dressings and immobilize in present position. Apply appropriate splinting and dressings.
    • ANCEF 1 gm IV/IO for adults or 50 mg/kg IV/IO up to 1 gm for pediatrics

DO NOT MANIPULATE OR REDUCE OPEN FRACTURES.


DIFFICULT TO CONTROL BLEED OR TRAUMATIC AMPUTATION:

  • If unable to easily control bleeding, consider the following procedures:
  • For amputations:
    • Splint in line with associated extremity.
    • If amputation incomplete, attempt to stabilize with bulky pressure dressing.
    • Cleanse amputated part with sterile saline. Wrap in a sterile saline soaked dressing. Place in plastic bag. Attempt to cool with cold pack during transport.
    • DO NOT APPLY DIRECTLY TO ICE
  • Refer to ANALGESIA /SEDATION PRACTICE PARAMETERS (2.04).