Extremity Trauma Flashcards
(3 cards)
Extremity trama evaluation
DETERMINE MECHANISM OF INJURY (MOI) AND EVALUATE
PMS, color, temperature, capillary refill, crepitus
Extremity Trauma Treatment
▪ Gross contamination such as leaves, or gravel should be removed if possible.
▪ Control external severe extremity hemorrhage (direct pressure, Combat Application Tourniquet (C.A.T.), apply to the most proximal anatomical position of extremity until the bleeding stops). Never apply C.A.T. directly over injury site or
joint.
▪ If clotting agent is available, severe junctional hemorrhage (e.g., neck, axillary, thoracic, abdominal, pelvis and groin) and any other severe external hemorrhage that is not able to be easily controlled using C.A.T). Shall be controlled using clotting agent . Pack wound with clotting agent and maintain pressure for a minimum of one minute. IF APPROPRIATE USE ISRAELI BANDAGE FOR JUNCTIONAL WOUNDS
▪ Treat and assess for shock for suspected femur fractures.
▪ Immobilize the entire limb for all suspected extremity fractures or dislocations (document PMS before and after splinting). For critical patients, splinting can be accomplished via backboard.
▪ Fractures should be splinted in the position found, unless there is no pulse present, or the patient cannot be transported due to the extremity’s unusual position. No more than two attempts can be made to place the injured extremity in a normal anatomical position. Discontinue attempts if the patient C/O severe pain or if there is resistance to movement felt.
▪ Elevate extremity and apply ice packs.
▪ Consider Pain Management Protocol.
▪ Open wounds, exposed bone ends or amputations should be covered with a moist
sterile dressing.
▪ Remove jewelry or watches from the affected extremity.
▪ Small amputated parts should be rinsed off, wrapped in sterile gauze and placed in a plastic bag. If ice is available, place the sealed bag in a larger container with ice & water or chilled saline. Label the bag with the patient’s name, date, and time of the amputation, and the time the part was wrapped and cooled.
Femur Fracture Management
▪ Assess and treat for shock.
▪ Cover open femur fractures with a moist sterile dressing.
▪ Consider Pain Management.
▪ Apply a Traction Splint for mid-shaft femur fractures unless:
o Patient has additional life-threatening injuries
o There is also a suspected pelvic fracture
o There is an open femur fracture with exposed bone. If there is a open fx where
there is no visible bone, you MAY use a traction splint.
o There is also a suspected hip fracture
o There is an avulsion/amputation of the ankle or foot
o Suspected fracture distal to mid shaft femur
▪ Document neurovascular exam before and after application of the Traction Splint
