Extremity Trauma

Anatomy Bones Joints Nerves Soft tissue

Types of Injuries Fractures - open, closed Dislocations Amputations Sprains/Strains Impaled Objects

Sprains and Strains Sprains - tearing or stretching of ligament. Strain - stretching and tearing of muscle. Assess the injured site. History - was there any sound?

Open vs Closed Fracture

Sign and Symptoms of Open Fracture Discoloration of the skin. Bone is penetrating out of skin. Swelling. Bleeding. Sometimes there may be a loss of distal pulse.

Sign and Symptoms of Closed Fracture Swelling Discoloration Contusion No external bleeding Sometimes loss of distal pulse

Management of a Fracture Primary assessment. Check for a pulse above and below the injury. Immobilize in the position found. Reassess the pulse. Ice / cold pack ( not directly on the skin). Elevate if practical.

Amputation Some amputation can be life threatening. Often the bleeding is easily controlled by applying a pressure dressing to the stump. Care of the amputated limb.

Care of the Amputated Limb Wrap the limb in clean, moist dressing. Place in bag -- name -- time Place on ice or in cold water. “DON’T FORGET TO SEND IT WITH THE PATIENT”

Assessment Mechanism of Injury Primary Survey Vital Signs History Secondary Assessment Look for the Amputated Part

Signs & Symptoms CLAPS / TICS-D Bleeding Increased heart rate Increased respiratory rate Hypotension Hypoxia Pale skin

Rules of Splinting Pulse check above and below Immobilize in the position found or most comfortable Open fractures - lightly cover bone Reassess the pulses RICE

Rules of Splinting R - rest I - immobilize C - cold E- elevate

Management Airway + C-spine immobilization prone High concentration O2 Treat for shock Cover open wounds Splint/Immobilize Keep amputated part cold and moist Transport

Summary These types of injuries are very painful. Be careful not to cause more pain. Circulation checks. Management of these injuries are the same.

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