Extremity TraumaExtremity Trauma

AnatomyAnatomy

•Bones

•Joints

•Nerves

•Soft tissue

Types of InjuriesTypes of Injuries

•Fractures - open, closed

•Dislocations

•Amputations

•Sprains/Strains

•Impaled Objects

Sprains and StrainsSprains 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 ClosedOpen vs Closed Fracture Fracture

Sign and Symptoms of Open Sign and Symptoms of Open FractureFracture

• 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 Sign and Symptoms of Closed FractureFracture

• Swelling

• Discoloration

• Contusion

• No external bleeding

• Sometimes loss of distal pulse

Management of a FractureManagement 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.

AmputationAmputation

• 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 LimbCare 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”

AssessmentAssessment

• Mechanism of Injury

• Primary Survey

• Vital Signs

• History

• Secondary Assessment

• Look for the Amputated Part

Signs & SymptomsSigns & Symptoms•CLAPS / TICS-D •Bleeding

•Increased heart rate

•Increased respiratory rate •Hypotension

•Hypoxia

•Pale skin

Rules of SplintingRules 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 SplintingRules of Splinting

• R - rest

• I - immobilize

• C - cold

• E- elevate

ManagementManagement•Airway + C-spine immobilization prone

•High concentration O2

•Treat for shock

•Cover open wounds

•Splint/Immobilize

•Keep amputated part cold and moist

•Transport

SummarySummary

• 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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