Extremity Injuries - Principles of Management

Question 1

Critical Intervention

Answer 1

• Cut and expose possible fractures
• Stop any bleeding
• Apply manual stabilization (if possible)
• If distal pulses are NOT present and criteria for manipulation is met, aligning the limb to restore blood flow is considered a critical intervention

(Note: packaging between RTC and NRTC PTs differs)

Question 2

Packaging Stable Patients (NRTC)

Answer 2

Treatment is done on scene:
- Complete Primary Survey
- Apply Entonox
- Package PTs injuries w/ soft supplies/traction splint according to TT&P guidelines

Question 3

Packaging Unstable Patients (RTC)

Answer 3

In the case of an unstable PT w/ fractures the goal is to stabilize all injuries as best we can as to not delay transport:
- Refer to Traumatic injuries chart for strap placement in lower limb fractures & consider Pain Management Protocol enroute

(See JIBC EMR TT&P pg. 59 for strap placements)

Question 4

Application of Ice

Answer 4

Applying ice can reduce pain, swelling & inflammation in injuries:
- Never place ice directly on skin
- Limit application to 10 mins on, 5 mins off
- Document your treatment
- Ice should NOT be used on unstable PTs or those where hypothermia is present