Fracture/Dislocation CPG Flashcards
What are the general principals for reducing a fracture?
- Provide procedural analgesia
- Irrigate with 500ml-1L normal saline if fracture compound
- Apply traction and mental contour traction
- If further manipulation required this should be done under traction
- Splint following reduction
What are the general principals of relocating a dislocation?
- Provide procedural analgesia
- Apply sustained traction in longitudinal direction from joint
- Have assistant providing counter traction above the injury
What do you do if a person has compromised neurovascual observations?
Transport them to the nearest higher level care within 15 minutes. If Travel time exceeds 15 minutes consult for further information.
What constitutes time criticality in a patient with a fracture?
Altered sensation, cold skin, loss of pulse or indicators of neuromuscular compromise as it is a threat of loosing the limb.
When should a pelvic splint be applied?
If there is suspected pelvic fractures due to injury to pelvis
If there is suspected haemorrhage as it acts as a haemorrhage control device
If a patient has both a suspected pelvic and mid shaft femur fracture what do you do?
Apply both the CT6 splint and pelvic splint. The Pelvic splint should be prioritised and applied first.
What can you not do with a patient in a pelvic splint/with a pelvic injury and why?
Log roll them as it may displace blood clots.
If you need to relocate a dislocation what should be considered?
- Ability to provide sufficient analgesia
- The chance of successful relocation
What are the care objectives of the CPG?
- Control external haemorrhage
- Apply good splinting
- Resolve compromises in neuro-vascular compromise where possible
- Use judicious analgesia
When should you prioritise pelvic splinting
- When there is a suspected pelvic fracture
- inadequate perfusion, altered conscious state secondary to mechanism that may cause pelvic injury
If there are compromised neuro-vascular observations for a fracture what should you do?
Provide pain relief and reduce the fracture and apply appropriate splinting
If there is a dislocation with compromised neuro-vascular observations what should you do?
Prioritise transport and consult with clinician to receive advise around relocation.
When should you re-asses neuro-vascular observations ?
Whenever you Manipulate, apply a splint or apply a sling.