Open Fracs Flashcards
1
Q
BOAST guidelines
A
IV Abx within 1hr of inj Init realign and splint repeat NV ass after reduc or splint Remove gross contam Saline soaked gauze with occlusive film Immed debridem if high contam eg sewage, marine, agric Debridem in 12hr for high impact, 24hr for low Defin tiss closure or cov in 72hr Amput in 72hr if req
2
Q
ATLS ass
A
Airway and C spine Breathing- sats, RR Circ- pulses, BP, cap refill, HR, ECG Disabil- GCS, neuro Exposure- abdo etc
3
Q
AMPLE hx framework
A
Allergies Meds PMH Last meal Events leading to inj
4
Q
Warm ischaemia
A
Tissue/organ remains at body temp for cert time after BS reduced or cut off.
5
Q
Probs
A
Tx vasc inj within 6 hr
Organic, marine, sweage contam means emergency
Compartm synd- passive str pain, breakthrough pain, tense swell.
6
Q
Mx
A
Surgery for init fix and debride within 24hr, consultant led. Defin mx 72hr NV ass Bloods- GS, FBC, UE, gluc, clott Fluids AB- co amox IV 1.2g in 3hours, clindamycin if pen allergic. Analgesia IV parac 1g, IV morph 10mg Anti emet cyclizine 50mg Tetanus vacc or toxoid Ig Ab Gentle irrig, gross decontam Photo and dress in saline gauze Back slab, realign Reass NV XR Theatre prep- thromboproph Surg in 6hr if NV inj or contam
7
Q
Gustillo
A
1- under 1cm, no contam 2- 1 to 10cm, poss contam, no NV inj. 3A- over 10cm. Soft tiss flap intact. 3B- periost stripp 3C- NV inj
