Packaging of Long Bone Injuries

Question 1

Long Bone Manipulation to Neutral Position

Answer 1

If criteria is met all long bone fractures can be realigned a neutral position in an attempt to restore blood flow:

ALL criteria below must be present:
- Marked angulation at the long bone
- Distal limb is pale, cool, and pulseless

Question 2

Humerus

Answer 2

Stable (NRTC) PT:
- Apply rigid splint that extents from the axils to the end of the fingertips
- Splinted arm can be stabilized with a sling/swath for additional support

Unstable (RTC) PT:
- Immobilize using anatomical splint against PTs body and clamshell
OR
- Apply rigid splint & secure in place with zap straps or triangular bandage as to not delay transport

Question 3

Radius/Ulna

Answer 3

Stable (NRTC) PT:
- Apply a rigid splint that extends from the axilla to the end of the fingertips
- Ensure hand is placed in position of function when splinting
- Splinted arm can be stabilized w/ sling for additional support

Unstable (RTC) PT:
- Immobilize using anatomical splint against PTs body & clamshell
OR
- Apply rigid splint & secure in place w/zap straps or triangular bandage as to not delay transport

Question 4

Femur

Answer 4

Stable (NRTC) PT:
- Consider traction splint
- Consider use of rigid splint if available

Unstable (RTC) PT:
- Stabilize fractures w/ straps & blankets as per traumatic injuries chart
- Secure injured limb w/ zap straps or triangular bandages
- Continue assessment & treatment enroute

Question 5

Tibia/Fibula

Answer 5

Stable (NRTC) PT:
- Consider the use of rigid splint if available

Unstable (RTC) PT:
- Pad to support the limb in position of comfort
- Stabilize fractures w/ straps & blankets as per traumatic injuries chart
- Secure injured limb to uninjured limb w/ zap straps or triangular bandages
- Place PT on the clamshell

Question 6

Hip/Head of Femur Fracture

Answer 6

Unstable (RTC) PT:
- If you suspect a hip dislocation or head of femur fracture, due to MOI and gross deformity, consider the PT unstable and transport after the Primary Survey
- Pad to support the limb in position of comfort
- Secure injured limb to uninjured limb w/ trauma straps & blankets
- Minimum straps to be placed: 2 above knee & 1 below knee