Extremity Trauma First AId

EXTREMITY TRAUMA OBJECTIVES Identify and treat fractures and soft tissue injuries in a tactical environment. Open Wounds Closed Wounds Musculoskeletal - Causes • Overuse • Acute sprains and strains • Trauma Overuse Acute Sprains and Strains Trauma Compound Fracture of the Ankle Musculoskeletal Presentation • • • • • • Pain Swelling Discoloration Temperature change Numbness/tingling Loss of function Musculoskeletal Evaluation • History • Physical examination – skin breaks – tenderness – swelling – discoloration – distal pulses – sensory exam – motor exam Musculoskeletal Treatment • Prevention • “RICE” • Analgesic – Tylenol • Analgesic & Anti-inflammatory – Aspirin – Ibuprofen (Motrin/Ranger Candy) – Naprosyn Fractures • Any break in the continuity of a bone • May vary from a simple crack to a completely shattered bone FX Femur Open Fracture Compound Fracture of the Ulna Other Injuries De-gloving Injury Blast Injury Ecchymosis • Discoloration caused by bleeding in tissue • Blood migrates toward skin and changes color with time Joints • Surrounded by joint capsule and ligaments, muscles and tendons Dislocations • Disruption of a joint such that the bone ends are no longer in contact • Torn ligaments and capsule Common Dislocations • • • • • Fingers Shoulder Hip Elbow Ankle Dislocated Elbow Knee Joint • • • • Femur, Tibia, and Patella Largest hinge joint in body Held together by complex ligaments Susceptible to injury Knee Injuries • • • • Ligaments and cartilage injuries are common Swelling, pain, limited ROM Frequent athletic injury Splint entire femur and tibia Dislocation of the Knee • • • • Severe deformity Popliteal artery commonly injured If pulse is present, splint in deformed position If pulse is absent, attempt once to realign limb and splint where pulse is strongest (RGR MEDIC) Dislocation of the Knee Ankle Injuries • Usually result from twisting, indirect force • Fracture, dislocations, sprains can occur • Swelling and deformity • Note circulation • Immobilize with padding and splint Sprain • Partial, temporary joint dislocation • Ligaments torn or stretched • May produce discoloration SAM SPLINT Management of Closed Injuries • • • • • R - Rest I - Ice C - Compression E - Elevation S - Splint (SAM Splints and cravats or ACE wraps) • R/O fracture Soft Tissue Injuries • Open - Violation of overlying skin or mucous membrane Management Stop the bleeding and bandage Summary • Although quite common, rarely life threatening • First priority in management same for all patients ( A,B,C’s) • RICES for most soft tissue injuries