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Extremity Trauma

Identify and treat fractures and soft tissue injuries in a tactical environment.

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EXTREMITY TRAUMA

OBJECTIVES

Identify and treat fractures and soft tissue injuries in a tactical environment.

Closed Wounds

Musculoskeletal – Causes

Overuse

Acute sprains and strains

Trauma

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

Other Injuries

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

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

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


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