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EXTREMITY TRAUMA

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.

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EXTREMITY TRAUMA

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  1. EXTREMITY TRAUMA

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

  3. Open Wounds

  4. Closed Wounds

  5. Musculoskeletal - Causes • Overuse • Acute sprains and strains • Trauma

  6. Overuse

  7. Acute Sprains and Strains

  8. Trauma Compound Fracture of the Ankle

  9. Musculoskeletal Presentation • Pain • Swelling • Discoloration • Temperature change • Numbness/tingling • Loss of function

  10. Musculoskeletal Evaluation • History • Physical examination • skin breaks • tenderness • swelling • discoloration • distal pulses • sensory exam • motor exam

  11. Musculoskeletal Treatment • Prevention • “RICE” • Analgesic • Tylenol • Analgesic & Anti-inflammatory • Aspirin • Ibuprofen (Motrin/Ranger Candy) • Naprosyn

  12. Fractures • Any break in the continuity of a bone • May vary from a simple crack to a completely shattered bone FX Femur

  13. Open Fracture Compound Fracture of the Ulna

  14. Other Injuries De-gloving Injury Blast Injury

  15. Ecchymosis • Discoloration caused by bleeding in tissue • Blood migrates toward skin and changes color with time

  16. Joints • Surrounded by joint capsule and ligaments, muscles and tendons

  17. Dislocations • Disruption of a joint such that the bone ends are no longer in contact • Torn ligaments and capsule

  18. Common Dislocations • Fingers • Shoulder • Hip • Elbow • Ankle Dislocated Elbow

  19. Knee Joint • Femur, Tibia, and Patella • Largest hinge joint in body • Held together by complex ligaments • Susceptible to injury

  20. Knee Injuries • Ligaments and cartilage injuries are common • Swelling, pain, limited ROM • Frequent athletic injury • Splint entire femur and tibia

  21. 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)

  22. Dislocation of the Knee

  23. Ankle Injuries • Usually result from twisting, indirect force • Fracture, dislocations, sprains can occur • Swelling and deformity • Note circulation • Immobilize with padding and splint

  24. Sprain • Partial, temporary joint dislocation • Ligaments torn or stretched • May produce discoloration

  25. SAM SPLINT

  26. Management of Closed Injuries • R - Rest • I - Ice • C - Compression • E - Elevation • S - Splint (SAM Splints and cravats or ACE wraps) • R/O fracture

  27. Soft Tissue Injuries • Open - Violation of overlying skin or mucous membrane

  28. Management Stop the bleeding and bandage

  29. 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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