View source for 3-8 TRAUMA-EXTREMITY

Perform Initial Trauma Care per Guidelines.

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|'''EMR - Emergency Medical Responder'''
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# Assess and maintain Scene Safety
# Control bleeding:
## Direct pressure, elevation and splinting
## Use pressure points as necessary
## Do not apply a tourniquet unless all other measures to control bleeding fail
# Do not utilize injured extremity for BP measurement
# Focused assessment of injury:
## Deformity
## Swelling, discoloration
## Distal pulses
## Gross sensory examination
## Presence of open wounds over possible fracture sites.
## Remove restrictive clothing and jewelry if possible.
# Apply manual stabilization
## Splint in position of comfort.  Assess and document CMS before and after splinting.
## If neurovascular exam is normal, splint in position found.      
## If pulses are absent or distal extremity is dusky or blue, make one attempt to apply traction to re-align bones in anatomic position.
## Any splint should extend to joint above and below fracture, or be secured to the bone above and below the injured joint.
## Traction splint-femur fracture
## Contraindicated if knee or hip involvement is suspected
## For partial amputations, attempt to splint in anatomical position.
## If possible, cover open fractures and wounds with sterile saline-soaked gauze.
## Elevate extremity and apply ice.
## Reassess CMS after every manipulation and frequently thereafter.

{| class="wikitable"
|'''EMT - Emergency Medical Technician'''  ''Perform/Confirm All Above Interventions''
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# Treat for shock as necessary
# Transport smoothly to ensure patient comfort.
# '''Consider ALS intercept''' for pain management.

{| class="wikitable"
|'''AEMT – Advanced Emergency Medicine Tech  ''' ''Perform/Confirm All Above Interventions''
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# Establish IV access if indicated.  Do not utilize injured extremity if possible. 

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|'''Intermediate -''' ''Perform/Confirm All Above Interventions''
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# Consider administration of pain medications, if approved, utilize pain management protocol for doses and monitoring.

                           
{| class="wikitable"
|'''Paramedic -''' ''Perform/Confirm All Above Interventions''
|}