3-8 TRAUMA-EXTREMITY

Perform Initial Trauma Care per Guidelines.

EMR - Emergency Medical Responder

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

EMT - Emergency Medical Technician  Perform/Confirm All Above Interventions

1. Treat for shock as necessary
2. Transport smoothly to ensure patient comfort.
3. Consider ALS intercept for pain management.

AEMT – Advanced Emergency Medicine Tech   Perform/Confirm All Above Interventions

1. Establish IV access if indicated.  Do not utilize injured extremity if possible.

Intermediate - Perform/Confirm All Above Interventions

1. Consider administration of pain medications, if approved, utilize pain management protocol for doses and monitoring.

                          

Paramedic - Perform/Confirm All Above Interventions