TITLE: Trauma Basics: Managing Lower Extremity Fractures (Revised 6/2010)
TIME REQUIRED: Three Hours
MATERIALS: Splints, Traction Splints, Scoop Stretcher, Long Spine Board, Blankets, Pillows, Roller Gauze, Triangular Bandages,
REFERENCES: Brady Emergency Care 10th Edition, Maryland Medical Protocols for Emergency Medical Services Providers, and MIEMSS DVD, Lower Extremities Resource for EMS Instructors
An important patient care skill is the ability to rapidly immobilize a suspected lower extremity fracture. Many lower extremity fractures are particularly emergent, both due to the forces involved in fracturing certain bones and the possibility of significant internal bleeding. Effective splinting minimizes the movement of broken bone ends or dislocated joints. Proper splinting of these lower extremity fractures will help to reduce damage to the soft tissues, prevent a closed fracture from becoming an open one, help to reduce bleeding, and minimize the pain felt by a patient.
OBJECTIVE (SPO): The Emergency Medical Technician will display a working knowledge of the various lower extremity splinting methods, their advantages and disadvantages and by practical application the method(s) of immobilizing various lower extremity injuries in accordance with the Maryland Medical Protocols for Emergency Medical Services Providers and local practice.
Lower Extremity Fractures
• Pelvic fractures
• Hip dislocation/fractures
• Femur fractures
• Knee fractures
• Tibia/Fibula fractures
• Ankle/Foot fractures
LOWER EXTREMITY FRACTURES
SPO 1-1 The student will demonstrate a basic understanding of lower extremity fracture management, and, by participation and observation, the various methods utilized to immobilize specific lower extremity fractures.
EO 1-1 Discuss care, realigning and hazards of splinting
EO 1-2 Describe and perform the various methods of immobilizing a pelvic fracture.
EO 1-3 Describe and perform the methods of immobilizing hip injuries
EO 1-4 Describe and perform the methods of immobilizing femur fractures
EO 1-5 Describe and perform the methods of immobilizing knee dislocation
EO 1-6 Describe and perform the various methods of immobilizing tibia/fibula fractures
EO 1-7 Describe and perform the various methods of immobilizing ankle/foot fractures It is the intended purpose of this drill is to review and build on basic skills with the emphasis on improving efficiency and teamwork. It is assumed that the participants have knowledge of the subject matter. The drill should include minimal instruction and maximum skills practice. It is also assumed that a proper patient assessment has been made which would reveal the injuries being treated. Teams of two students should be created for the practical exercises.
- Introduction (1-1)
- The proper care for all painful, swollen, or deformed lower extremities is splinting.
- In order to be effective, splinting must immobilize bone ends and adjacent joints.
- Emergency Medical Technicians immobilize fractured extremities for the following reasons:
- Minimizing the movement of broken bone ends and dislocated joints
- Decreasing the amount of pain felt by a patient
- Prevention of additional injury to soft tissue in the area of the fracture
- Prevention of a closed fracture becoming a more serious open fracture
- To help minimize blood loss
- Realigning a Deformed Extremity
- Allows a fractured extremity to be more easily immobilized
- It can restore circulation to an extremity
- Attempts at splinting a fractured extremity in the deformed position increases the chance that it can become an open fracture and allows more damage to soft tissues.
- Injuries to joints should usually be splinted the way they are found unless circulation has been disrupted.
- If circulation has been affected an attempt should be made to a neutral position if no resistance is felt
- Hazards of Splinting
- "Splinting someone to death", A focus on splinting without the treatment of life threatening conditions
- Applying a splint too tightly can restrict blood flow and injure nerves and muscles