ExtremityTrauma and

Soft Tissue Trauma

lndah Dwi Pratiwi
Dept. Keperawatan Gawat Darurat
FIKES
-
UMM
2At4
Fractures
Dislocations
.
Extremely painful injuries
.
May lead to amputation ) check PMS
(Campbell & Chapter 20O8)
Objectives
.
Prioritizeextremity trauma in the assessment and
management of life-threatening injuries
.
Discuss the major complication and treatment of the
following extrem ity injury:
1. Fractures
2. Disloc:tions
3. Amputations
4. Openwounds
5. Sprains and strains
5. lmpaied objects
7. Compartmentsyndrome
.
Estimate blood loss from pelvic and extremity fractures
Fractures
.
Life-threatening hemorrhage
.
Dangers of contamination
.
Treatment???
(Campbell & Ch:pter 20081
Amputation
.
Possible massive hemorrhage
.
Treatment??
-
Applied pressure
-
Secure the amputated part
,.
. ..--.- -..-+
(Campbell & Chapter 2008)
Open wounds
.
Cover wounds with sterile dressings and
bandage
'
lrrigation with NS to clean debris
.
Stop bleeding ) pressure
.
lf there is a severe hemorrhage ) transport
immediately
{Campbell & Chapter 2008}
lmpaled Object
DO NOT remove impaled object
Assessment
and Management
Scene size-up and History
.
Pre hospital ) is it safe?
.
Mechanism of injury is important ) to
identify potential
severity of the injury
.
History ) could be obtained during
primary
Survey
(Campbell
& Chapter 2OO8)
Compartment
Syndrome
.
Trauma
{crush
injury closed fractured or
compression) may cause bleeding and swelling
in closed space
.
Early symptoms ) pain
and paresthesia
.
Late symptoms ) 5
ps
C.rqtbel&c'e*rm)
Mechanism of lnjury
Mechanism of lnjury
Management
of Pelvic Fractures
Management
of Hip Dislocations
Assessment
.
Primary Survey
-
Obvious pelvis fracture or large bone fracture
*
Find and control bleeding from the extremities
.
Secondary Survey"
-
DCAP BTLS
-
Plrl.S
Splinting
.
Purpose )to prevent motion in the broken bone
ends
.
When to splint ???
.
Rules of splinting:
-
Adequately visualize the injured part
-
Check PMS at the distal ofthe fracture before and afrer
splinting
-
Covers open wounds
-
Splint the joint
above and below the injury
-
lc -!: :;f :,C-::-:+ :a:. tr-:e-:-e:i,-
{Campbdl & Clrapter 20O8j
4' VJf LVLA
Management
of Lower leg fracture
Management
of clavicle fracture
Summary
.
Note mechanism of injury
.
Remember priorities
) ABCs first
.
Visualize the injured part
.
Do not waste tim on minor splinting
.
Pelvic and femur fractures ) load-and_go
.
lf doubf splint possible
fractures