Musculoskeletal Trauma SSgt Jeffery C. Pintler Washington Air National Guard
Incidence/Mortality/Morbidity <ul><li>Occur in 70-80% of all multi-trauma patients </li></ul><ul><li>Blunt or Penetrating ...
Incidence/Mortality/Morbidity <ul><li>Problem is  not  just the bone injury </li></ul><ul><ul><li>Other injuries caused by...
Musculoskeletal System Function <ul><li>Scaffolding/Support </li></ul><ul><li>Protection of vital organs </li></ul><ul><li...
Musculoskeletal Structures <ul><li>Skin </li></ul><ul><li>Muscles </li></ul><ul><li>Bones </li></ul><ul><li>Tendons </li><...
Muscular System
Skeletal System
Musculoskeletal Structures -  Skin <ul><li>Holds all structures together </li></ul><ul><li>Barrier function </li></ul><ul>...
Musculoskeletal Structures - Muscle <ul><li>Three types of muscle cells </li></ul><ul><li>Voluntary (Skeletal) </li></ul><...
Musculoskeletal Structures <ul><li>Tendons </li></ul><ul><ul><li>Bands of connective tissue binding muscles to bones </li>...
Types of Joints <ul><li>Ball/Socket </li></ul><ul><ul><li>Shoulder/Hip </li></ul></ul><ul><li>Hinge </li></ul><ul><ul><li>...
Fracture <ul><li>Break in continuity of bone </li></ul><ul><li>Closed </li></ul><ul><ul><li>Overlying skin intact </li></u...
Common fractures
Fracture Descriptions <ul><li>Open vs Closed </li></ul><ul><li>X-Ray descriptions </li></ul><ul><ul><li>greenstick </li></...
Complications associated with Fractures <ul><li>Hemorrhage </li></ul><ul><ul><li>Possible loss within first 2 hours </li><...
Complications associated with Fractures <ul><li>Disability </li></ul><ul><ul><li>Diminished sensory or motor function </li...
Musculoskeletal Assessment <ul><li>Initial Assessment </li></ul><ul><ul><li>ABCDs </li></ul></ul><ul><ul><li>Life threats ...
Musculoskeletal Assessment <ul><li>The six “P”s of musculoskeletal assessment </li></ul><ul><ul><li>Pain </li></ul></ul><u...
Musculoskeletal Assessment <ul><li>Palpation and Inspection </li></ul><ul><ul><li>Swelling/Ecchymosis </li></ul></ul><ul><...
Musculoskeletal Assessment <ul><li>Palpation and Inspection </li></ul><ul><ul><li>Tenderness </li></ul></ul><ul><ul><ul><l...
Musculoskeletal Assessment <ul><li>Palpation and Inspection </li></ul><ul><ul><li>Distal to injury, assess: </li></ul></ul...
Musculoskeletal Assessment <ul><li>Initial Assessment </li></ul><ul><ul><li>ABCDs </li></ul></ul><ul><ul><li>Life threats ...
Management - General <ul><li>Immobilization Objectives </li></ul><ul><ul><li>Prevent further damage to nerves/blood vessel...
Management - General <ul><li>Principles of Fracture Management </li></ul><ul><ul><li>Splint joint above, below </li></ul><...
Management - General <ul><li>Principles of Fracture Management (cont) </li></ul><ul><ul><li>Position of function </li></ul...
Dislocations <ul><li>Displacement of bone end from articulating surface at joint </li></ul><ul><li>Pain or pressure is mos...
Dislocations <ul><li>Nerves, blood vessels pass very close to bone.  Pressure on these structures can occur  </li></ul><ul...
Sprains <ul><li>Stretching. tearing of ligaments surrounding joint  </li></ul><ul><li>Occur when joint is twisted beyond n...
Sprain Management <ul><li>Characteristics </li></ul><ul><ul><li>Pain </li></ul></ul><ul><ul><li>Tenderness </li></ul></ul>...
Strains <ul><li>Tearing, stretching of musculo/tendonous unit.  </li></ul><ul><li>Spasm, pain on active movement </li></ul...
Traumatic Amputation <ul><li>First priority - ABC’s </li></ul><ul><ul><li>Bleeding from stump usually  not   a problem </l...
Tourniquet applied to an arm amputation
Tourniquet applied to a leg amputation
Traumatic Amputation - Limb Management <ul><li>Place in saline moist gauze </li></ul><ul><li>Place in plastic bag </li></u...
Sling and swathes applied to humerus fracture
Applying a cravat sling
Splint applied to a fractured elbow
Swathes applied to a fractured elbow
Splint applied to a fractured forearm
Sling and swath applied to a fractured forearm
Splint applied to a fractured wrist
Improvised jacket sling
Pelvic Fracture <ul><li>Direct or indirect force </li></ul><ul><li>Pelvic ring tends to break in two places </li></ul><ul>...
Pelvic Fx Management <ul><li>Treat as potential critical trauma patient </li></ul><ul><li>Comfortable position if possible...
Military Anti-Shock Trousers Pneumatic Anti-Shock Garment
Femur Fracture <ul><li>Femoral Neck (Hip) </li></ul><ul><ul><li>Most common in mid to late 60’s age group. </li></ul></ul>...
Femur Fracture <ul><li>Mid-Shaft </li></ul><ul><ul><li>Result from torsion in very young or old </li></ul></ul><ul><ul><li...
Femur Fracture - Management <ul><li>Assess for traction splint contraindications </li></ul><ul><li>May use PASG, secure to...
Femur Fracture - Management <ul><li>Traction Splints </li></ul><ul><ul><li>Used on mid-shaft femur fractures </li></ul></u...
Lower Extremity Fracture <ul><li>Patellar </li></ul><ul><ul><li>Due to direct impact </li></ul></ul><ul><li>Tibia/Fibula <...
Management - Lower Extremity Fracture <ul><li>Patellar, Tibia/Fibula, and Calcaneal </li></ul><ul><ul><li>Assess for neuro...
Splint applied to an upper leg fracture
Splint applied to a fractured knee
Uninjured leg used as a splint
Hemorrhage Management <ul><li>Direct Pressure </li></ul><ul><ul><li>Most effective method </li></ul></ul><ul><ul><li>Press...
Applying and securing a field dressing
Applying manual pressure
Pressure points for control of arterial bleeding
Tourniquet <ul><li>Last resort, but do not wait too long. </li></ul><ul><li>Use flat wide material </li></ul><ul><li>BP cu...
Application of a tourniquet to stop bleeding
References <ul><li>Field Manual 8-230 U.S. Army 2003 </li></ul><ul><li>Combat Lifesaver Instructor Manual U.S. Army 2003 <...
Upcoming SlideShare
Loading in...5
×

Muscle Skeletal

6,981

Published on

SSgt Jeffery C. Pintler
Washington Air National Guard

2 Comments
5 Likes
Statistics
Notes
  • Great for military. I plan to use with 86th CSH for educating medics.
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • To many pages!
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
No Downloads
Views
Total Views
6,981
On Slideshare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
412
Comments
2
Likes
5
Embeds 0
No embeds

No notes for slide
  • Muscle Skeletal

    1. 1. Musculoskeletal Trauma SSgt Jeffery C. Pintler Washington Air National Guard
    2. 2. Incidence/Mortality/Morbidity <ul><li>Occur in 70-80% of all multi-trauma patients </li></ul><ul><li>Blunt or Penetrating </li></ul><ul><li>Upper extremity rarely life-threatening </li></ul><ul><ul><li>may result in long-term impairment </li></ul></ul><ul><li>Lower extremity associated with more severe injuries </li></ul><ul><ul><li>possibility of significant blood loss </li></ul></ul><ul><ul><li>femur, pelvic injuries may pose life-threat </li></ul></ul>
    3. 3. Incidence/Mortality/Morbidity <ul><li>Problem is not just the bone injury </li></ul><ul><ul><li>Other injuries caused by the injured bone </li></ul></ul><ul><ul><ul><li>Soft tissue </li></ul></ul></ul><ul><ul><ul><li>Vascular </li></ul></ul></ul><ul><ul><ul><li>Nervous system </li></ul></ul></ul><ul><ul><ul><li>Decreased function </li></ul></ul></ul>
    4. 4. Musculoskeletal System Function <ul><li>Scaffolding/Support </li></ul><ul><li>Protection of vital organs </li></ul><ul><li>Movement </li></ul><ul><li>Production of Red Blood Cells </li></ul><ul><li>Storage of minerals </li></ul>
    5. 5. Musculoskeletal Structures <ul><li>Skin </li></ul><ul><li>Muscles </li></ul><ul><li>Bones </li></ul><ul><li>Tendons </li></ul><ul><li>Ligaments </li></ul><ul><li>Cartilage </li></ul>
    6. 6. Muscular System
    7. 7. Skeletal System
    8. 8. Musculoskeletal Structures - Skin <ul><li>Holds all structures together </li></ul><ul><li>Barrier function </li></ul><ul><li>Protects underlying structures </li></ul><ul><li>Subcutaneous tissue </li></ul>
    9. 9. Musculoskeletal Structures - Muscle <ul><li>Three types of muscle cells </li></ul><ul><li>Voluntary (Skeletal) </li></ul><ul><ul><li>Conscious control </li></ul></ul><ul><li>Smooth (Bronchi, GI tract, blood vessels) </li></ul><ul><ul><li>Unconscious control </li></ul></ul><ul><li>Cardiac </li></ul><ul><ul><li>Contracts rhythmically on its own </li></ul></ul>
    10. 10. Musculoskeletal Structures <ul><li>Tendons </li></ul><ul><ul><li>Bands of connective tissue binding muscles to bones </li></ul></ul><ul><li>Cartilage </li></ul><ul><ul><li>Connective tissue covering the ends of bones </li></ul></ul><ul><ul><li>Needed for joint movement </li></ul></ul><ul><li>Ligaments </li></ul><ul><ul><li>Connective tissue supporting joints </li></ul></ul><ul><ul><li>Attach bone ends to each other </li></ul></ul>
    11. 11. Types of Joints <ul><li>Ball/Socket </li></ul><ul><ul><li>Shoulder/Hip </li></ul></ul><ul><li>Hinge </li></ul><ul><ul><li>Elbow/Knees/Fingers/TMJ </li></ul></ul><ul><li>Pivot </li></ul><ul><ul><li>Between radius and ulna </li></ul></ul><ul><li>Gliding </li></ul><ul><ul><li>Bones of wrist </li></ul></ul>
    12. 12. Fracture <ul><li>Break in continuity of bone </li></ul><ul><li>Closed </li></ul><ul><ul><li>Overlying skin intact </li></ul></ul><ul><li>Open </li></ul><ul><ul><li>Wound extends from body surface to fracture site </li></ul></ul><ul><ul><li>Produced either by bones or object that caused Fx </li></ul></ul><ul><ul><li>Danger of infection </li></ul></ul><ul><ul><li>Bone end not necessarily visible </li></ul></ul>
    13. 13. Common fractures
    14. 14. Fracture Descriptions <ul><li>Open vs Closed </li></ul><ul><li>X-Ray descriptions </li></ul><ul><ul><li>greenstick </li></ul></ul><ul><ul><li>oblique </li></ul></ul><ul><ul><li>transverse </li></ul></ul><ul><ul><li>comminuted </li></ul></ul><ul><ul><li>spiral </li></ul></ul><ul><ul><li>impacted </li></ul></ul><ul><ul><li>epiphyseal </li></ul></ul>
    15. 15. Complications associated with Fractures <ul><li>Hemorrhage </li></ul><ul><ul><li>Possible loss within first 2 hours </li></ul></ul><ul><ul><ul><li>Tib/Fib - 500 ml </li></ul></ul></ul><ul><ul><ul><li>Femur - 500 ml </li></ul></ul></ul><ul><ul><ul><li>Pelvis - 2000 ml </li></ul></ul></ul><ul><li>Interruption of Blood Supply </li></ul><ul><ul><li>Compression on artery </li></ul></ul><ul><ul><ul><li>decreased distal pulse </li></ul></ul></ul><ul><ul><li>Decreased venous return </li></ul></ul>
    16. 16. Complications associated with Fractures <ul><li>Disability </li></ul><ul><ul><li>Diminished sensory or motor function </li></ul></ul><ul><ul><ul><li>inadequate perfusion </li></ul></ul></ul><ul><ul><ul><li>direct nerve injury </li></ul></ul></ul><ul><li>Specific Injuries </li></ul><ul><ul><li>Dislocation </li></ul></ul><ul><ul><li>Amputation/Avulsion </li></ul></ul><ul><ul><li>Crush Injury (soft tissue trauma discussion) </li></ul></ul>
    17. 17. Musculoskeletal Assessment <ul><li>Initial Assessment </li></ul><ul><ul><li>ABCDs </li></ul></ul><ul><ul><li>Life threats managed first </li></ul></ul><ul><ul><li>Don’t overlook life/limb threatening musculoskeletal trauma </li></ul></ul><ul><ul><li>Don’t be distracted by “gross” but non-life/limb threatening musculoskeletal injury </li></ul></ul>
    18. 18. Musculoskeletal Assessment <ul><li>The six “P”s of musculoskeletal assessment </li></ul><ul><ul><li>Pain </li></ul></ul><ul><ul><ul><li>on palpation </li></ul></ul></ul><ul><ul><ul><li>on movement </li></ul></ul></ul><ul><ul><ul><li>constant </li></ul></ul></ul><ul><ul><li>Pallor - pale skin or poor cap refill </li></ul></ul><ul><ul><li>Paresthesia - “pins and needles” sensation </li></ul></ul><ul><ul><li>Pulses - diminished or absent </li></ul></ul><ul><ul><li>Paralysis </li></ul></ul><ul><ul><li>Pressure </li></ul></ul>
    19. 19. Musculoskeletal Assessment <ul><li>Palpation and Inspection </li></ul><ul><ul><li>Swelling/Ecchymosis </li></ul></ul><ul><ul><ul><li>Hemorrhage/Fluid at site of trauma </li></ul></ul></ul><ul><ul><li>Deformity/Shortening of limb </li></ul></ul><ul><ul><ul><li>Compare to other extremity if norm is questioned </li></ul></ul></ul><ul><ul><li>Guarding/Disability </li></ul></ul><ul><ul><ul><li>Presence of movement does not rule out fracture </li></ul></ul></ul>
    20. 20. Musculoskeletal Assessment <ul><li>Palpation and Inspection </li></ul><ul><ul><li>Tenderness </li></ul></ul><ul><ul><ul><li>Use two point fixation of limb with palpation with other hand. </li></ul></ul></ul><ul><ul><ul><li>Tenderness tends to localize over injury site. </li></ul></ul></ul><ul><ul><li>Crepitus </li></ul></ul><ul><ul><ul><li>Grating sensation </li></ul></ul></ul><ul><ul><ul><li>Produced by bones rubbing against each other. </li></ul></ul></ul><ul><ul><ul><li>Do not attempt to elicit. </li></ul></ul></ul>
    21. 21. Musculoskeletal Assessment <ul><li>Palpation and Inspection </li></ul><ul><ul><li>Distal to injury, assess: </li></ul></ul><ul><ul><ul><li>skin color </li></ul></ul></ul><ul><ul><ul><li>skin temperature </li></ul></ul></ul><ul><ul><ul><li>sensation </li></ul></ul></ul><ul><ul><ul><li>motor function </li></ul></ul></ul><ul><ul><li>If uncertain, compare extremities </li></ul></ul><ul><ul><li>When in doubt splint! </li></ul></ul>
    22. 22. Musculoskeletal Assessment <ul><li>Initial Assessment </li></ul><ul><ul><li>ABCDs </li></ul></ul><ul><ul><li>Life threats managed first </li></ul></ul><ul><ul><li>Don’t overlook life/limb threatening musculoskeletal trauma </li></ul></ul><ul><ul><li>Don’t be distracted by “gross” but non-life/limb threatening musculoskeletal injury </li></ul></ul>
    23. 23. Management - General <ul><li>Immobilization Objectives </li></ul><ul><ul><li>Prevent further damage to nerves/blood vessels </li></ul></ul><ul><ul><li>Decrease bleeding, edema </li></ul></ul><ul><ul><li>Avoid creating an open Fracture </li></ul></ul><ul><ul><li>Decrease pain </li></ul></ul><ul><ul><li>Early immobilization of long bone fractures critical in preventing fat embolism </li></ul></ul>
    24. 24. Management - General <ul><li>Principles of Fracture Management </li></ul><ul><ul><li>Splint joint above, below </li></ul></ul><ul><ul><li>Splint bone ends </li></ul></ul><ul><ul><li>Loosely cover open fracture sites </li></ul></ul><ul><ul><li>Neurovascular assessment </li></ul></ul><ul><ul><ul><li>before and after splinting </li></ul></ul></ul><ul><ul><li>Gentle in-line traction of long bone </li></ul></ul><ul><ul><ul><li>maintain normal alignment if possible </li></ul></ul></ul><ul><ul><ul><li>reduction of angulated fracture site </li></ul></ul></ul>
    25. 25. Management - General <ul><li>Principles of Fracture Management (cont) </li></ul><ul><ul><li>Position of function </li></ul></ul><ul><ul><li>Pain management </li></ul></ul><ul><li>Body Splinting </li></ul><ul><ul><li>In urgent patient, entire body is stabilized by using a long board </li></ul></ul><ul><ul><li>Lower extremity fractures can be splinted as one to the long board </li></ul></ul><ul><li>Long Board </li></ul><ul><ul><li>Splints every bone and joint </li></ul></ul><ul><ul><li>No loss of time </li></ul></ul><ul><ul><li>Focus on critical conditions </li></ul></ul>
    26. 26. Dislocations <ul><li>Displacement of bone end from articulating surface at joint </li></ul><ul><li>Pain or pressure is most common symptom </li></ul><ul><li>Principal sign is deformity </li></ul><ul><li>May experience loss of motion of joint </li></ul>
    27. 27. Dislocations <ul><li>Nerves, blood vessels pass very close to bone. Pressure on these structures can occur </li></ul><ul><li>Checking distally essential </li></ul><ul><ul><li>Pulse presence </li></ul></ul><ul><ul><li>Pulse strength </li></ul></ul><ul><ul><li>Sensation </li></ul></ul>
    28. 28. Sprains <ul><li>Stretching. tearing of ligaments surrounding joint </li></ul><ul><li>Occur when joint is twisted beyond normal range of motion </li></ul><ul><li>Most common = Ankle </li></ul>
    29. 29. Sprain Management <ul><li>Characteristics </li></ul><ul><ul><li>Pain </li></ul></ul><ul><ul><li>Tenderness </li></ul></ul><ul><ul><li>Swelling </li></ul></ul><ul><ul><li>Discoloration </li></ul></ul><ul><li>Typically does not manifest deformity </li></ul><ul><li>Ice, compression, elevation, immobilize </li></ul><ul><li>When in doubt, splint </li></ul><ul><li>Consider analgesia </li></ul>
    30. 30. Strains <ul><li>Tearing, stretching of musculo/tendonous unit. </li></ul><ul><li>Spasm, pain on active movement </li></ul><ul><li>Usually no deformity, swelling </li></ul><ul><li>Pain present on active movement </li></ul><ul><li>Avoid active movement, weight bearing </li></ul>
    31. 31. Traumatic Amputation <ul><li>First priority - ABC’s </li></ul><ul><ul><li>Bleeding from stump usually not a problem </li></ul></ul><ul><li>Next priority is to save limb </li></ul>Traumatic Amputation Management <ul><li>Control Bleeding </li></ul><ul><li>Elevate </li></ul><ul><li>Apply direct pressure to stump </li></ul><ul><li>Avoid tourniquet except as last resort </li></ul>
    32. 32. Tourniquet applied to an arm amputation
    33. 33. Tourniquet applied to a leg amputation
    34. 34. Traumatic Amputation - Limb Management <ul><li>Place in saline moist gauze </li></ul><ul><li>Place in plastic bag </li></ul><ul><li>Place bag on ice </li></ul><ul><li>Do not </li></ul><ul><ul><li>Warm amputated part </li></ul></ul><ul><ul><li>Place part in water </li></ul></ul><ul><ul><li>Place directly on ice </li></ul></ul><ul><ul><li>Use dry ice </li></ul></ul>
    35. 35. Sling and swathes applied to humerus fracture
    36. 36. Applying a cravat sling
    37. 37. Splint applied to a fractured elbow
    38. 38. Swathes applied to a fractured elbow
    39. 39. Splint applied to a fractured forearm
    40. 40. Sling and swath applied to a fractured forearm
    41. 41. Splint applied to a fractured wrist
    42. 42. Improvised jacket sling
    43. 43. Pelvic Fracture <ul><li>Direct or indirect force </li></ul><ul><li>Pelvic ring tends to break in two places </li></ul><ul><li>Bone fragments can cause damage </li></ul><ul><ul><li>Major vessels </li></ul></ul><ul><ul><li>Urinary bladder </li></ul></ul><ul><ul><li>Rectum resulting in contamination </li></ul></ul><ul><ul><li>Nerves (Lumbrosacral plexus or sciatic) </li></ul></ul>
    44. 44. Pelvic Fx Management <ul><li>Treat as potential critical trauma patient </li></ul><ul><li>Comfortable position if possible </li></ul><ul><li>Splint = Minimize movement </li></ul><ul><ul><li>Scoop stretcher </li></ul></ul><ul><ul><li>Body to long board </li></ul></ul><ul><ul><li>MAST for splint </li></ul></ul><ul><li>Replace volume prn </li></ul><ul><ul><li>Possible 4000cc blood loss </li></ul></ul><ul><ul><li>2 IV of LR </li></ul></ul>
    45. 45. Military Anti-Shock Trousers Pneumatic Anti-Shock Garment
    46. 46. Femur Fracture <ul><li>Femoral Neck (Hip) </li></ul><ul><ul><li>Most common in mid to late 60’s age group. </li></ul></ul><ul><ul><li>Leg tends to rotate outward </li></ul></ul><ul><ul><ul><li>looks like anterior hip dislocation </li></ul></ul></ul><ul><ul><li>Minimal blood loss tends to occur due to joint capsule </li></ul></ul><ul><li>Management </li></ul><ul><ul><li>NO traction splint </li></ul></ul><ul><ul><li>long board, scoop or MAST </li></ul></ul>
    47. 47. Femur Fracture <ul><li>Mid-Shaft </li></ul><ul><ul><li>Result from torsion in very young or old </li></ul></ul><ul><ul><li>High speed deceleration with impact </li></ul></ul><ul><ul><ul><li>Hypovolemic shock </li></ul></ul></ul><ul><ul><ul><li>Fat Embolism </li></ul></ul></ul><ul><ul><li>Early immobilization with traction splint will help prevent </li></ul></ul><ul><ul><li>1000 to 2000 cc blood loss </li></ul></ul>
    48. 48. Femur Fracture - Management <ul><li>Assess for traction splint contraindications </li></ul><ul><li>May use PASG, secure to long board </li></ul><ul><ul><li>Secure to opposite extremity and then to long board (premise for the Sager splint) </li></ul></ul><ul><li>Assess for : </li></ul><ul><ul><li>Soft tissue, vascular, or nerve injury </li></ul></ul><ul><ul><li>Assess for hypovolemia </li></ul></ul>
    49. 49. Femur Fracture - Management <ul><li>Traction Splints </li></ul><ul><ul><li>Used on mid-shaft femur fractures </li></ul></ul><ul><ul><li>Do not use if suspected fracture involves </li></ul></ul><ul><ul><ul><li>proximal or distal 1/3 of femur </li></ul></ul></ul><ul><ul><ul><li>pelvis </li></ul></ul></ul><ul><ul><ul><li>hip (or hip dislocation) </li></ul></ul></ul><ul><ul><ul><li>knee (or knee dislocation) </li></ul></ul></ul><ul><ul><ul><li>ankle (or ankle dislocation) </li></ul></ul></ul>
    50. 50. Lower Extremity Fracture <ul><li>Patellar </li></ul><ul><ul><li>Due to direct impact </li></ul></ul><ul><li>Tibia/Fibula </li></ul><ul><ul><li>High potential for: </li></ul></ul><ul><ul><ul><li>Open fracture </li></ul></ul></ul><ul><ul><ul><li>Hemorrhage </li></ul></ul></ul><ul><ul><ul><li>Infection </li></ul></ul></ul><ul><li>Calcaneal </li></ul><ul><ul><li>Results from falls (foot landing) </li></ul></ul><ul><ul><li>High incidence of lumbar sacral compression </li></ul></ul>
    51. 51. Management - Lower Extremity Fracture <ul><li>Patellar, Tibia/Fibula, and Calcaneal </li></ul><ul><ul><li>Assess for neurovascular impairment </li></ul></ul><ul><ul><li>Realign long bones </li></ul></ul><ul><ul><li>Splinting possibilities </li></ul></ul><ul><ul><ul><li>board splint or cardboard splint </li></ul></ul></ul><ul><ul><ul><li>vacuum splint </li></ul></ul></ul><ul><ul><ul><li>pillow </li></ul></ul></ul>
    52. 52. Splint applied to an upper leg fracture
    53. 53. Splint applied to a fractured knee
    54. 54. Uninjured leg used as a splint
    55. 55. Hemorrhage Management <ul><li>Direct Pressure </li></ul><ul><ul><li>Most effective method </li></ul></ul><ul><ul><li>Pressure bandage </li></ul></ul><ul><li>Elevation </li></ul><ul><ul><li>Combination with direct pressure </li></ul></ul><ul><li>Pressure Point </li></ul><ul><ul><li>Brachial, Femoral, Carotid </li></ul></ul><ul><li>Tourniquet </li></ul><ul><ul><li>last resort </li></ul></ul><ul><ul><li>rarely required </li></ul></ul>
    56. 56. Applying and securing a field dressing
    57. 57. Applying manual pressure
    58. 58. Pressure points for control of arterial bleeding
    59. 59. Tourniquet <ul><li>Last resort, but do not wait too long. </li></ul><ul><li>Use flat wide material </li></ul><ul><li>BP cuff </li></ul><ul><li>Close to the wound as possible </li></ul><ul><li>Do not remove </li></ul><ul><li>Leave in plain view </li></ul><ul><li>Note time applied and clearly communicate during transfer of care </li></ul>
    60. 60. Application of a tourniquet to stop bleeding
    61. 61. References <ul><li>Field Manual 8-230 U.S. Army 2003 </li></ul><ul><li>Combat Lifesaver Instructor Manual U.S. Army 2003 </li></ul>
    1. A particular slide catching your eye?

      Clipping is a handy way to collect important slides you want to go back to later.

    ×