Fractures (All Pts)

Principles of Fracture Management

General principles for Fracture Management - Control external haemorrhage - Support the injured area - Immobilise the joint above and below the fracture site - Evaluate and record neurovascular condition distal to the fracture site

Provide appropriate pain relief (adult) (paediatric) and correct hypovolaemia (adult) (paediatric).

Appropriate splinting can assist in pain reduction and arrest of haemorrhage.

Before and after splinting - Realign long bone fractures in as close to normal position as possible. - Open fractures with exposed bone should be irrigated with a sterile isotonic solution prior to realignment and splinting. - If joints are involved there is an increased possibility of neurovascular impairment and reduction is not recommended. - Femoral shaft fractures and fractures of the upper 2/3 of the tibia and fibula should be managed with a traction splint unless there are distal dislocations or fractures.

In suspected fractures of the pelvis the legs should be anatomically splinted together (to internally rotate the feet) and the pelvis splinted with a sheet wrap or other appropriate device.

Pts who meet major trauma criteria (adult) (paediatric) are time critical but appropriate splinting should be considered part of essential Ambulance management and should not be compromised in order to decrease time at scene.