Sunday, January 29, 2017

Why should an EMT be concerned with pain, pallor, paralysis, paresthesia, pressure, and pulse

Pain will show where the fracture or injury is at
  • Pallor – The skin distal (below) the injury site may be pale. The skins capillary may take longer to refill.
  • Paralysic may be a sign of nerve, muscle, tendon and ligament damage
  • Paresthesia may be an indication of nerve damage
  • Pressure may be damaged tissue or blood loss
  • Pulse loss may be an indication to damage to the arterial vessels

Why should an EMT splint a musculoskeletal injury
  • When an EMT splints a musculoskeletal injury they are stopping further damage to the fracture or dislocated bone
  • When an EMT splints an injury they reduce pain for the patient
  • Splinting will help with reducing blood loss by allowing the injury to not move.

What should an EMT consider when doing an assessment based approach to bone/joint injuries

What are the steps an EMT should consider when doing an assessment to a bone fracture injury?

  • Scene size up. Can the EMT figure out what the method of injury is?
  • General impression
  • Is there any major bleeding
  • Is there any open fracture sites
  • Is there an obvious deformity
  • What is the patients mental status
  • How is the patients airway
  • How is the patients bleeding
  • How is the patients circulation
  • Immediate transport if there are severe signs of hemorrhage, shock, pulselessness cyanosis distal to the injury

Why should an EMT consider a femur and pelvis fracture to be critical fractures

A femur and pelvis fracture can be extremely painful. They can also be extremely bloody injuries. 1.5 liters of blood can easily be lost by a patient with a femur or pelvis fracture.

When should an EMT not traction splint a suspected femur fracture

“Do not try to splint the injury!” This is a warning that Emergency Dispatch (911) gives all the time. It is an important warning. Splinting a fracture or splinting the fracture wrongly can actually cause more damage than good. 

For an EMT not to injure a patient further there are some precautions that the medic should take. 

Do not splint a suspected femur fracture if the injury is within 1-2 inches of the knee or ankle. 

Do not splint if the knee, hip, or pelvis has been injured. If the patient has a partial amputation or avulsion with bone separation, and the distal limb is 
connected only by marginal tissue. A traction splint would cause more damage 
to the marginal tissue and possibly cause total amputation of the limb.