In this micro-lecture, we discuss fracture management; treating patients who have some type of fracture to a bone in the body. Enrolled students have unlimited access to a rich library of learning materials such as this.
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Paramedics will routinely treat patients who have got some type of fracture to a long bone, or any other type of bone in the body. Paramedic management of fractures really just focus around immobilizing the injury, preventing any further damage, reducing a patient’s pain through pain control and immobilization, as well as managing the A, Bs, and Cs, and not being too distracted by the actual fracture itself.
Okay, so the first thing the paramedic needs to do when they’re managing a fracture is to identify it. Now, typical signs and symptoms of fracture include swelling, loss of movement, irregularity in its appearance, crepitus, deformity, bruising, loss of movement, a patient reports that they’re not able to stand on it. So these are all typical signs and symptoms of a fracture.
Now of course, a patient’s gonna usually complain of quite a significant amount of pain. And it’s in your best interest to effectively evaluate that pain and provide the most appropriate pain relief. Remembering that paramedics usually do a have a number of different pain management drugs in their barrage of equipment, so accurately assessing the number on a scale of naught to ten, and giving the most appropriate pain is also really, really important.
Now, it’s important to also assess the location of the fracture. So for example, is it just an isolated long bone fracture such as a tibia or fibia? And I don’t mean just an isolated long bone fracture. Or, is there any involvement anywhere else? For example, is there any involvement of the knee, or the lower limbs, or the spine? Do you need to consider spinal immobilization, or is it just the isolated … Is it just that one location under review?
Now of course, when you’re managing this situation, the patients generally won’t let you go anywhere near them until you’ve reassured them, communicated effectively with
them, provided the strong pain relief, effectively immobilized the injury using a range of different devices. Now the typical devices include vacuum splints, which we’ll have a play around with in your workshop. You might also find that if it’s a fracture femur, you’re immobilizing the patient using a CT-6 device, or a Sager Traction device, or a Donway device. Get online and take a look at what these devices look like. Ambulance services and private providers of primary medical services do tend to have their own devices, and they’re usually based around their own personal needs in that given moment in time.
So let’s just recap, then. First and foremost, a paramedic must be able to recognize the fracture. They must be able to maintain a sense of situational awareness and not be distracted by just the fracture. So for example, if there is a hemorrhage control situation, you need to control that first. If there’s a situation involving a c-spine, you’ve gotta be able to manage that as a matter of priority. And then finally, when you get to managing the fracture, you need to expose the injury, which is part of your primary survey, take a look at it. After you’ve given some strong pain relief, or an appropriate amount of pain relief, and keep that injury still. Prevent it from being moved. Minimize any injury to the patient, and basically just reassess, reassess, reassess.
So that’s a whistle stop tour of fracture management. And again, you will have an opportunity to practice management of a fracture injury in the face-to-face workshop.
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