haemorrhage control 1 - wordpress.com · •measurement for thomas splint • the uninjured leg...
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• Toclinicallyrecognisefracturesofthefemurascause/contribuFontoshock
• AbletoselectequipmentrequiredforThomasSplint
• AbletoexplaintheapplicaFonofskintracFon
• Reviewofpolicyforopenlowerlimbfractures
OBJECTIVES
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DIAGNOSISOFFRACTUREDFEMUR
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• Mechanism,Physiology&Clinically
• Clinically–Rapidprimarysurvey,swelling,wounds,shortlimb,can’tSLR
REMEMBER:internalrotaFon=dislocatedhipCHECKforNVstatusplusDopplerifrequired-MayneedCTangio&vascularintervenFonifcoldleg
• Don’tforgetthepelvis!
• MAINPROBLEMISBLOODLOSS• Inasimplefracture,alossof½-1litreofblood,moreinanopenfracture
• Bloodreplacementiso^enrequiredinsimplefractures,ando^enessenFalinopeninjuries
• TRACTION=IMMEDIATETEMPORARYCONTROLOFOBVIOUSHAEMORRHAGE
FRACTUREDFEMUR
4
• Decisionbasedonclinicalfindings,NOTx-ray• THINKaboutanalgesia?• Don’tforgettracFoncanbeappliedbyjustpullingtheleg!
• Thomassplint
CONSIDERATIONSwhenapplyingtracFon
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1. TapeMeasurement2. ThomasSplint3. Tubi-grip(sizef)4. Razor5. AdhesiveSkinTracFonKit6. ChineseWindlass7. GauzeandCokonTissuePad(Gamgee)8. WoolPadding9. Cokonstretchbandaging(Crepe)10. Tape
EQUIPMENTFORTHOMASSPLINT
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• MeasurementforThomassplint• Theuninjuredlegshouldbemeasuredandanallowancemadeforswelling,presentandanFcipated
• Measurethecircumferenceoftheupperthigh.Addtwoinchesforringmeasurement
• Measurethelengthofthefull,legstarFngattheglutealfold.Addfiveinchesforrequiredlengthofsplintneeded
THOMASSPLINT
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• CordTracEon
• PassingthemedialcordoverlateralcordhelpstocontrolthetendencyforlateralrotaFon
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TRACTION
FREQUENTQUESTIONS• CanIapplytracFonagainstafracturedpelvis?Ifunstablepelvicfracture,applybinderandsplintlimbs(eveninpresenceoffracturedfemur),donotapplytracFon
• ShouldItakeoffatracFondeviceappliedpre-hospitalNO!Ifit’sworkingLEAVEitonunFltheatre,butcheckforpressureareasPLEASEreturntoEDa^ertakingoffintheatre
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