Family members report that their 62-year-old mother complained of dizziness and right leg weakness just before falling down a flight of stairs. Your assessment indicates that the patient is responsive, but confused and talking with garbled speech. Her breathing is adequate and her radial pulse is strong. Vital signs are pulse 84 beats/min, respirations 18 breaths/min, blood pressure 188/110 mmHg, and SpO2 96%. There is an open fracture to her right forearm. When instructed to do so, the patient does not move the fingers of her right hand. When caring for this patient, which sequence of actions seems most appropriate?

Here are some guidelines for handling musculoskeletal trauma and nontraumatic fractures: Splinting: Use ample padding when splinting possible fractures, dislocations, sprains, and strains. Splint limbs in the position of function or normal anatomic alignment. If circulation or neurological functions are compromised, gently reposition the limb. This may require administration of pain medications prior to any movement. Immobilization: To perform a reduction of a fracture, EMS providers start by checking for distal circulation, sensation, and motor function. Next, stabilize above and below the... Show more

Here are some guidelines for handling musculoskeletal trauma and nontraumatic fractures:
Splinting: Use ample padding when splinting possible fractures, dislocations, sprains, and strains. Splint limbs in the position of function or normal anatomic alignment. If circulation or neurological functions are compromised, gently reposition the limb. This may require administration of pain medications prior to any movement.
Immobilization: To perform a reduction of a fracture, EMS providers start by checking for distal circulation, sensation, and motor function. Next, stabilize above and below the injury, followed by applying gentle traction to the distal extremity in the direction it is facing.

First aid
For fractures, take these actions right away while waiting for medical help:
Stop any bleeding. Apply pressure to the wound with a sterile bandage, a clean cloth or a clean piece of clothing.
Keep the injured area from moving.
Apply ice packs to limit swelling and help relieve pain.
Treat for shock. 

Closed injuries can be managed with the R.I.C.E.R. regime: Rest, Ice, Compression, Elevation, and Referral for appropriate medical treatment. 

Open injuries can be divided into: Abrasions, Lacerations, Incisions, Punctures, Avulsions, and Amputations. 

Treatment for open injuries includes: Protecting yourself from disease with medical gloves, Washing or irrigating the wound, Controlling bleeding with direct pressure, Applying pressure dressings or an air splint, and Avoiding contamination. 

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