1. Extremities Care and Treatment

2. Extremities Assessment guidelines:  Look for signs and symptoms of fractures and dislocations  Remember D-O-T-S Deformity Open wound Tenderness Swelling  Look at and gently feel the extremity, starting at the distal end (fingers or toes) and working upward.

3. Assessment guidelines (cont.) Consider the mechanism of injury in evaluating the possibility of a fracture and its location:  Forces that cause musculoskeletal injuries are direct forces (e.g. a car bumper strikes a pedestrian’s tibia),  Indirect forces along the long axis of bones (e.g. a person falls on to his or her outstretched hand, fracturing the clavicle),  And twisting forces, (e.g. a person’s foot is fixed in one spot while the leg is suddenly twisted). Remember to check the extremity for circulation, sensation, and movement.

4. General First Aid Principles R.I.C.E.  Rest  Ice  Compression  Elevation Apply appropriate splint to immobilize fractures and dislocations

5. Bone Injuries Remove or cut away clothing over injury site. Look and feel for D-O-T-S Bleeding from open fracture? If No:  Check circulation, sensation, and movement  Apply splint  Recheck circulation, sensation and movement periodically  Seek medical attention If Yes:  Control bleeding; do not push bone; cover wound and bone with a dressing.  Check circulation, sensation, and movement  Apply splint  Recheck circulation, sensation and movement periodically  Seek medical attention

6. Muscle Injuries Blow to a muscle?  If Yes: Contusion Use R.I.C.E. procedures  If No: Uncontrolled muscle spasm? If Yes:  Cramp  Drink cool water  For affected muscle, apply ice pack; gently stretch and/or apply pressure If No:  Muscle stretched or torn?  If Yes:  Strain (pulled muscle)  Use R.I.C.E.

7. Joint injuries Injury located in a joint?  If Yes: Deformed appearance of joint?  If No:  Sprain  If Yes:  Dislocation  Check circulation, sensation and movement  Stabilize joint  Seek medical attention.  If No: Probable strain (muscle pull or tear) or contusion (blow to a muscle)