Trauma Scenario, what would you do?

[apssbc]

Something I decided Im going to do every now and again. Ill be putting up scenarios. Well say that for any scenario that I pose we are post SHTF, emp and all electricity is gone. Emergency medicine is limited to what you know and what equipment you have on hand or what nature can provide you. Threats have been eliminated unless noted otherwise. There is no further treatment available. Post you thoughts/assessments/treatments and after some responses Ill give you the answer of what I would do.

Background on me Im a full time medic/firefighter, and a certifed tac medic.

Scenario 1- Another mag member has taken a fall of approx 10 feet at your base camp and there is no threats in the area. He is a 45 year old male, alert and oriented per normal. Patient did not have any loss of consciousness. He is laying on the ground complaining of severe right lower leg pain, and left elbow pain. The patient also has pain in his lower back. When you expose his leg you find a obvious deformity to his right tib/fib (lower leg bones), and have no pulse in the right foot. The left elbow has swelling to it and he complains of pain upon movement, pt has good pulses in his wrist. Pt back is revealed to show a few minor lacerations with some dirt and other foreign material in them. Pts vitals are stable and he has no other complaints.

Go! ;)

[realist]

The leg needs a traction splint on as soon as possible to get the blood flowing. I would splint it with splints that are too long. Them using cravat I would construct an improvised traction to straighten out the limb and see if I could get the blood flowing to the foot again. What do you think about giving aspirin to maybe thin the blood to assist? Just a thought.

I would sling the arm and immobilize it by a chest strap just to keep it in place. Since there is only complain of pain and not an obvious break or dislocation I would not mess with it. I would keep the fingers exposed to keep an eye on them to make sure of blood flow.

The back since there was no obvious deformity I would leave it alone.

Move the subject inside and monitor.

Obviously if I could get additional help that would be requested.

[Twitchy]

traction splint leg to begin blood flow, sling arm for precautionary measures. clean lacerations if i have time on the way to find a doc or something... not much i can do but the way it seems is that your friend has a compund fracture and needs professional attention immediately or risk losing his lower leg...

[izzyscout21]

http://i764.photobucket.com/albums/xx288/2crgrunt/walk-it-off-sports-leg-soccer-demotivational-poster-1234653208.jpg

[Sniper-T]

I would move him into a better location for treatment, and then I would use an 'unsanctioned' method of putting him under. Using several people, if necessary, I would set his leg, and splint it to watch for swelling/circulation problems. I would also thoroughly examine his elbow, to ensure there isn't a small fracture, and then immobilize it.

I would clean the abrasions, and cover.

Allow to wake up, and treat for shock.

Then I would cast it, probably using a paper machett (sp) type of deal.

[LUNCHBOX]

After saying goodbye to him....j/k. I would splinter/sling/clean as stated above. (I'm no medic) until the level of damage to the back is determined all movement is done by liter carry if possible.

[apssbc]

Excellent work everyone who replied. Being that he did not pass out he is lucky. All the answers are correct, there is no definite yes or no due to variations in skills, equipment, and different teaching. First thing you want to do is take your time and make sure he is not moving his neck or back. Have another member hold his neck still and instruct the pt not to move. Then start removing clothing to expose injuries.

Due to the pt not having a pulse distal to the injury you need to try and re-position the injury to restore blood flow. You would have to manually pull traction on the foot until you have the pulse back then try and set up a device to hold that traction. Maybe a Weight and a strap, pulley and a weight or anything else you can think of. Then splint the wound until it can be casted if you have that capability.

The elbow should be immobilized and swathed to the body. When immobilizing a joint you secure the splint at the bone above and below the injury. When immobilizing a broken long bone you secure at the joint above and below. After immobilizing the elbow tie a sling to support it then swath (or secure it) to the chest, being mindful that he needs to breathe :).

As for his back the injury would be determined to be minor and as long as there are no other spinal complaints you can allow him to move. Assess the back by rolling the pt in one fluid motion if possible while keeping the head neutal and inline with the body. Then feel the back for any grinding feeling, major swelling, or stepoffs (spine feels like a small staircase). If that is all good than just treat the wounds. Wash the mud and other crap out and dress the wound after applying a antibiotic ointment. Also try and dose the pt with antibiotics if avaliable.

[apssbc]

Follow up questions
1. What if no pulse is restored to the ankle?
2. What natural items can be used or made into antibiotic type ointments/meds?

Let keep this discussion going ;)

[Evolver]

100% honey is a good antibiotic and tumric is a good anti inflammatory.

If there is no pulse after all attempts of bone adjusting is done the leg will start to die and infection will soon set in so an amputation might need to be none.

[mitunnelrat]

After much thought and consideration, I'm very glad you live nearby ;)