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How would you splint this injury?

Discussion in 'BLS Discussion' started by SplintedTheWrongLeg, Jun 9, 2018.

  1. SplintedTheWrongLeg

    SplintedTheWrongLeg Forum Probie

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    https://goo.gl/images/FQbnQH
    My first impression is that this seems to be a joint injury to me; So I would first control bleeding, check for PMS, and attempt to splint in a position of function, etc.. (splinting bone above and below)

    But I feel like that may cause more damage than good by putting pressure on an open fracture, and you do not want to end up pushing the bone somewhere it can cut off circulation or cause bleeding. Maybe a pillow splint?
    Please help me, this is driving me nuts!

    Thanks!
     
  2. StCEMT

    StCEMT Forum Deputy Chief

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    Had something very similar last year. Generous use of blankets and Fentanyl were her friend.
     
    SplintedTheWrongLeg likes this.
  3. Akulahawk

    Akulahawk EMT-P/ED RN Community Leader

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    I'd think about doing some hemorrhage control and then as long as there's still a pedal pulse, I'm going to splint it as it is. I like vacuum splints for this but a garden-variety cardboard box splint, some padding and gauze to hold everything in place will do just fine. You could even make a SAM splint work for this if you needed to. As horrible-looking as this is, don't forget that this is but ONE injury and there may be others, so quickly look for them before you get engrossed in dressing and splinting this one.
     
    SplintedTheWrongLeg and Jim37F like this.
  4. hometownmedic5

    hometownmedic5 Forum Asst. Chief

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    Fentanyl, pillow splint as is assuming adequate circulation, more fentanyl, txa if the bleeding is noteworthy and the patient is within protocol, more fentanyl.
     
    SplintedTheWrongLeg likes this.
  5. SplintedTheWrongLeg

    SplintedTheWrongLeg Forum Probie

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    Thanks to all for the responses. This was a weird one for me to work out!
    If EMS has taught me anything, it’s to look beyond the appearance of an injury.
     

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