Fx pelvis and femur injuries

[courageheartx]

I need an opinion....

If you came upon a scene of an accident, lets say vehicle vs pedestrian, you've assesed the patient level of conciousness. AXO3. His airway is patent,free of fluid. Is breathing rate is 24,shallow and labored. So anyways aside from your assesments,how will you move this patient? orthopaedic scoop,then spine board? how will you roll this patient to assess if their are any other injuries? Traction splint is out of picture because your protocol says it is a "assist advanced provider only"

[CBEMT]

What does traction splint have to do with moving the patient? You've said nothing to indicate it's even necessary.

If you're scooping, you better pray like hell that there is nothing significant on the back that's going to surprise the hospital because you never looked.

[mobey]

I need a little more info...

Did we find a Fx pelvis?

Is the pt unCx?

If the pt is unCx I would not use a traction splint anyway (contraindicated) It is a load and go, no time for fancy equipment.

If a Pelvic Fx was found, I would scoop him onto a backboard with a sheet on it to swath around the unstable pelvis. Then Immobilize the spine, load and go. There is no good way to asses the back using this method but I cannot justify rolling a pt with an unstable pelvis.

[courageheartx]

What does traction splint have to do with moving the patient? You've said nothing to indicate it's even necessary.

If you're scooping, you better pray like hell that there is nothing significant on the back that's going to surprise the hospital because you never looked.

what if you did have a femur fx, would you splint and stabilize it before moving the patient?

[courageheartx]

I need a little more info...

Did we find a Fx pelvis?

Is the pt unCx?

If the pt is unCx I would not use a traction splint anyway (contraindicated) It is a load and go, no time for fancy equipment.

If a Pelvic Fx was found, I would scoop him onto a backboard with a sheet on it to swath around the unstable pelvis. Then Immobilize the spine, load and go. There is no good way to asses the back using this method but I cannot justify rolling a pt with an unstable pelvis.

the pelvis is definetly unstable.the pt is conscious but dazed a little bit. after all he was just hit by a car.

[courageheartx]

so you would just not asses the back for injury?

[Doczilla]

You can provide manual stabilization on the femur fx while you look at the back and simultaneously place the backboard. Don't spend too much time immobilizing the leg. You need to scoop and scoot.

'zilla

[courageheartx]

You can provide manual stabilization on the femur fx while you look at the back and simultaneously place the backboard. Don't spend too much time immobilizing the leg. You need to scoop and scoot.

'zilla

thanks. so then you would load and go,stabilize while en route?

[mobey]

OK Cx pt, confused, with unstable pelvis, and femur Fx right?

I will be interested in how to do this better...

But no I would not get a good back assessment.

Manual C-Spine w/collar, Scoop onto backboard, swath pelvis with sheet, Fully immobilize, Load and go. Enroute splint femur with whatever splint set is handy. No I will not put a traction splint on a femur with an unstable pelvis, nor on a confused Pt. Splinting this pts leg is not a high priority, He is confused and could be bleeding in so many places I don't have time to name them all. Confusion tells me possible head injury (combined with MOI), Fx pelvis and femur spell S H O C K.

I have left out all other treatments, this is just about splinting.

[Scaramedic]

Have some one maintain manual traction on femur, have sam sling on board, roll patient onto board. Secure pelvis with sam sling and place hare traction. Total time: < 2min. Take pt woo hoo to hospital calling trauma alert. Drop off pt, do paperwork. Finish 12" Subway Meatball Sandwich. Clear from hospital.