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Prehospital Care of Orthopedic Injuries

Published online by Cambridge University Press:  28 June 2012

Eitan Melamed ,
Amir Blumenfeld ,
Boaz Kalmovich ,
Yona Kosashvili ,
Guy Lin ,
Amir Korngreen ,
Igal Mirowsky ,
Rami Mosheiff ,
Dror Robinson  and
Moshe Salai
Eitan Melamed*
Affiliation:
Israel Defense Forces (IDF) Trauma Branch, Surgeon General Headquarters, IDF Medical Corps
Amir Blumenfeld
Affiliation:
Israel Defense Forces (IDF) Trauma Branch, Surgeon General Headquarters, IDF Medical Corps
Boaz Kalmovich
Affiliation:
Israel Defense Forces (IDF) Trauma Branch, Surgeon General Headquarters, IDF Medical Corps
Yona Kosashvili
Affiliation:
Israel Defense Forces (IDF) Trauma Branch, Surgeon General Headquarters, IDF Medical Corps
Guy Lin
Affiliation:
Israel Defense Forces (IDF) Trauma Branch, Surgeon General Headquarters, IDF Medical Corps
Amir Korngreen
Affiliation:
Trauma Service, Department of Orthopedic Surgery, Soroka University Medical Center, Beer-Sheba, Israel
Igal Mirowsky
Affiliation:
Chief of Spine Surgery, Department of Orthopedic Surgery, Assaf-Harofe Medical Center, Zrifin, Israel, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Rami Mosheiff
Affiliation:
Trauma Service, Department of Orthopedic Surgery, Hadassah Medical Center, Jerusalem, Israel, Hebrew University School of Medicine, The Hebrew University, Jerusalem, Israel
Dror Robinson
Affiliation:
Department of Orthopedic Surgery, Rabin Medical Center-Golda Campus, Petahtiqua, Israel, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Moshe Salai
Affiliation:
Department of Orthopedic Surgery, Rabin Medical Center-Beilinson Campus, Petahtiqua, Israel, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
*
IDF Trauma Branch PO Box 02149 Israel E-mail: [email protected]
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Abstract

Orthopedic injuries are predominant among combat casualties, and carry the potential for significant morbidity. An expert consensus process (Prehospital care of military orthopedic trauma: A consensus meeting, Israel Defense Forces Medical Corps, May 2003) was used to create guidelines for the treatment of these injuries by military prehospital providers. The consensus treatment guidelines developed by experienced orthopedic trauma personnel from leading trauma centers in Israel are presented in this paper.

For victims with open fractures, the first priority is hemorrhage control. Splinting, irrigation, and wound care should be performed while waiting for transport, or, in any scenario, in the case of an isolated limb injury. The use of traction splints was advocated for both the rapid transport scenario (up to one hour from the time of injury to arrival at the hospital) and the delayed transport scenario. In the urban setting, traction splints may not be necessary. Any victim experiencing pelvic pain following a high-energy mechanism of injury should be presumed to have an unstable pelvic fracture, and a sheet should be tied around the pelvis. The panel agreed that field-reduction of dislocations should be avoided by the medical officer unless it is anticipated that the patient will need to go through a long evacuation chain and the medical officer is familiar with specific reduction techniques.

Keywords

bone injurycircumferential sheetdislocationsfracturesorthopedic injuriespelvic injuriesprehospital caresplinting
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 22 , Issue 1 , February 2007 , pp. 22 - 25
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2007

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