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Extremity Trauma

Identify and treat fractures and soft tissue injuries in a tactical environment.

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Identify and treat fractures and soft tissue injuries in a tactical environment.

Closed Wounds

Musculoskeletal – Causes


Acute sprains and strains


Musculoskeletal Presentation




Temperature change


Loss of function

Musculoskeletal Evaluation


Physical examination

skin breaks




distal pulses

sensory exam

motor exam

Musculoskeletal Treatment





Analgesic & Anti-inflammatory


Ibuprofen (Motrin/Ranger Candy)



Any break in the continuity of a bone

May vary from a simple crack to a completely shattered bone

Other Injuries


Discoloration caused by bleeding in tissue

Blood migrates toward skin and changes color with time


Surrounded by joint capsule and ligaments, muscles and tendons


Disruption of a joint such that the bone ends are no longer in contact

Torn ligaments and capsule

Common Dislocations






Knee Joint

Femur, Tibia, and Patella

Largest hinge joint in body

Held together by complex ligaments

Susceptible to injury

Knee Injuries

Ligaments and cartilage injuries are common

Swelling, pain, limited ROM

Frequent athletic injury

Splint entire femur and tibia

Dislocation of the Knee

Severe deformity

Popliteal artery commonly injured

If pulse is present, splint in deformed position

If pulse is absent, attempt once to realign limb and splint where pulse is strongest (RGR MEDIC)

Dislocation of the Knee

Ankle Injuries

Usually result from twisting, indirect force

Fracture, dislocations, sprains can occur

Swelling and deformity

Note circulation

Immobilize with padding and splint


Partial, temporary joint dislocation

Ligaments torn or stretched

May produce discoloration


Management of Closed Injuries

R – Rest

I – Ice

C – Compression

E – Elevation

S – Splint (SAM Splints and cravats or ACE wraps)

R/O fracture

Soft Tissue Injuries

Open – Violation of overlying skin or mucous membrane



Although quite common, rarely life threatening

First priority in management same for all patients ( A,B,C’s)

RICES for most soft tissue injuries

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