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368Re: [E-Chir] Scenario 5

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  • Bethoc (Lesley)
    Jan 22, 2010
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      Excellent points so far, especially the splinting and need for medical intervention (Xrays to diagnose and cast).
      A couple more things to consider..
      -closed wound, therefore you can put ice on it 15 mins on and off, with a cloth barrier to be nice to the skin
      -use a commercial sling or improvised sling to elevate and immobilize the limb to the body to prevent it from jostling around
      -keep fingertips visible for distal circulation check
      -NO use of traction.. just spint as you find it. Traction cannot be properly maintained without the use of specialized and expensive equipment
      -consider if this person is on blood thinners or has a bleeding disorder (internal bleeding may be more severe and/or serious sequelae)
      -remove rings/watches if any on affected limb
      -take a book with you/the casualty to the ER.. you/he may be waiting a long time
      wincing at what would be a lot of pain for this person,

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      --- On Tue, 1/19/10, Ninka <dyscordant_rose@...> wrote:

      From: Ninka <dyscordant_rose@...>
      Subject: [E-Chir] Scenario 5
      To: e-chir@yahoogroups.com
      Received: Tuesday, January 19, 2010, 8:29 AM

      You're spending the afternoon at your local fight practice. It's been a good fighting day with a fair number of fighters out happily hitting each other with sticks. While watching one of the fights you (and everyone else around you) notices that one of the newer fighters ends up blocking a shot with his forearm and he is not wearing vambraces. At first it doesn't seem as if there is a problem as the fighter actually throws a couple more shots before he notices something is wrong. Knowing that you are at the practice the fighter and a couple of his buddies walk over to you. You see that the injured fighter is cradling his left arm to his body and while he looks a bit pale he is gracefully accepting the razzing that his friends are giving him for actually trying to block a shot with his arm, not his sword or his shield. He sits down in a chair as he gets to you. On exam you notice that his left forearm is bruised, deformed and starting to swell. There is no bleeding or broken skin noted. He tells you that it feels like his bones are grinding together and that it hurts. A lot. He can move his fingers though it does increase his pain somewhat. He is not complaining of any numbness or tingling and his fingers are warm and pink below the injury site.

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