EXTREMITY TRAUMA PROTOCOL

Version May 20, 2022

Absolute Rules

Slow, controlled handling — rescuers only
Never ask the victim to assist you
Never move the injured limb(s)
Never apply ice directly on the skin
Properly padded splint — limb must not move inside

🫀 Absence of Circulation — Limb AxisIf the limb shows signs of absent circulation (loss of sensation + motor function + blue extremity): attempt to realign along its axis.
If pain occurs → stop immediately.

🩸 Open FractureAlso apply the hemorrhagic trauma protocol in case of open fracture.

🏋 Immobilization PrinciplesImmobilize the limb in the position found · Immobilize the joint above AND below the trauma · Check distal circulation before and after immobilization.

🧊 Ice — ApplicationNever apply ice directly on the skin. Use a protective towel. Recommended application: 15–20 minutes.

📊 Continuous ReassessmentFrequently reassess vital signs (ABC) as well as distal circulation, sensation, and motor function (CSM).

PROTOCOL — EXTREMITY TRAUMA

💍 Remove jewelry and clothing if possible
While maintaining cervical immobilization · Prevent edema from trapping jewelry

🦴 Immobilization of the Injured Limb

↑ Immobilize
joint ABOVE

🦴
TRAUMA

Immobilize
joint BELOW ↓

Immobilize the limb in the position found

Check CSM (Circulation · Sensation · Motor function)
before and after immobilization

If absent distal circulation (loss of sensation + motor function + blue extremity):
→ Attempt to realign the limb along its axis
→ If pain occurs: stop immediately

🩸 If open fracture:
→ Also apply the hemorrhagic trauma protocol

🧊 Apply ice on the trauma site
Always with a protective towel — never direct contact with skin

🌡 Cover the victim — warm blanket or space blanket
Prevent hypothermia and maintain comfort

📊 Frequently reassess vital signs (ABC)
Monitor distal CSM · Ensure the splint is not compressing

📞 Seek care at a hospital
by calling 911