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Thread: Thoughts on fractured bones

  1. #1
    Member ironartist's Avatar
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    Default Thoughts on fractured bones

    here's a cool web site I ran across, http://www.doomandbloom.net/2012/03/...es-part-2.html
    Visions Steel/841-WELD(9353)
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    Member greythorn3's Avatar
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    thanks allot iron!
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    I have to throw in a BIG caution and red flag here. That website is talking about providing medical treatment in less than optimal situations, as opposed to Emergency Care in the field.


    If one is in the field and has a partner with a suspected broken bone, the care is different depending on the type of fracture. Either way, we cannot fix the broken bone in the field even if we are a surgeon! Trying to blindly reduce a fracture (or dislocation) can cause internal bleeding and nerve damage.


    You care for a broken forearm differently than you do a femur fracture. Open (compound) fracture is different than closed. The only time one should try and "reduce" a fracture in the field is if there is compromised CMS (Circulation, Motion, Sensation) distal of the fracture, and obvious deformity. In that case you should pull slight traction and attempt to re-align (as opposed to reduce) ONE TIME. Then recheck CMS. If it is improved then great, mobilize with a splint and deal with transport/evacuation. If not, then "bummer, this is worse than we thought" mobilize with a splint and deal with transport/evacuation asap! Truth is, the guy probably won't let you pull and twist on it until you THINK you've got it right anyway. If he does, you could end doing more damage than if you'd have just splinted it in the first place.


    A femur fracture is a different animal all together. It is a life threatening injury, a broken arm is not. A traction splint MUST be applied to prevent the quads from going into spasms causing the broken femur to slice up the femoral artery which will lead to the person bleeding to death.


    Bottom line is. Don't read an article like this and think that is how you should care for someone injured in the field. Our goal is to stabilize the person as best we can with what we've got, cause no further harm and then get them to definitive medical care asap. Not to try something we read on a blog….


    There's a big difference between providing emergency care and playing doctor. Learn the basics first.

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    Fantastic post and much better articulated than what came to my mind. Mitigate bleeding, immobilize breaks and evacuate! This is the protocol that has saved thousands of lives in Iraq and Afghanistan compared to past wars. Even in a catastrophic disaster medical care would be available within the time frame needed to handle most any break as long as you can minimize bleeding, insure breathing, control shock and eliminate movement. The info depicted in that doomsday blog induces movement, increases bleeding and will likely send the patient into shock. Probably be more humane to just start by putting a pillow over their head and take care of the breathing part too.

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    Member AlaskaHippie's Avatar
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    Agreed with Snyd and Lujon.

    There are classes available out there for First Responders that would be a valuable resource.

    People spend a LOT of time learning to be proficient in medical care, and other fields, hence the term "Expert". Those are the folks you want to learn from.
    Last edited by Brian M; 03-10-2012 at 09:38.
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    Quote Originally Posted by LuJon View Post
    ...Even in a catastrophic disaster medical care would be available within the time frame needed to handle most any break as long as you can minimize bleeding, insure breathing, control shock and eliminate movement. The info depicted in that doomsday blog induces movement, increases bleeding and will likely send the patient into shock....
    And in a mass casualty situation one needs to know triage so you don't spend time trying to save those who will die anyway and while your spending time doing that, the ones you could have saved die.

    I could see a place for the info in the blog but only if you are in an area where you are forced to play doctor. Like a remote village with no chance of care for months. Then were talking about "home remedy" doctoring, not emergency care.
    A gun is like a parachute. If you need one, and don’t have one, you’ll probably never need one again

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    Member ironartist's Avatar
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    Quote Originally Posted by Snyd View Post
    were talking about "home remedy" doctoring, .
    <BR>This is exactly right someday it might be all we have access to or here your telling me someone like bushrat or other remote folks wouldn't hesitate setting a minor broken bone, come on man I wouldn't hestitate having someone help me if that's what there was, in a hot minute.
    Last edited by Brian M; 03-10-2012 at 09:38.
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    Easy there Iron. I'm merely pointing out the difference between emergency care versus playing doctor. Two different situations. Even in the bush in Alaska the basic principals I described are the same. If one chooses to set their own broken bone and stay in the bush, they've probably made that choice long before they ever got injured. And they are willing to live with the consequences of things not healing up the best they could if they could have gotten better medical care.

    For probably 99% of the people reading this forum, the worst thing they can do is try to play doctor and set a broken bone. I'm talking outside of the medical field.
    A gun is like a parachute. If you need one, and don’t have one, you’ll probably never need one again

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    Member ironartist's Avatar
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    Your the pro, thats fine and I do understand your point, but somtimes redneck ways do work, I relocated a dislocated shoulder out in the woods cause that is what I had to do.
    Last edited by Brian M; 03-10-2012 at 09:39.
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    I'm trying to understand here (every post except the first one).

    "Knowledge is bad because someone might mis-use it?"

    If I had blurted that out, I would hope someone would ask me to reconsider, because that's an argument to burn all books.

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    Default Caution, Non Zombie Links Inbound*.....

    http://www.climbalaska.org/wfr.html <--Schedule of Wilderness First Responder Classes in SouthCentral.

    http://www.heroforlife.com/ <--Link to CPR/BLS classes in SouthCentral

    http://www.avtec.edu/cna-a.htm <-- CNA Classes Available in SouthCentral

    http://www.multimedalaska.com/courses.html <-- EMT Certification Classes Available in SouthCentral


    *Except this one:
    http://www.nursesagainstzombieism.com/ <-- What will most likely be classified as "educashional" by a certain demographic.
    “Life has become immeasurably better since I have been forced to stop taking it seriously.” ― H.S.T.
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    Reading a blog on setting fractures hardly qualifies as "learning". The whole thing was so full of bad info it borders on down right dangerous. I have set up hospitals in hostile areas that provided patient care that is second to none. I am acutely aware of our capabilities! Given a few hours I can hit the ground and have an imaging department set up and your xrays in front of a specialist at Johns Hopkins or the Cleveland Clinic if needed.

    If you have circulation you are FAR better off immobilizing the fracture and seeking medical attention. We have X-ray systems that fit into a suitcase and expandable surgical suites that are the size of a connex and can be shipped out via aircraft at a moments notice. Broken bones in almost all cases short of spinal injuries aren't going to change significantly even if you have to wait for a week.

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    Member ironartist's Avatar
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    lujon these flying ambulances are just gonna show up out at hunting camp for a broken finger? Set it already, wrap it up and and go fricken kill something who are you kidding, I'm a redneck
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    http://orthoinfo.aaos.org/topic.cfm?topic=a00257

    From the above link:

    "If you think a broken (fractured) finger is a minor injury, think again. Without proper treatment a fractured finger can cause major problems. The bones in a normal hand line up precisely. They let you perform many specialized functions, such as grasping a pen or manipulating small objects in your palm. When you fracture a finger bone, it can cause your whole hand to be out of alignment. Without treatment, your broken finger might stay stiff and painful."
    “Life has become immeasurably better since I have been forced to stop taking it seriously.” ― H.S.T.
    "Character is how you treat those who can do nothing for you."

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    Member ironartist's Avatar
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    Some of us can deal with pain more than others, if you'd rather wait a week or 10 days to get it fixed the more power to ya, I'd be all for fixing it myself
    Visions Steel/841-WELD(9353)
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    Moderator hunt_ak's Avatar
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    Quote Originally Posted by AlaskaHippie View Post
    Much like live fire drills on public land with unqualified instructors
    I've help set up two firearms courses this year with one of the best instructors in the nation if anyone is interested....

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    "Splint Them Where They Lie". That is what's taught in all the First Aid, Combat Life Saver and Tactical Combat Casualty Care classes where dealing with this is sometimes a daily occurance. Yes, for you old timers (retirees), CLS is now TCCC. There is no way of telling what type of internal damage has been done with a broken bone. It could be a simple fracture, a break or a compound fracture but that one you will know from the bone sticking out. You could unknowingly do more harm than good. Stop the bleeding if there is any, splint it, elevate it and evac.
    "...arms like laws discourage and keep the invader and plunderer in awe...Horrid mischief would ensue were the good deprived of the use of them." -Thomas Paine

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    Quote Originally Posted by FamilyMan View Post
    I'm trying to understand here (every post except the first one).

    "Knowledge is bad because someone might mis-use it?"

    If I had blurted that out, I would hope someone would ask me to reconsider, because that's an argument to burn all books.
    No... "Bad knowledge is bad especially when someone uses it"
    A gun is like a parachute. If you need one, and don’t have one, you’ll probably never need one again

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    Quote Originally Posted by AlaskaHippie View Post
    http://www.climbalaska.org/wfr.html <--Schedule of Wilderness First Responder Classes in SouthCentral.

    http://www.heroforlife.com/ <--Link to CPR/BLS classes in SouthCentral

    http://www.avtec.edu/cna-a.htm <-- CNA Classes Available in SouthCentral

    http://www.multimedalaska.com/courses.html <-- EMT Certification Classes Available in SouthCentral


    *Except this one:
    http://www.nursesagainstzombieism.com/ <-- What will most likely be classified as "educashional" by a certain demographic.
    I started a sticky for links like this. I'll put these there. Well, except the Zombie link.... that one can die...
    A gun is like a parachute. If you need one, and don’t have one, you’ll probably never need one again

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    Quote Originally Posted by ironartist View Post
    Some of us can deal with pain more than others, if you'd rather wait a week or 10 days to get it fixed the more power to ya, I'd be all for fixing it myself

    Quote Originally Posted by ironartist View Post
    lujon these flying ambulances are just gonna show up out at hunting camp for a broken finger? Set it already, wrap it up and and go fricken kill something who are you kidding, I'm a redneck
    I think this is where the confusion is. No one is saying don't provide care. If you break your finger hunting. You can't really fix it in the field, all you can do is immobilize it. If it is deformed and you have a loss of sensation or circulation at the tip of your finger, then you know you've got some possible nerve and blood vessel damage. Go ahead and attempt to "re-align" it and see if that helps with the compromised CMS. If it doesn't do any good, you can pull on it all day long and do nothing more than cause more damage. Once you've attempted the re-alignment, splint it and go kill something! But when you get home, go to the doc so they can "set" it properly. They can make sure the bone ends are lined up properly so it will heal correctly and that there is no nerve impingement. Again, if you live in a remote area where you are never going to be able to get medical attention then it may heal or may not heal properly.

    There are techniques for reducing a dislocated shoulder. But, if you don't know what your doing and you start yanking on someones arm in the woods, you could end causing permanent nerve damage and they may never be able to use their hand again. All the nerves that go down your arm are bunched up in there. I've had a dislocated shoulder and dang near passed out from the pain and could'nt feel my fingers. If you can get help coming or get them out of the woods it's your best bet to use blankets, game bags, duct tape, whatever to stablize it in the position of most comfort. Most people wont hardly let you touch them let alone yank on it. Obviously there can be extenuating circumstances especially if your dealing with someone who has a history of shoulder dislocation.

    It sounds like you want to be able to do some of this stuff. Take an EMT and or a wilderness first responder course. That's a good start. You'll learn a bag of tricks you can use depending on the situation. If you're a downhill skier join your local Ski Patrol. Then not only do you learn the stuff but you get to actually use the skills both in on hill practice/training and real life. You'll find out how much yanking a pulling someone will let you do!
    A gun is like a parachute. If you need one, and don’t have one, you’ll probably never need one again

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