Wilderness and Rescue Medicine 8th Edition

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Section IV: Trauma

General Principles

Unstable Injury Wilderness Perspective

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• Persistent ischemia • Significant deformity • Femur fracture • Pelvic fracture • Compartment syndrome High - Risk Problems:

• Open fracture • Joint infection

Low Risk

High Risk

© 2018 WMA

Splints and wraps are applied where necessary to reduce the risk of further soft-tissue trauma in unstable musculoskeletal injury. At the same time, they can create an increased threat to the patient’s safety and survival. A sling and swathe, for example, can inhibit a skier’s ability to negoti- ate a cliff band safely. Backboard or litter stabiliza- tion can drown a patient on an overturned boat. Sometimes the benefit of a stabilized injury does not match the overall risk to the patient and the plan must be modified.