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EMSNation Ep. #83 BLS Immobilization of Extremity Injuries- Initial Pain Management Intervention

Visit our website for more podcast episodes on Evidence Based Medicine: http://emsnation.org/ In this segment, we show how to properly immobilize an injury to the shoulder and later a lower extremity injury. The proper immobilization of the injury is a first and significant step to pain management in our patients and is not to be overlooked. This video will show a step by step process of applying a cravat and a swathe. The cravat can be applied by sneaking point end under arm to shoulder, wrapping arm with other half and bring it to the shoulder on the other side, tying a knot at the elbow, and we can improve comfort by padding behind the neck before tying the knot. Wrapping a swathe around the arm with padding can further help immobilize the shoulder. As we are evaluating and securing the injury we want to assess CSM before and after the application of the sling and swathe. The second part of this video will show how to apply a padded board splint with 4 cravats while maintaining immobilization. Fully deploying the cravat while someone is holding the limb and using an ankle hitch technique can help minimize movement. When tying the knot, moving it over the wood can help for easy removal later in the ED. Although you may be discouraged that immobilization is often removed in the ED, proper immobilization techniques can make a large difference when the patient needs it most in the field and during transport! 0:23 Proper immobilization of a shoulder dislocation with a sling and a swathe 0:54 Assessing CSM of the injured limb 1:05 Application of a cravat 1:59 Adding padding under the knot 2:19 Tying and reinforcing the knot 2:43 Applying a swathe with padding under the knot 3:30 Reassess for CSM 3:43 BLS pain management with proper immobilization 4:28 Tips for splints: padding voids, making sure the splint is snug 4:44 Simulation of properly stabilize a lower extremity fracture with padded board splints 5:14 Applying 4 cravats using the full length 6:05 Applying the padded board splint with proper knot and placement over the wood 6:48 Applying an ankle hitch 7:30 Tips for reassessment 7:53 Discussion/use of this video Subscribe to iTunes: https://itunes.apple.com/us/podcast/e... Like us on Facebook:   / prehospitalnation   As EMS Medical Directors we value the incorporation of best practice and evidence-based medicine into delivering high quality prehospital care. The Statewide protocols present a historic opportunity for us to collectively take our game to the next level. We have worked hard to make these videos worth your while. We value your time as an EMS provider and using simulation videos as scaffolding to help bridge your knowledge of the new protocols can be invaluable. There is, however, no substitute for reviewing the new protocols you will be exercising in depth. It is challenging to produce something for a wide range of providers from new CFRs and new EMS physicians to experienced providers; nevertheless BLS is the keystone of all of our practice and we set out to give it the attention it deserves. New providers will notice language and terms that may be challenging but understandable from the context or definitions provided within. We encourage providers who have participated in our educational initiatives in the past to view this video series with a critical eye. Experienced providers are likely also teachers and field training officers. In that role, look for things that you could use to teach your students. Also, look for things that the actors could do differently in their scenarios and think about how you would address them if they were your trainees. As a note, while these videos all have lessons and take away learning points, many are intentionally designed to present patient care that could in fact be provided better. Whether paid or volunteer, we wish you the best of luck in your EMS career. It is a noble field filled with many challenges. Be safe and never stop learning. We also wanted to specifically thank our partner in production of these videos - Laerdal Medical Corporation. Their mission – Helping Save Lives – could not be more tantamount when discussing the nature of BLS care. Learning to incorporate simulation into one’s regular practice can initially be challenging; however, a consistent well-designed program can be invaluable to providers in advancing multiple modalities of care from specific skills to psychosocial training and empathic communication. Follow us on Twitter:   / ems_nation