Ortho

Deformed limb / cannot bear weight

CCMS-MED-SOP-001 §13

Deformity, point tenderness, open wound, or a child who will not use the arm. Image if there is doubt. You splint; you do not diagnose in the hallway.

1. 1

   Neurovascular check: pulse, capillary refill, sensation, motor — before and after you splint.

2. 2

   SAM splint or equivalent: pad, shape, immobilize the joint above and below, recheck NV, ice, position of comfort.

3. 3

   Open fracture: cover, 911, do not 'reduce' in the foyer unless a clinician owns a pulse-threatening deformity.

• Nursemaid's elbow is a toddler holding the arm pronated after a pull, no swelling. Reduction is a clinician skill. If there was a fall or there is swelling, treat as fracture.

This field guide does not replace 911, a medical director, or licensed clinical judgment. It does not authorize anyone to practice beyond license and current training.