Open fractures
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Treating Open Fractures: A Step-by-Step Guide
Understanding Open Fractures
An open fracture occurs when a broken bone punctures through the skin, exposing the bone and creating a more complex injury than a standard fracture. **Open fractures present significant risks**, including severe bleeding and the high potential for infection.
Initial Challenges in Treating Open Fractures
When dealing with an open fracture, the primary concerns are:
- Bleeding: The exposed bone has likely caused severe skin lacerations, leading to significant blood loss.
- Infection: The broken bone end is exposed to the environment, making it an easy entry point for bacteria.
Steps for Managing an Open Fracture
1. Controlling the Bleeding
If the bleeding is severe, you may need to **apply a tourniquet**. In cases where an artery has been ruptured, blood may spurt from the wound, requiring immediate action to prevent life-threatening blood loss.
- Place the tourniquet just above the injury site. For example, if the fracture is below the elbow, position the tourniquet above the elbow.
- If the bleeding does not stop, you may need to apply a second tourniquet higher up the limb.
2. Applying a Haemostatic Agent and Dressing
After controlling the bleeding, the next step is to apply a **haemostatic agent** such as WoundClot. This helps to seal the wound and promote healing while also being easy for surgeons to remove later.
- Cover the exposed bone and surrounding wound with the haemostatic agent.
- Apply a trauma dressing over the top to secure the area.
3. Bandaging the Wound
When bandaging an open fracture, be cautious not to apply pressure directly on the bone ends, as this can cause further damage and increase pain. **Immobilise the limb** in its current position without attempting to push the bone back into the body.
Key Point: Each open fracture is unique, and treatment should be tailored to the specific injury. Focus on controlling the bleeding, preventing infection, and immobilising the limb until professional medical help arrives.
Final Considerations
Open fractures are severe injuries that require careful management to prevent complications. **Never attempt to reposition the bone yourself**. Instead, stabilise the injury, control the bleeding, and get the patient to emergency services as quickly as possible.