MedBugs: SAQ #104

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Case: Rural open fracture

A 34-year-old man has been brought to your rural ED after falling out of a tractor on his farm. He has sustained an isolated injury to his right lower limb.

$Rural open fracture$

1. a) List (6) features of the Gustilo Classification for open fractures. 6 marks

2. b) State (6) treatment priorities for this patient’s lower limb injuries. 6 marks

Atier your initial management, one of the nurses alerts you that the patient’s foot looks more pale than it did before, with reduced dorsalis pedis pulse. Your hospital CT scanner is currently being repaired and unavailable for use. You decide to perform an arterial pressure index utilising a bedside doppler US device.

3. c) Please complete the following equation. Arterial pressure index (API) = 1 mark

4. d) Please state (4) steps in performance of API of the injured lower limb. 4 marks

5. e) What API would be indicative of likely arterial injury? 1 mark

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