Crushed and Mangled Extremities

Tetanus Toxoid Intravenous Antibiotics Posi Z-Splint (Position of Safe immobilisation Splint) Elevation of the Limb


Initial Management

  1. Resuscitate the patient according to ATLS principles with the emphasis on cardiovascular support
  2. Tetanus prophylaxis
  3. Initiate prophylactic antibiotic (Cefazolin)
  4. Irrigate wounds with saline and remove macroscopic contaminants. Wounds can be covered with saline dressings or saline.
  5. Request x-rays of the injured part of the limb.
  6. The limb should be immobilised with a POSI Z-splint
  7. Refer appropriately to a tertiary specialist hand surgery unit as soon as possible.