How To Evaluate The Severity Of A Bone Injury In The Field?

Assessing Deformity and Function Loss

When evaluating a bone injury, quickly assess the affected limb for deformity, such as angulation, rotation, or shortening. Measure the affected limb against the unaffected one to determine the extent of deformity. If the deformity is severe, apply a temporary splint to stabilize the area. Assess the patient’s ability to bear weight, flex, or extend the affected limb, as significant function loss may indicate a more severe injury.

Applying the P-A-T-T-I-E-R Criteria

Apply the P-A-T-T-I-E-R criteria to further assess the severity of the bone injury:

• Pain: Evaluate the patient’s pain level, as significant pain may indicate a more severe injury.
• Angulation: Measure the degree of angulation in degrees, aiming for 10-20 degrees of acceptable deviation.
• Tenderness: Assess the tenderness around the affected area, as significant tenderness may indicate soft tissue damage.
• Temperature: Check the affected area for warmth or coolness, as significant temperature changes may indicate infection.
• Inflammation: Assess the presence of swelling, redness, or bruising around the affected area.
• Edema: Check for significant swelling or edema, which may indicate a more severe injury.
• Range of motion: Assess the patient’s ability to move the affected limb through its full range of motion.
• Instability: Evaluate the stability of the affected limb, as significant instability may indicate a more severe injury.

Prioritizing Injuries and Evacuation

Prioritize injuries based on the severity of deformity, open wounds, or neurovascular compromise. If the injury requires immediate medical attention, evacuate the patient as soon as possible. If the injury is not immediately life-threatening, apply an improvised splint or traction device to stabilize the affected limb and manage pain.