Prehospital Fracture Management
Assessment and management of fractures in the prehospital setting
Prehospital fracture management is a key component of trauma care, focusing on early recognition, assessment, and stabilisation of bone injuries before arrival at hospital. Prompt and appropriate management helps reduce pain, prevent further tissue damage, and minimise complications such as neurovascular compromise.
This resource explores the principles of prehospital fracture care, including assessment of mechanism of injury, limb alignment, immobilisation, splinting, and ongoing neurovascular monitoring. Designed for paramedics, EMTs, ECAs, and first responders, it supports safe, effective decision-making and high-quality patient care in the prehospital environment.
Prehospital Fracture Management – Articles
Prehospital Fracture Management – Resources
🔗 JRCALC Clinical Guidelines
Official UK prehospital guidance covering the assessment and management of fractures, including limb alignment, immobilisation, analgesia considerations, neurovascular assessment, and safe transport decisions.
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Prehospital Fracture Management – Did You Know?
Pain control improves fracture outcomes
Early and effective analgesia can reduce physiological stress, improve patient cooperation, and make splinting and immobilisation safer and more effective.
Neurovascular checks are time-critical
Fractures can compromise circulation and nerve function. Early and repeated neurovascular assessment helps identify limb-threatening complications such as compartment syndrome.
Immobilisation reduces further tissue damage
Proper splinting limits movement at the fracture site, reducing pain, bleeding, and the risk of additional soft tissue and neurovascular injury.
Realignment may be necessary before splinting
Grossly deformed fractures may require gentle realignment to restore circulation and reduce pain before immobilisation and transport.
Swelling can worsen rapidly
Swelling often increases after injury, so splints and bandages should be reassessed regularly to avoid circulatory compromise during transport.
Prehospital Fracture Management – CPD Reflection Prompts
Reflective practice is a key part of continuing professional development (CPD) and clinical improvement. Use these prompts below to guide your self-reflection on a recent prehospital fracture management case.
Reflect on a recent prehospital fracture intervention, such as limb assessment, immobilisation, splinting, analgesia, or realignment prior to transport:
- jWhat went well during your initial assessment of the suspected fracture?
- jHow effective was your pain management strategy in supporting patient comfort and cooperation?
- jHow did your choice of immobilisation or splinting technique align with current guidance?
- jWhat challenges did you encounter when managing the fracture (e.g. deformity, swelling, environment, patient distress)?
- jHow did you assess and monitor neurovascular status before and after immobilisation?
- jHow did patient factors such as age, comorbidities, mechanism of injury, or multiple injuries influence your approach?
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Consider writing this reflection in your CPD portfolio or ePortfolio using the Gibbs Reflective Cycle or What? So What? Now What? framework. This reflective exercise not only enhances clinical self-awareness but also provides documented evidence of learning that can count towards your annual HCPC CPD requirements. Keeping detailed, structured reflections like this is essential for maintaining your registration and demonstrating safe, effective, and reflective practice as a healthcare professional. This can count toward your annual HCPC CPD requirements.
Prehospital Fracture Management – FAQs
Frequently Asked Questions about Prehospital Fracture Management in Paramedic Practice
What is prehospital fracture management?
Prehospital fracture management refers to the assessment and early care of suspected or confirmed fractures before arrival at hospital. This includes recognising injury patterns, providing analgesia, immobilising the affected limb, assessing neurovascular status, and preparing the patient for safe transport.
Why is early fracture management important?
Early fracture management helps reduce pain, prevent further tissue damage, minimise bleeding, and lower the risk of complications such as neurovascular compromise or compartment syndrome.
Should all fractures be immobilised?
Most suspected fractures should be immobilised where possible to limit movement and reduce pain. Immobilisation should include the joints above and below the injury, unless this causes excessive pain or is not feasible due to patient condition or environment.
Is realignment required before splinting?
Grossly deformed fractures may require gentle realignment to restore circulation, reduce pain, or allow effective splinting. Realignment should only be performed when clinically indicated and within scope of practice.
How often should neurovascular checks be performed?
Neurovascular status should be assessed before and after immobilisation and reassessed regularly during transport. Changes in sensation, movement, colour, temperature, or pulses require urgent reassessment.
