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Immediate priorities
Stabilization priorities
Airway and ventilation compromise from polytrauma
If altered mental status or impending airway compromise, RSI pathway
Hemorrhagic shock triggers
If SBP < 90 mmHg or shock index > 1, massive hemorrhage pathway
Concomitant injuries pattern
High-energy mechanism
Fall from height
Analgesia early
If severe pain, IV opioid titration with monitoring
If opioid-sparing needed, regional anesthesia pathway
Limb-threatening checks
Distal perfusion status
If absent radial pulse or cool hand, emergent reduction/splinting and vascular imaging
Compartment syndrome risk
If escalating pain out of proportion or tense compartments, emergent surgical consult
Open fracture contamination
If open wound, immediate antibiotics and tetanus protocol
Key decision points
Early stratification
Isolated closed fracture with intact neurovascular exam
ED splinting and outpatient ortho follow-up pathway
Open fracture
Immediate antibiotics
Urgent orthopedic consult for operative debridement
Neurovascular deficit
Radial nerve palsy documentation
Vascular compromise escalation
Polytrauma
Trauma team activation criteria
Monitoring and documentation
Essential documentation set
Neurovascular exam pre- and post-splint
Radial pulse
Capillary refill
Motor and sensory exam by nerve distribution
Skin integrity
Blistering
Threatened skin tenting
Pain trajectory
Worsening pain after splint as red flag
Imaging timestamps
Pre-reduction films if deformity severe and time allows
Post-splint alignment films
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.