Click to goto CDHA Public Site Click to goto DivEMS Dal Public Site Click to goto EHS Nova Scotia

Extremity Trauma

Date Last Search Run: Feb 01, 2022
Table last updated: May 26, 2021
Data last added: Apr 26, 2021

Recommendation RECOMMENDATION FOR INTERVENTION
STRENGTH OF EVIDENCE FOR INTERVENTION   SUPPORTIVE (Green) NEUTRAL (Yellow) AGAINST (Red) NOT YET GRADED (White)
1 (strong evidence exists)    
2 (fair evidence exists)      
3 (weak evidence exists)    


Interventions

Antibiotic (open fracture)
Level Direction Primary Outcome Patient/Process Setting Reference
III Supportive (Green) Safety Patient PH-Paramedic Lack W., Seymour R., Bickers A., Studnek J., Karunakar M. Prehospital Antibiotic Prophylaxis for Open Fractures: Practicality and Safety. PEC 2019; 23(3):385-8. Medline

Immobilize
Level Direction Primary Outcome Patient/Process Setting Reference

Procedural Sedation
Level Direction Primary Outcome Patient/Process Setting Reference
I Supportive (Green) Sedation time Process Nejati A., Moharari RS., Ashraf H., Labaf A., Golshani K. Ketamine/propofol versus midazolam/fentanyl for procedural sedation and analgesia in the emergency department: A randomized, prospective, double-blind trial. Acad Emerg Med 2011; 18(8):800-6. Medline
I Neutral (Yellow) Adverse events Patient ED-MD Cevik E., Bilgic S., Kilic E., Cinar O., Hasman H., Acar AY., et al. Comparison of ketamine-low-dose midozolam with midazolam-fentanyl for orthopedic emergencies: a double-blind randomized trial. Am J Emerg Med 2013; 31(1):108-13. Medline
II Neutral (Yellow) Procedural pain intensity Process PH-Paramedic & MD Galinski M., Hoffman L., Bregeaud D., Kamboua M., Ageron FX., Rouanet C., et al. Procedural Sedation and Analgesia in Trauma Patients in an Out-of-Hospital Emergency Setting A Prospective Multicenter Observational Study. PEC 2018; 22(4) 497-505. Medline
II Neutral (Yellow) Pain score reduction Patient Jamal SM., Fathil SM., Nidzwani MM., Ismail AK., Yatim FM. Intravenous ketamine is as effective as midazolam/fentanyl for procedural sedation and analgesia in the emergency department. Med J Malaysia. 2011; 66(3):231-3. Medline
III Supportive (Green) Pain and anxiety Patient Hoeffe J., Doyon TE., Bailey B., et al. Intranasal fentanyl and inhaled nitrous oxide for fracture reduction: The FAN observational study. Am J Emerg Med 2017; 35(5):710-5. Medline

Traction Splint for femur
Level Direction Primary Outcome Patient/Process Setting Reference


[ PEP Database - Table of Contents ] [ Email: PEP@Dal.ca ]