Obvious signs of injury such as loss of muscle strength in the arms or legs or loss of sensation can be ominous. Ideally, someone with medical training should examine the patient. The mechanism of injury can give a clue as to whether a spinal injury is likely. In these situations, patients should be placed flat and logrolled until they can be evaluated by medical personnel, because attempted transport by those untrained can lead to neurologic injury. Evacuation may be necessary.
Open fractures are emergency orthopedic injuries.
In this high-energy fracture, the bone penetrates the skin and is thus exposed to the outside environment, including contamination with local debris and bacteria. Pressure dressings should be placed to keep the bone ends clean, and any gross deformity should be minimized and splinted if possible. Transport time is critical to reduce the risk of infection. Patients should be quickly moved by ground or air transport to the nearest medical center. There are many excellent references about how to cope with injuries in the backcountry.