Management of Limb Injuries

Management of Limb Injuries

During disasters and conflicts

In disasters, up to 90% of the surgical workload faced by national and international emergency medical teams involves limb injury. The need has never been greater for clear practical guidance for surgical teams to practice safe, effective limb injury care fit for the context of conflict or disaster, and not necessarily what they do in normal daily practice.

The WHO Emergency Medical Team (EMT) Initiative helps countries and NGOs to set up teams that will be able to maintain agreed standards of quality and self-sufficiency, resulting in better patient care. With more teams striving to reach these standards, clear guidance on best practice is needed, particularly for managing patients with limb injuries, which make up the majority of cases.

Read more on the WHO Emergency Medical Teams website.

Read the book online



Content by chapter

  • 1. Context


    Phases of disasters

    Burden of disease in sudden onset disasters

    Earthquakes / Tsunamis / Floods

    Healthcare in danger

    Patient factors

  • 2. Ballistics

    Ballistics & Energy


    Bullet wounds

    Blast injuries


    Sample content
  • 3. Logistics, field support and training

    Logistics and self-sufficiency

    Logistics standards

    Training for EMTS

    Considerations for training

  • 4. Anesthesia and perioperative care

    Initial assessment

    Pre-operative care

    Post-operative care


    Pain management and patient record

  • 5. Damage control surgery and resuscitation

    Principles of damage control surgery and resuscitation

    Resuscitation and pelvic fractures

    Diagnosis and management

    Placement of anterior frames for pelvic fractures

  • 6. Limb wounds

    Wound management

    Wound surgery

    Wound debridement by layers


  • 7. Closed fractures

    Closed fracture management


    After-care and follow up

    Removing casts


    Paediatric considerations

    Transfers Management of closed fractures with internal fixation

  • 8. Open fractures

    Wound debridement

    Fracture stabilization

    External fixation for open fractures

    Management of open fractures

  • 9. Compartment syndrome and crush syndrome

    Compartment syndrome diagnosis

    Compartment syndrome treatment

    Crush syndrome

    Crush syndrome management in SODs

  • 10. Amputations

    Lower extremity amputations

    Specific technical considerations

    Upper extremity amputations

    Special considerations

    Complications of amputation

    Key messages regarding amputation

  • 11. Burns

    Clinical management of burns

    Surgical management of burns

    Chemical and electrical burns

  • 12. Ethics of healthcare in disasters and conflicts

    Main ethical theories

    Tools to deal with ethical dilemmas

    EMT guiding principles

    Research ethics in disasters

  • 13. Rehabilitation

    Acute care treatment

    Sub acute treatment

    Chronic-long term treatment

    Family involvement and equipment

  • Annexes

    ICRC ABCD initial assessment

    ICRC Burns Overview

    ICRC Thromboprophylaxis guideline

    ICRC Triage

    ICRC Femur Fracture and Traction

An initiative of the AO Foundation and the International Committee of the Red Cross. In collaboration with The World Health Organization EMT Secretariat