Paramedics may be called upon to care for patients with a variety of soft tissue injuries related to both minor and major trauma.  The term encompasses a broad range of conditions such as contusions, sprains, strains, tendinitis and bursitis.  The most commonly injured soft tissues include muscles, tendons and ligaments; complex injuries may involve multiple structures.  Common causes include falls, sports injuries, motor vehicle accidents or assaults.

• Paramedics should differentiate between acute and chronic injuries.  The latter are likely due to overuse, or may indicate a chronic pain syndrome.  Acute pain is generally less than six weeks duration.  Careful history taking is recommended.
• In acute injuries, maintain high index of suspicion for an associated fracture or dislocation
• If a fracture or dislocation is suspected, apply appropriate splinting and transport promptly
• Assess for neurovascular impairment and transport promptly if present
• In the case of head, back or neck injury apply spinal motion restriction guidelines as indicated

• Primary treatment consists of rest, ice, compression and elevation
• If open wounds are associated with the injury, irrigate with sterile saline and before applying appropriate sterile dressings
• Consider paramedic scope appropriate analgesia as indicated

Patients with minor injuries may meet local transport criteria for waiting room offload as directed by current policy.

• Conduct ongoing monitoring of neurovascular function and observe for signs of compartment syndrome
  • The anterior compartment of the lower leg is the most common site for development of compartment syndrome
  • The 6 P’s of compartment syndrome are a late sign (pain, pallor, pulselessness, paresthesia, paralysis, and pokilothermia)
• Avoid applying ice packs directly to the skin
• If the injury involves an ankle, assess using the Ottawa Ankle Rules

Minor Trauma