Date Published

September 11, 2017

Updated For

ALS PCS Version ALS PCS Version 5.2


Question: In regards to the BLS version 2.0 - extremity injury, bone/joint, there's a guideline regarding elbow dislocations. It says that if we encounter an elbow dislocation with nerovascular compromise, that we can contact receiving hospital or Base Hospital Physician for advice regarding manipulation or in-line traction. In the new BLS 3.0, this guideline has been left out. Are we still expected to perform the guideline if we ever encounter this, or has this been purposely taken out? Thank you.


As per the BLS 3.0:

In situations involving a patient with an extremity injury, the paramedic shall:

    1. splint injured extremities, as follows: a. assess distal circulation, sensation, and movement before and after splinting,
    b. splint joint injuries as found,
    c. notwithstanding paragraph 1(b) above, if the distal pulse is absent or the fracture is severely angulated, apply gentle traction; if resistance or severe pain is encountered, splint as found.



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