<b>If polytrauma</b><br>ffAssess and manage airways ffAssess and treat shock (see section 1.1.2)}<b>Closed fractures</b><br>ffAssess nerve and blood supply distal to the injury: if no sensation/pulse, refer as an emergency ffImmobilise the affected part with a splint ffApply ice or cold compresses ffElevate any involved limb - ffGive an analgesic e.g. paracetamol 1 g every 6-8 hours to relieve pain Child: 10 mg/kg every 6-8 hours ffFor severe pain, use opioids stat –– Morphine 5-10 mg IV or Pethidine 50-100 mg IM ffRefer to hospital for further management}<b>Open fractures</b><br>ffStop any bleeding by applying pressure ffClean open wound and cover with sterile dressing ffGive Tetanus Toxoid if not fully vaccinated ffStart antibiotic –– Amoxicillin 500 mg every 8 hours Child: 25 mg/kg every 8 hours (or 40 mg/kg every 12 hours)}<b>If severe soft tissue damage</b><br>ffAdd gentamicin 2.5 mg/kg every 8 hours ffRefer URGENTLY to hospital for further management