ATLS
X-ray
CT – look for air in<unk> 
Trauma labs PRN
Those in which<unk>  penetration is unclear can have<unk>  loaded with either saline or methylene blue to look for extravasation from wound.
Debate on sensitivity and specificity – some say sensitivity is far too low.
However, negative<unk>  loading test was associated with 0% infection rate in one study with non-operative management.
For knees, 50 mL is standard (sensitivity 46%, increased with ROM).
>195 mL loading (very painful) needed for 95% sensitivity in small lacerations near the knee.
For elbows, 20 mL with range of motion gave 86% sensitivity, 40 mL gave 95%.
For ankle, 10 mL is average needed, 23 mL and 30 mL for 90% and 95% sensitivity.
A 2013 study suggests air in<unk>  on CT of periarticular<unk>  fracture is 100% specific and sensitive for a clinically significant open<unk>  compared to saline loading test- SLT(level III)
Study performed on 63 knee<unk> s
Patients in the study were still discharged with Augmentin 875 BID if CT/SLT negative
Debate on sensitivity and specificity – some say sensitivity is far too low.
However, negative<unk>  loading test was associated with 0% infection rate in one study with non-operative management.
For knees, 50 mL is standard (sensitivity 46%, increased with ROM).
>195 mL loading (very painful) needed for 95% sensitivity in small lacerations near the knee.
For elbows, 20 mL with range of motion gave 86% sensitivity, 40 mL gave 95%.
For ankle, 10 mL is average needed, 23 mL and 30 mL for 90% and 95% sensitivity.
>195 mL loading (very painful) needed for 95% sensitivity in small lacerations near the knee.
Study performed on 63 knee<unk> s
Patients in the study were still discharged with Augmentin 875 BID if CT/SLT negative
Open joint injury
Compartment syndrome
Open fracture
Contusion
Acute knee injury
Crush syndrome
Knee fractures
Degloving injury