Acute and Complex musculo-skeletal injuries

Question 1

What are the priorities for assessment of an acute MSK injury?

Answer 1

A - airway

B - breathing: Sats and RR

C - circulation: HR, BP

D - Disability: spinal trauma, glucose

Question 2

How do you describe a fracture?

Answer 2

Anatomical structure

Position

Type: simple or comminuted

Direction: eg tranverse or oblique

Displacement

Question 3

When might you give tetanus immunoglobulin for a fracture?

Answer 3

If not vaccinated

Question 4

What are some causes of raised BP in acute MSK injury patient?

Answer 4

Pain

Raised ICP

(Recreational drugs)

Question 5

What are the standard post-op orders?

Answer 5

D - diet (nil by mouth)

A - activity eg weight bearing

V - vitals (infrequency of monitoring)

I - IVs, fluids, balance

D - drugs, drains and dressings

Question 6

How can you identify an aortic injury on CXR?

Answer 6

Distended knuckle of aorta

Question 7

What are the trauma series imaging?

Answer 7

CXR

Pelvic XR

(Lateral cervical spine XR)

Question 8

What are some pain relief options for a fracture

Answer 8

Reduce the fracture

Multimodal pain relief - Morphine, paracetamol, NSAIDs

Question 9

What is the classification system for open fractures?

Answer 9

Gustilo-Anderson

Question 10

How do you assess someone’s GCS?

Answer 10

Eyes - 4: Opens spontaneously

3: Opens in response to command
2: Opens in response to pain
1: No response

Verbal: 5: Responsive

4: Confused
3: Inappropriate words
2: Incomprehensible sounds
1: No sounds

Motor response

6: Responds to command
5: Localises to pain
4: Withdraws from pain
3: Flexes in response to pain
2: Extends in response to pain
1: No response