Acute and Complex Musculoskeletal Injury Flashcards
What factors are important to know about an accident when assessing musculoskeletal injuries?
Speed MB vs MV vs tree vs trunk Point of impact Ejection/distance from vehicle Seat belt/helmet/ Time of accident ?? Mortality
What factors are important to assess in the primary survey?
Airway Breathing Circulation Disability Exposure
What factors are important to assess in the secondary survey?
Repeat primary survey
Examine from head to toe
Log roll
Assess neurological and orthopaedic injuries
AP chest and pelvis/Cx spine AP/lat/open mouth (why open mouth??)
Why should a CXR be performed?
??
What factors of a wound should be assessed?
Size of laceration
Skin under tension (and presence/absence of bone)
Contamination
What factors are involved in a limb assessment for musculoskeletal injury?
Wound Neurological (motor and sensory) Vascular Bone Soft tissue
REVISE SPINAL LEVEL AND PERIPHERAL NERVE DISTRIBUTIONS
…
What is normal capillary return?
1-2 seconds
What factors of vascularity should be assessed?
Pulse
Colour
Temperature
Capillary return
What are you particularly looking for when examining the bone in a limb assessment?
Limb alignment
What are you particularly looking for when examining the soft tissue in a limb assessment?
Any evidence of compartment syndrome
Gustilo Anderson classification
I: wound 1cm, minimal contamination and soft tissueinjury
III: extensive soft tissue injury, considerable contamination of the wound
IIIA - adequate soft tissue cover
IIIB inadequate soft tissue cover, periosteal stripping + severe comminution of the fracture
IIIC arterial injury
Management of open fracture?
ABC
Antibiotics
Tetanus prophylaxis
???
When is someone considered immune in terms of tetanus prophylaxis?
Within 10 years of a 3 dose course
Within 10 years of a booster
Within 6 months of a 2 dose course
When is external fixation indicated?
For some IIIB and IIIC fractured tibiae
