Ch. 36 Flashcards
Your elderly patient has fallen from the curb and complains of hip, leg, and back pain. You observe the foot of the injured limb turned outward. Palpation of the pelvis reveals the head of the femur in the inguinal area. You suspect the patient is suffering from ________, so your management will include ________.
A) anterior hip dislocation; reduction of the injured hip and transport to an emergency department
B) posterior hip dislocation; reduction of the injured hip and transport to an acute care facility
C) posterior hip dislocation; reduction of the injured hip and transport to a trauma center
D) anterior hip dislocation; stabilization of the injured hip and transport to an emergency department
D) anterior hip dislocation; stabilization of the injured hip and transport to an emergency department
Page Ref: 837
Objective: 36.1 Define key terms introduced in this chapter; 36.4 Describe each of the following types of injuries: dislocations and subluxations, fractures, sprains, and strains; 36.12 Explain the rationale for splinting musculoskeletal injuries.
Following the primary assessment of an injured soccer player, you note that the contour of the extended and injured leg drops at the knee. Assessment of the distal perfusion reveals a present pulse at the level of the malleolus. You suspect ________ and will treat by ________.
A) an anterior dislocation of the hip; applying gentle traction in an attempt to reduce the deformity
B) a posterior dislocation of the hip; immobilizing the affected limb in the position found
C) an anterior dislocation of the knee; applying gentle traction in an attempt to reduce the deformity
D) a posterior dislocation of the knee; immobilizing the affected limb in the position found
D) a posterior dislocation of the knee; immobilizing the affected limb in the position found
Page Ref: 837
Objective: 36.1 Define key terms introduced in this chapter; 36.4 Describe each of the following types of injuries: dislocations and subluxations, fractures, sprains, and strains; 36.12 Explain the rationale for splinting musculoskeletal injuries.
Which one of the following statements about different musculoskeletal injuries is TRUE?
A) A sprain is an injury to a joint with possible damage to or tearing of ligaments.
B) A dislocation occurs when the bone within a joint is broken.
C) A fracture occurs when a tendon connecting muscle to a bone is overstretched and injured.
D) Strains are injuries that occur to ligaments and the joints to which they are attached.
A) A sprain is an injury to a joint with possible damage to or tearing of ligaments.
Page Ref: 837
Objective: 36.2 Describe the structures and functions of the musculoskeletal system, including bones, cartilage, joints, ligaments, skeletal muscle, and tendons; 36.4 Describe each of the following types of injuries: dislocations and subluxations, fractures, sprains, and strains.
A patient with a closed fracture to the forearm has been properly splinted when which of the following are immobilized?
A) Elbow and forearm
B) Shoulder, elbow, and forearm
C) Wrist, forearm, and elbow
D) Wrist and forearm
C) Wrist, forearm, and elbow
Page Ref: 828
Objective: 36.2 Describe the structures and functions of the musculoskeletal system, including bones, cartilage, joints, ligaments, skeletal muscle, and tendons; 36.12 Explain the rationale for splinting musculoskeletal injuries.
Which one of the following statements shows that an AEMT understands field care of a patient with a possible joint dislocation?
A) “The care for a patient with a joint injury is identical to that of a fracture.”
B) “If a distal pulse is absent, three attempts to straighten the joint can be made.”
C) “If a joint injury is suspected, ice packs and not splints are indicated.”
D) “Warm packs, not cold packs, are indicated for a patient with a possible joint injury.”
A) “The care for a patient with a joint injury is identical to that of a fracture.”
Page Ref: 828
Objective: 36.2 Describe the structures and functions of the musculoskeletal system, including bones, cartilage, joints, ligaments, skeletal muscle, and tendons; 36.4 Describe each of the following types of injuries: dislocations and subluxations, fractures, sprains, and strains; 36.12 Explain the rationale for splinting musculoskeletal injuries.
You are assessing a patient who has fallen from a ladder and is in severe pain from an angulated, midshaft femur. Although angulated, there is good circulation and sensation distal to the injury site. The patient is conscious and alert and complains of severe pain. The MOST correct treatment for this patient is to:
A) treat for shock with oxygen, administer IV fluids, and secure the patient to a spine board.
B) administer oxygen and IV, apply traction splinting, and give analgesics for pain as indicated.
C) administer oxygen and IV, ladder splint as found, give analgesics for pain, and transport.
D) give morphine, splint the extremity as found, and transport.
B) administer oxygen and IV, apply traction splinting, and give analgesics for pain as indicated.
Page Ref: 832-833
Objective: 36.7 Establish the priority for assessing and treating musculoskeletal injuries with respect to a patient’s overall condition; 36.11 Consider the need for fluid replacement and pain management in patients with musculoskeletal injuries; 36.16 Given a variety of scenarios involving patients with musculoskeletal injuries, manage the injuries using general rules of proper splinting.
You are treating a patient who has an open wound directly over the fracture site. This is called a(n):
A) compound fracture.
B) open fracture.
C) comminuted fracture.
D) transverse fracture.
B) open fracture.
Page Ref: 833
Objective: 36.4 Describe each of the following types of injuries: dislocations and subluxations, fractures, sprains, and strains.
You are evaluating a patient who is experiencing pain, deformity, and a loss of pulse to his left upper extremity following a riding accident. You suspect a dislocated shoulder. Your protocols allow an attempt to realign an injured extremity grossly in the case of impaired distal neurovascular function. Based on this information, you should:
A) provide oxygen and paralytics to reduce the fracture site.
B) make multiple attempts at resetting the joint into socket.
C) splint the shoulder in position found and transport rapidly.
D) make one attempt to manipulate the joint while checking distal pulse.
D) make one attempt to manipulate the joint while checking distal pulse.
Page Ref: 827
Objective: 36.4 Describe each of the following types of injuries: dislocations and subluxations, fractures, sprains, and strains; 36.14 Discuss pitfalls associated with improper splinting.
When treating a patient with a long-bone injury who also has soft-tissue involvement, the AEMT should:
A) rapidly splint the injury and then bandage the wound to prevent infection.
B) splint the injury while leaving the wound available for dressing and bandaging.
C) cover the open wound with the splint to assist bleeding control.
D) dress and bandage the open wound prior to splinting.
D) dress and bandage the open wound prior to splinting.
Page Ref: 834
Objective: 36.7 Establish the priority for assessing and treating musculoskeletal injuries with respect to a patient’s overall condition; 36.16 Given a variety of scenarios involving patients with musculoskeletal injuries, manage the injuries using general rules of proper splinting.
A nine-year-old boy has fallen from a swing. Assessment findings reveal no threats to the airway, breathing, or circulation but do indicate deformity, pain, and swelling to his right wrist. The right radial pulse is strong and is accompanied by skin that is pink and warm to the touch. Which one of the following actions indicates that the AEMT is properly caring for this patient?
A) Maintaining the wrist below the level of the heart to decrease swelling
B) Applying cold packs to the wrist to reduce swelling
C) Straightening the wrist to promote blood flow to the hand
D) Massaging the wrist gently to decrease the pain
B) Applying cold packs to the wrist to reduce swelling
Page Ref: 828
Objective: 36.5 Describe the signs and symptoms associated with injury to the musculoskeletal system; 36.7 Establish the priority for assessing and treating musculoskeletal injuries with respect to a patient’s overall condition.
Management of life-threatening injuries to the pelvic ring MUST include:
A) immobilization of the fracture, hemodynamic support, and rapid transport to a trauma center.
B) application of a PASG, large-bore vascular access with two 1000 cc bags of NS or LR, aggressive fluid therapy to maintain systolic blood pressure above 90-100 mmHg, and immediate transport to trauma facility.
C) patient immobilization, aggressive fluid therapy to maintain systolic blood pressure above 90 mmHg, and transport to trauma center.
D) immobilization of the cervical spine, application of the PASG, large-bore vascular access with appropriate fluid resuscitation to maintain systolic blood pressure above 90-100 mmHg, and immediate transport to the trauma center.
A) immobilization of the fracture, hemodynamic support, and rapid transport to a trauma center.
Page Ref: 836
Objective: 36.6 Explain why fractures of the femur, pelvis, and multiple concomitant long bones are considered critical fractures; 36.13 Describe special considerations for splinting pelvic fractures.
Management of a traumatic fracture of the femur should include:
A) stabilization of affected limb using a longboard and padding with pillows and blanket rolls, and then transport to the emergency department.
B) application of traction using either the unipolar or bipolar device, supportive fluid therapy, and transport to a trauma center.
C) application of traction using a unipolar device, application of a PASG, supportive fluid therapy, and transport to a trauma center.
D) application of a traction device, application of a PASG, immobilization using a longboard, transport to the emergency department.
B) application of traction using either the unipolar or bipolar device, supportive fluid therapy, and transport to a trauma center.
Page Ref: 836
Objective: 36.6 Explain why fractures of the femur, pelvis, and multiple concomitant long bones are considered critical fractures; 36.13 Describe special considerations for splinting pelvic fractures.
A young man riding a motorcycle was hit head on and ejected from the bike. Your scene size-up reveals him to be lying supine in the roadway with obvious deformity to his right thigh and left ankle, with blood noted to his pants in these areas. How should the AEMT assess this patient’s circulation?
A) Check the radial pulse.
B) Check for distal pulses in both lower extremities.
C) Ask the patient about numbness.
D) Have the patient use his feet to dorsiflex and plantar flex.
B) Check for distal pulses in both lower extremities.
Page Ref: 827
Objective: 36.16 Given a variety of scenarios involving patients with musculoskeletal injuries, manage the injuries using general rules of proper splinting.
The AEMT should assess a patient’s neurovascular status:
A) prior to and after applying a splint.
B) after applying a splint if the patient complains of pain.
C) before applying a splint if the patient complains of weakness.
D) before and after applying a splint if the patient complains of numbness.
D) before and after applying a splint if the patient complains of numbness.
Page Ref: 827
Objective: 36.7 Establish the priority for assessing and treating musculoskeletal injuries with respect to a patient’s overall condition.
You are called to the local school playground for a six-year-old who fell off the teeter-totter. Her only complaint is pain to her right knee. Following your initial assessment, you should perform:
A) a rapid secondary assessment.
B) a detailed physical exam.
C) a reassessment.
D) a focused secondary assessment.
D) a focused secondary assessment.
Page Ref: 827
Objective: 36.7 Establish the priority for assessing and treating musculoskeletal injuries with respect to a patient’s overall condition.
You have an 18-year-old woman who was hit in the arm by a softball. Upon inspection, you observe swelling and tenderness but no deformity or crepitus. The patient has no external bleeding, but there is tissue discoloration. You suspect internal bleeding and begin treatment that includes:
A) immobilization.
B) pain control.
C) hemorrhage control.
D) preventing contamination of the wound.
A) immobilization.
Page Ref: 828
Objective: 36.16 Given a variety of scenarios involving patients with musculoskeletal injuries, manage the injuries using general rules of proper splinting.