ECare - Chapter 28 (Musculoskeletal Trauma)

Question 1

cartilage

Answer 1

tissue covering joint ends; also forms certain body parts

Question 2

mechanisms of musculoskeletal injury

Answer 2

direct force, indirect force, and twisting force

Question 3

signs of a fracture

Answer 3

painful, swollen, or deformed extremity

Question 4

traction splint

Answer 4

splint that applies constant pull along length of lower extremity to stabilize fracture and reduce muscle spasm

use for femur

Question 5

fracture

Answer 5

break in bone

Question 6

comminuted fracture

Answer 6

bone is broken in many places

Question 7

greenstick fracture

Answer 7

incomplete fracture

Question 8

angulated fracture

Answer 8

broken bone is bent at an angle

Question 9

dislocation

Answer 9

disruption of a joint

Question 10

sprain

Answer 10

stretching and tearing of ligaments

Question 11

strain

Answer 11

overstretching of muscle

Question 12

compartment syndrome

Answer 12

injury caused when tissues such as blood vessels and nerves are constricted in a space from swelling, tight casting, or cast

Question 13

crepitus

Answer 13

grating sensation/sound when fractured bone ends rub together

Question 14

patient assessment: musculoskeletal injuries

Answer 14

Pain or tenderness
Pallor
Paresthesia (pins and needles)
Pulses diminished in injured extremity
Paralysis 
Pressure

Question 15

Patient Care: Musculoskeletal Injuries

Answer 15

1. Primary assessment
2. Secondary assessment & apply cervical collar if needed
3. Splint extremities (if unstable immobilize whole body and go)
4. cover open wound with sterile dressings, elevate, and cold pack

Question 16

when to realign injuries

Answer 16

only to restore effective circulation and hold splint

Question 17

realigning injuries

Answer 17

1. EMT 1 holds distal extremity while EMT 2 places hand above and below injury
2. EMT 1 provides manual traction in direction of long axis; should be no resistence
3. continue until properly aligned

Question 18

manual traction

Answer 18

applying tension to straighten and realign fractured limb before splinting

Question 19

rigid splints

Answer 19

limb needs to be moved to anatomic position; use for long bone injuries

Question 20

formable splints

Answer 20

can be molded; use for joint injuries in the way it was found

Question 21

traction splints

Answer 21

femur fractures

Question 22

splinting long bone/joint injuries

Answer 22

1. stabilize injury site
2. PMS
3. Realign injury if deformed or no pulse
4. measure splint
5. Apply and secure splint
6. PMS

Question 23

contraindication for traction splint

Answer 23

pelvis, hip, knee injury, partial amputation where traction could separate extremity, injury to lower third of leg

Question 24

application of traction splint

Answer 24

1. stabilize leg and apply manual traction
2. PMS
3. Apply splint
4. ischial strap (proximal securing device)
5. distal securing device (ankle hitch)
6. mechanical traction
7. PMS

Question 25

Patient Assessment: Shoulder Girdle Injuries

Answer 25

pain in shoulder, dropped shoulder, blow to the back over scapula

Question 26

Patient Care: Shoulder Girdle Injuries

Answer 26

1. PMS
2. sling and swathe (no rigid splint)
3. thin pillow between arm and chest before splinting if anterior dislocation of head of humerus
4. don’t straighten anything
5. PMS

Question 27

Patient Assessment: Pelvic Injuries

Answer 27

pain in area, pain when pressure applied to iliac crests/pubic bones, can’t lift legs, lateral outward rotation of injured foot (can also be hip injury), pressure on urinary bladder, rectum/penal bleeding

Question 28

Patient care: pelvic injuries

Answer 28

1. move as little as possible
2. PMS
3. straighten lower limbs in no injuries to hip/lower limbs
4. stabilize lower limbs: rigid splints
5. long board
6. PMS
7. shock/oxygen
8. transport/vitals

Question 29

pelvic wrap

Answer 29

1. use if pelvic injury
2. place sheet at patient’s greater trochanter (proximal end of femur)
3. bring sides of sheet around to front of patient and tie
4. secure with clamps/ties

Question 30

patient assessment: hip dislocation

Answer 30

anterior/posterior hip dislocation,

Question 31

patient care: hip dislocation

Answer 31

1. PMS
2. spine board
3. immobilize limb with pillows/blankets
4. secure to long spine board
5. PMS
6. shock/oxygen
7. transport/vitals

Question 32

patient assessment: hip fracture

Answer 32

localized pain, knee pain, swelling, can’t move limb when on back, can’t stand, foot turned outward, injured limb is shorter

Question 33

patient care: hip fracture

Answer 33

PMS before/after splinting, manage for shock/oxygen and use long spine board

bind legs together and padded boards

Question 34

Patient Assessment: Femoral Shaft Fracture

Answer 34

intense pain, open fracture with deformity, injured limb is shorten

Question 35

Patient Care: Femoral Shaft Fracture

Answer 35

1. control bleeding
2. shock/oxygen
3. PMS
4. traction splint
5. OMS

Question 36

Patient Assessment: Knee Injury

Answer 36

pain/tenderness, swelling, deformity w/ swelling

Question 37

Patient Care: Knee Injury

Answer 37

bent: PMS, immobilize in position found, two padded board splints to thigh and above ankle , PMS
straight: PMS, immobilize with two padded boards or single, PMS

Question 38

Patient Assessment: Tibia/Fibula Injury

Answer 38

pain/tenderness, swelling, possible deformity

Question 39

Patient Care: Tibia/Fibula Injury

Answer 39

air-inflated splint, two splint method, single splint with ankle hitch

Question 40

Patient Assessment: Ankle/Foot Injury

Answer 40

pain, swelling, deformity

Question 41

Patient Care: Ankle/Foot Injury

Answer 41

soft splint: PMS, stabilize limb, lift limb but no manual traction, three cravets under pillow and tie, fourth cavet to arch of foot, shock, ice