Extremity Trauma Flashcards
What are the 3 types of tourniquets?
CAT
EMT
SOFTT
Abx for extremity trauma
Ertapenem
Cefazolin
Cefoxitin
Hemostatic gauze for TCCC
Combat
Chito
Xstat
Junctional tourniquets
JETT
SAMS
CRoC
What is given PO as Abx?
Moxifloxicin
Auscultation over the injury may reveal a bruit indicative of
vascular damage, thrombosis, or compression
Arterial injury signs?
1) Active hemorrhage
2) Expanding or pulsatile hematoma
3) Bruit or thrill over wound
4) Absent distal pulses
5) Extremity ischemia
Contraindications to traction femur splint?
Pelvic frac
femoral neck frac
Foot/ankle amputation
Frac adjacent to knee
Abx prophylaxis?
a) Cefoxitin
b) Cefazolin
c) Ertapenem
Association of pelvic frac with amputation?
1) Any lower limb – 22%
2) Unilateral – 10%
3) Bilateral lower limb amputation – 30%
4) Bilateral lower limb above knee amputation – 39%
What pelvic ring fracture causes the greatest bleeding such as from a fall from a height landing leg first?
Vertical Shear
- Majority of pelvic ring fractures
lateral compression pelvic ring fracture
(open book) symphysis pubis is disrupted and volume of pelvis is increased
anterior posterior compression fracture of pelvis
What do you clean amputation with?
LR
What do you wrap the amputated part in?
Sterile moist LR solution
How many compartments are in the forearm?
3
How many compartments are in the calf?
4
2 most common causes of compartment syndrome?
- Hemorrhage from fracture
* Edema following reperfusion injury
What is the capillary pressure that is exceeded in compartment syndrome?
30mmHg
2 most common signs of compartment syndrome?
Pain and paresthesia
Types of splints?
Rigid
Formable
Improvised
Anatomical
Types of rigid splints?
(a) Plaster
(b) Fiberglass
(c) Wood
(d) Metal (Scoop Splint)
(e) Inflatable “air splints”
What’s significant about rigid splints?
CANNOT change in shape
Most common diagnosis for use of rigid splint?
stable, nondisplaced, closed fracture of a long bone.
Contraindications for rigid splint?
(a) Early (premature) casting: Casting before maximal swelling has occurred can cause necrosis and compartment syndrome.
(b) Open wound: Never place a cast over an open wound because of the potential for infection. If the wound is not too large, a window may be cut in the cast to monitor it.
(c) Unstable fractures: These fractures need surgical repair; splint only until definitive treatment can be provided.
Examples of formable splints?
1) Vacuum splints
2) Pillows
3) Blankets
4) Cardboards splints
5) SAM splints
6) Wire ladder splints
Examples of anatomical splints?
Ankle taping
Ace wrap
Cravats for arm body splints
Do you elevate a splinted extremity if spinal injury is not suspected?
Yes
(c) Injuries below the elbow, ensure the hand is placed in position of function.
OK
(d) Injuries of the elbow and above, use narrow sling to reduce pressure on elbow.
Ok
2 types of ankle splints?
sugar tong and posterior
Splint for ankle sprains to prevent inversion or eversion?
Sugar Tong
splint may be used with stable tibial or fibular fractures and plantar fasciitis to restrict dorsiflexion or plantar flexion of the foot and ankle complex.
Posterior splint
What splint does the following?
a) Decrease the pain and damage caused by a femur fracture.
(b) Stabilize the fracture
(c) Align the limb to be placed in splint
Hare Traction Splint
What splint cannot be used for femur fractures with complete or partial amputation of the lower extremity.
Hare Traction Splint
- because no attachment point to pull traction
1) A traction splint is NOT applied to an injury within 2 inches of the pelvic or the knee
OK
Other contraindications of hare traction splint?
(b) Hip dislocation
(c) Open femur fracture
(d) Femur fracture close to the knee
(e) Injuries of the upper extremity
(f) Partial amputations or avulsions with bone separation.
(g) Lower leg, foot, or ankle injuries.
Complications of hare traction?
(a) Compression of nerves, tissues and blood vessels from the splint.
(b) Reduction of distal circulation.
(c) Aggravation of injury to include nerve, vessel, and muscle damage.
(d) Delay in transport.
where do you position hare traction splint??
** Position against ischial tuberosity
What is your landmark for pelvic binder?
*** Greater trochanter
The amount of traction usually required does not exceed what amount on hare traction?
*** 15 pounds
Excessive traction can be harmful
