Musculoskeletal Trauma

Question 1

How would you assess a limb for external bleeding?

Answer 1

1) Palpate for pulse
2) Changes in pulse quality
3) Doppler tone
4) ABPI

Question 2

What does a rapidly expanding haematoma suggest?

Answer 2

Significant vascular injury

Question 3

What does a cold, pale, pulseless extremity indicate?

Answer 3

Interruption of arterial blood supply

Question 4

If manual pressure to an artery does not stop bleeding, what steps should you take to stop bleeding from the extremity?

Answer 4

In order …

1) Pressure to the artery proximal to the injury
2) Tourniquets applied to skin
a) manual (Windlass Device)
b) pneumatic

Question 5

What pneumatic pressures are needed to stop external bleeding in the upper limb?

Answer 5

250mmHg

Question 6

What pneumatic pressures are needed to stop external bleeding in the lower limb?

Answer 6

400mmHg

Question 7

When you apply a tourniquet for limb trauma, what must you do?

Answer 7

1) record time of tourniquet application
2) Immediate surgical consultation
3) Early transfer to trauma centre

Question 8

When can you deflate a tourniquet in a limb trauma setting?

Answer 8

1) Stable patient with tourniquet after 1hr

Question 9

When can arteriography or other diagnostic tools be used?

Answer 9

In patients with no haemodynamic compromise

Question 10

How to stop bleeding in an open/closed fracture of limb?

Answer 10

reduce fracture & splint