Ortho Emergencies

Question 1

What is the one thing you cannot for get to check in a patient with a fracture?

Answer 1

neurovascular status: can they feel sensation and move, and do they have a pulse most distal to the facture?

Question 2

What is the one thing you cannot for get to check in a patient with a fracture?

Answer 2

neurovascular status: can they feel sensation and move, and do they have a pulse most distal to the fracture?

Question 3

What are three complications of splinting and reduction in a fracture?

Answer 3

compartment syndrome
ischemia
thermal injury
pressure sores
infection
joint stiffness

Question 4

What is the difference between a partial and complete amputation?

Answer 4

Partial: something is keeping it attached (skin, bone)
Complete: they carried it in in the other hand :/

Question 5

This type of amputation is caused by a tear that includes nerves, veins, and arteries?

Answer 5

avulsion

Question 6

This type of amputation causes extensive tissue damage and is the hardest to reattach?

Answer 6

crush injury

Question 7

Irreversible necrosis happens ___ H after amputation occurs?

Answer 7

6H

Question 8

How do you manage an amputated body part?

Answer 8

Irrigate it
wrap it in a moist cloth
place on ice (NOT in a freezer)
Get to OR asap

Question 9

A patient presents to the ED after they fell during a run and hit their thigh on the edge of the sidewalk. They report 10/10 pain in their thigh, tightness, slight loss of sensation, and on PE you note reduced distal pulses and pallor of the leg. What is the likely dx, tool to assess this condition, and tx?

Answer 9

Compartment syndrome
Delta pressure measure muscle compartment pressure
TX is removing tight clothing, surgical fasciotomy-get to OR asap

Question 10

A pt presents to the ED with report of a swollen knee and feeling sick. Upon PE you note the left knee is red, warm to the touch, and swollen. The right knee appears normal. The patient has a fever, & chills. What is the likely dx, cause of this condition, dx tool, and treatment?

Answer 10

Septic arthritis
Cause: S. aureus, strep, or gonorrhea
tool: fluid aspiration
TX: Admit to hospital and give IV abx

Question 11

Pediatric patients, diabetic adults, and geriatric patients are at high risk for this bone condition marked by inflammation, swelling, fever, and pain at site of infection?

Answer 11

osteomyelitis

Question 12

What is an infection of any part of the boney skeleton (a bone)?

Answer 12

osteomyelitis

Question 13

TX for osteomyelitis?

Answer 13

broad spectrum ABX

Question 14

What are the 4 things you assess for neurovascular compromise?

Answer 14

1 Symmetrical distal pulses in all extremities
2 capillary refill in each limb
3 Weakness
4. paresthesia

Question 15

What is the imaging modality of choice in an ortho emergency and what do you want to ensure you get in the “picture” to assess the complete injury?

Answer 15

x-ray
get joint above and below injury

Question 16

An open fracture is considered an orthopedic emergency due to the risk of what, and what is the appropriate management?

Answer 16

Risk of infection entering the body and bone
Treat with empirical IV ABX and send to ortho surgery

Question 17

This airway assistance is used in patients who have no gag reflex (unconscious); it pulls the tongue forward to keep it from blocking the airway

Answer 17

oropharyngeal airway

Question 18

This airway device is contraindicated in patients with facial trauma, can be used on pt with a gag reflex, and requires lubrication?

Answer 18

nasopharyngeal airway

Question 19

Patients who require help with their airway and breathing need ____?

Answer 19

endotracheal intubation

Question 20

What are the three parts of rapid sequence intubation?

Answer 20

1 rapid administration of a sedative agent 2paralytic
3 intubation

Question 21

What 2 points are measured for an oropharyngeal airway?

Answer 21

from PT ear to corner of mouth

Question 22

This type of adjunct (not permanent) airway Provides oval seal around laryngeal inlet at esophageal junction & can help reduce aspiration but not prevent it?

Answer 22

laryngeal mask airway