Surgery: Ortho_extra notes Flashcards
Components of vascular assessment
- skin temperature (is it warm?)
- skin appearance (is it pale?)
- cap refill
- pulse and its character
Compare both sides
What to do if you can’t feel the pulse?
Use doppler
(if still cannot do with doppler → CT angiogram to confirm vascular compromise)
What does triple immobilisation of spinal cord consist of? (3)
- hard collar
- block (sides)
- tape over forehead
What is used to look for internal haemorrhage in the trauma setting?
Where to look for haemorrhage using FAST scan? (4)
- thorax
- abdo
- pelvis
- limbs
Why do we put a pelvic binder on every patient in a trauma setting?
to close pelvic injury/fracture → to minimise potential bleed
What to do first in a fracture of a long bone and a bleed?
Put the bone in a better alignment to prevent significant bleed
What is the secondary assessment in trauma setting?
- head to toe examination done by an orthopaedic
(looking and assessing any lesions, bruises, deformities, fractures)
- to identify the need for extra imaging
What’s a tertiary assessment?
- Done on the ward (once a traumatic patient has stabilised)
- It is a repetition of secondary assessment to make sure nothing has been missed during a trauma setting (pressure, easy to miss some minor injuries)
What the most important analgesic in the management of fractures?
Reduce the fracture!
This helps to reduce pain (due to less tension on soft tissues, vessels and skin)
Do we leave a ‘metalwork’ in? E.g. plate and screws
Usually in unless:
- infection
- children up to 16 years of age (as the bone will grow)
- clavicle/ ankle → thin skin so the metalwork will be visible and maybe catching on clothes etc
Mono-lateral external fixator
- use
- how long do we leave it in for?
Use: When a tissue around the fracture is to distorted/swollen to be able to close in again after a potential surgery → to temporarily fixate the bone until swelling settles down → further surgery will be required to fix the bone properly
How long for: max 2 weeks due to risk of infection → then further fixation (surgery)
Mechanism of injury leading to spiral fracture
twisted/torsional force
A child with a long bone spiral fracture - what is the possible mechanism of injury?
Possibly non-accidental injury
Possible mechanism of a transverse fracture?
Side force