Ch 32 EMT: Musculoskeletal Trauma Quiz

Musculoskeletal Injuries Overview

• Musculoskeletal injuries can be classified as open or closed fractures.
• A fracture indicates a break in the bone, which can cause angulation or displacement of bone segments.

Dislocations and Joint Injuries

• Dislocation occurs when soft tissue and ligaments are stretched, causing bones to move out of their normal position.
• Common joint injuries can be observed by the position of the extremities and accompanying pain.

Patient Assessment

• During initial assessments, avoid focusing only on dramatic injuries; assess for life-threatening conditions first.
• Check pulse, motor function, and sensation distal to the injury before and after splinting.

Splinting Techniques

• The primary purpose of splinting is to prevent movement and reduce the chance for further injury.
• For long-bone injuries, immobilize the limb in the position of function to ensure stability.
• Use sling and swathe method for upper arm injuries; immobilization should extend from the shoulder to the wrist.

Specific Injuries and Management

• A comminuted fracture features multiple fragments at the fracture site; a displaced fracture results in bone segments not aligning properly.
• Compartment syndrome arises from pressure buildup within muscles, leading to potential tissue loss if untreated.
• Blood at the meatus of the penis signals possible pelvic trauma or fracture.

Mechanisms of Injury

• Twisting forces cause muscle strain and ligament tears, while direct force results in immediate localized damage.
• Fractures can occur from both trauma and non-traumatic causes, such as stress on the bone from repetitive activity.

Identification and Response to Serious Conditions

• Signs of pelvic fractures may include pain, shock, and inability to lift legs.
• Patients with suspected fractures must be immobilized and transported carefully to prevent further damage.

Importance of Proper Treatment

• Angulation at a fracture site indicates a need for careful realignment and splinting.
• It is crucial to explain uncertainty regarding sprains versus fractures to patients before any definitive treatment.

General Principles

• Always assess for distal pulses and sensations post-injury and post-splinting.
• Elevated legs and the use of cold packs can help manage swelling in open musculoskeletal injuries.

Special Considerations

• Use of a PASG may be relevant for certain conditions like fractured pelvis, emphasizing its role in stabilization.
• Specific techniques vary depending on the injury location, with targeted approaches for shoulder, ankle, knee, etc.

These notes highlight critical aspects of assessment, identification, and management of musculoskeletal injuries that are essential for effective emergency care.### Hip Dislocation Overview

• Hip dislocations are serious injuries usually accompanied by severe pain, immobility, and deformity.
• They can be classified into posterior and anterior dislocations, with posterior being more common.

Mechanisms of Injury

• Injuries such as forearm deformities can occur from falls, typically categorized as indirect force (e.g., falling onto outstretched hands).
• Indirect force leads to injuries through energy transmitted to the limb, often resulting in fractures above or below the point of impact.

Signs of Hip Dislocation

• Posterior hip dislocation commonly results in the limb being positioned with the knee bent and foot in a loose position.
• Anterior dislocation may have outwardly rotated lower limbs, contrary to earlier assumptions.

Complications of Bone Fractures

• Bone fractures can lead to complications including hemorrhage, nerve damage, and significant swelling.

Usage of Pelvic Wraps

• Pelvic wraps are indicated in cases of instability or deformity of the pelvis and should be assessed based on mechanism of injury.

Types of Fractures

• A comminuted fracture involves multiple bone fragments, unlike a simple fracture that occurs in just one place.
• Fractures can also be classified by characteristics such as angulated (angular displacement) or greenstick (incomplete).

Splinting Techniques

• Proper splinting should occur during secondary examinations for injuries like angulated forearms.
• Principles include checking distal neurovascular function, immobilizing both joints above and below injury sites, and avoiding actions that may worsen conditions.

Assessment of Extremity Injuries

• Assessment utilizes the "six Ps": Pain, pallor, paresthesia, pulses, paralysis, and pressure, to detect circulatory and nerve compromise.
• Careful comparison of injured and uninjured sides helps identify potential injuries.

Circulatory Concerns in Limb Injuries

• In cases of severe deformities with cold and mottled feet, exploring the possibility of restoring circulation should be prioritized before splinting.

Anatomic Terminology

• The sternum is a vital bone located in the chest.
• The axial skeleton comprises the skull and spinal column, contrasting with the appendicular skeleton (limb bones).

Complications from Improper Splinting

• Proper management is crucial to avoid ignoring life-threatening conditions or compromising circulation while addressing extremity injuries.

Physiological Structures of Bones and Joints

• Cartilage facilitates smooth movements between bone surfaces at joints, while ligaments connect bones and stabilize them.
• The periosteum wraps around bones, providing protection and receiving blood supply.

Knowledge Gaps and Misconceptions

• Misconceptions regarding tendon and ligament functions (tendons connect muscles to bones, not ligaments) must be clarified.

Application of Traction Splints

• In cases of suspected femur injuries, applying traction involves utilizing about 10% of the patient's body weight, not exceeding 15 pounds.

Evaluating Joint Injuries

• Careful palpation and movement evaluation can reveal symptoms of joint injuries, but never assume integrity before a thorough check.

Emergency Medical Response

• EMTs must prioritize patient safety, ensuring primary survey focuses on life threats before becoming involved in orthopedic evaluations.
• Injuries to joints, like the knee, may include fractures to associated bones such as the patella and proximal tibia and fibula but not the femur.

Post-Injury Protocol

• Post-dislocation through splinting should always begin with checking distal circulation before securing a sling and swathe for transport.

Test your knowledge on musculoskeletal injuries with this quiz focused on Chapter 32 of the EMT curriculum. Explore key concepts such as fractures, dislocations, and the mechanics of joint injuries. Perfect for EMT students preparing for exams!