Emergency Care Component 8: Musculoskeletal Injuries

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Questions and Answers

Match the type of injury with the appropriate splintage type:

Patella Dislocation = Vacuum splint Tibia/Fibula shaft # = Long leg box splint Ankle # = Short leg vacuum splint Clavicle = Self splintage

Match the splintage type with its usage context:

Long leg vacuum splint = Tibia/Fibula shaft # Triangular sling = Humerus Short box splint = Foot #’s Kendrick Traction splint = Femur #

Match the injury to its non-usage conditions:

Femoral # = Cannot use Kendrick Traction splint if # to ankle Patella Dislocation = May spontaneously relocate when splinting Radius # = Use vacuum splint for forearm # Ulna = Use short box splint

Match the type of splint with its specifics:

Short leg box splint = Used for Ankle # Long Leg Box splint = Used for Tibia/Fibula shaft # Short vacuum splint = Used for Foot #’s Vacuum splint = Used for various arm fractures Signup and view all the answers

Match the injury category with the related splint specifics:

Clavicle = Self splintage method Femur # = Quick application of traction required Humerus = Applicability of triangular sling Knee dislocation = Long leg box splint consideration Signup and view all the answers

Match the type of fracture with its description:

Open fracture = A fracture with a wound at the site caused by bone pushing through the skin Closed fracture = A fracture where no puncturing of the skin has occurred Pathological fracture = Fractures that occur from minor trauma due to underlying conditions Complicated fracture = A fracture associated with dislocation or additional injury Signup and view all the answers

Match the definition with the correct term related to joint injuries:

Dislocation = The abnormal separation of joint surfaces Sprain = Injuries involving tears of ligaments Strain = Stretching and tearing of muscle fibers Fracture = Break in the continuity of the bone Signup and view all the answers

Match the type of soft tissue injury with its characteristics:

Sprain = Damage to ligaments around a joint without penetrating the joint capsule Strain = Involves stretching or tearing of tendon or muscle fibers Contusion = A bruise resulting from a direct blow Laceration = A tear or cut to the skin or soft tissues Signup and view all the answers

Match the type of fracture to its alternative name:

Closed fracture = Simple fracture Open fracture = Compound fracture Stress fracture = Fatigue fracture Greenstick fracture = Incomplete fracture often seen in children Signup and view all the answers

Match the injury type with the typical example:

Dislocation = Shoulder joint separation Sprain = Ankle ligament injury Strain = Hamstring pull Fracture = Femoral fracture after a fall Signup and view all the answers

Match the condition with its impact on bone health:

Osteoporosis = Increases risk of fractures from minor injuries Cancer = Can lead to pathological fractures Arthritis = May complicate joint injuries and healing Diabetes = Can affect healing of fractures and soft tissue injuries Signup and view all the answers

Match the type of injury with the symptom:

Sprain = Swelling and bruising around the joint Strain = Pain and muscle spasms Dislocation = Visible deformity and loss of joint function Fracture = Intense pain and inability to use the limb Signup and view all the answers

Match the term with its treatment approach:

Sprain = Rest, ice, compression, elevation Fracture = Immobilization and possibly surgery Dislocation = Reduction and immobilization Strain = Rest and rehabilitation exercises Signup and view all the answers

Match the assessment methods for neurovascular status with their corresponding descriptions:

Motor = Ask the patient to move the limb Sensory = Apply light touch to evaluate sensation Circulation = Assess a distal pulse and skin temperature ABCDE = Initial assessment of airway, breathing, circulation, disability, exposure Signup and view all the answers

Match the six ‘P’s of ischaemia with their corresponding symptoms:

Pain = Out of proportion to the injury not eased by splinting or pain relief Pallor = Compromised blood flow to limb Pulselessness = Loss of peripheral pulses leading to potential occlusion of circulation Perishing cold = Limb is cold to touch Signup and view all the answers

Match the types of management for musculoskeletal injuries with their descriptions:

Immobilisation = Immobilise joints above and below the fracture Examination = Look, feel, move to assess injury Pain management = Consider interventions to relieve discomfort Cold compress = Recommended for strains and sprains Signup and view all the answers

Match the conditions that require time-critical assessment with the corresponding actions:

Major trauma = Refer to MAJOR TRAUMA TOOL and transfer to major trauma centre Limb injury = Assess Motor Sensory Circulation (MSC) Neurovascular status = Reassess after manipulation or handling of fracture Fractures = Apply splintage to stabilise the injury Signup and view all the answers

Match the types of splinting with their intended purposes:

Padding between legs = Used for Neck of Femur (NOF) injuries Support = Provides stability to the injured area Pain reduction = Reduces discomfort associated with movement Prevent further damage = Minimises injury to blood vessels and nerves Signup and view all the answers

Match the features of ischaemia with their types:

Paralysis = Loss of movement Paraesthesia = Changes in sensation Pain = Discomfort that isn't relieved by standard methods Pallor = Visible compromised blood flow Signup and view all the answers

Match the management steps for soft tissue injuries with their actions:

Cold compress = Recommended for reducing swelling Limb elevation = Helps to decrease inflammation Examination = Look, feel, and assess range of motion Immobilisation = Stabilises the affected area to prevent further injury Signup and view all the answers

Match the pain-related considerations with their definitions:

Out of proportion pain = Pain that does not correlate with the severity of the injury Muscle spasms = Involuntary contractions causing discomfort Pressure on skin = Risk associated with splinting that can lead to further damage Haemorrhage = Potential blood loss contributing to reduced blood flow Signup and view all the answers

Match the following musculoskeletal injury complications with their descriptions:

Bleeding = Loss of a significant amount of blood Infection = Introduction of pathogens leading to inflammation Compartment syndrome = Increased pressure within a muscle compartment Long term disability = Prolonged limitation of physical function Signup and view all the answers

Match the following injury types with their blood loss estimates:

Mid shaft femoral fractures = 500-2000mls Open fractures = 1000mls plus Pelvic fractures = Up to 1000mls Musculoskeletal injuries = Variable, depending on specific injury type Signup and view all the answers

Match the recommendations with their purpose in managing musculoskeletal injuries:

Splinting = Reduces further blood loss and pain Assessment = Identifies life-threatening problems Requesting a clinician = Ensures proper pain management Emergency transport = Accelerates timely medical intervention Signup and view all the answers

Match the following consequences with their potential impact on a patient:

Damage to blood vessels = Compromises circulation Loss of tissue = Afflicts recovery and limb function Damage to nerves = Affects sensation and motor control Long term disability = May require rehabilitation services Signup and view all the answers

Match the following statements with their relevance to musculoskeletal injuries:

Patients may experience significant pain = Affects the management protocols Consideration of time-critical injuries = Impacts urgency in treatment Pain management is crucial = Enhances patient comfort during transport Assessment should not be distracted = Ensures comprehensive care approach Signup and view all the answers

Match the type of force with its description in musculoskeletal injuries:

Direct force = Force leads to injury at the point of impact. Indirect force = Force transmitted through the skeleton to weakest point. Magnitude = Strength of the applied force. Duration of force = Length of time the force is applied to the injury. Signup and view all the answers

Match the type of musculoskeletal injury with its example:

Sprain = Stretching or tearing of ligaments. Fracture = Break in the continuity of the bone. Dislocation = Bone is forced out of its normal position. Tendonitis = Injury due to overuse of a tendon. Signup and view all the answers

Match the concept of pain management to its relevance:

Early pain management = Improves patient comfort during assessment. Pain assessment = Determines the severity of the condition. Complications = Potential secondary issues arising from the injury. Signs and symptoms = Indicators of the nature of the injury. Signup and view all the answers

Match the mechanism of injury with its characteristics:

Direct force = Injury occurs at the impact site. Indirect force = Injury occurs away from the impact site. High magnitude = Excessive force resulting in severe injury. Low magnitude = Mild force that may lead to minor injuries. Signup and view all the answers

Match the clinical action with its description in musculoskeletal injury assessment:

Assessment of visible injuries = Focus on dramatic presentations of injury. Assessment of less visible problems = Evaluate internal injuries that may be life-threatening. Pain relief measures = Administer analgesics to manage distress. Time critical injuries = Identify and act on severe injuries promptly. Signup and view all the answers

Match the type of treatment interventions with their description:

Immobilization = Stabilizing the injured area to prevent movement. Surgery = Surgical intervention for severe fractures. Physical therapy = Rehabilitation to restore mobility. Pain management = Methods to reduce patient discomfort. Signup and view all the answers

Match the term related to injury with its definition:

Complication = A secondary issue that complicates recovery. Mechanism of Injury = The process that led to the injury. Signs = Observable indicators of injury. Symptoms = Patient-reported experiences related to the injury. Signup and view all the answers

Match the factor affecting musculoskeletal injuries with its impact:

Direction of force = Affects which structures are injured. Magnitude of force = Determines severity of the injury. Duration of force = Influences the extent of tissue damage. Type of tissue = Different tissues respond differently to injuries. Signup and view all the answers

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Study Notes

Introduction to Musculoskeletal Injuries

Common injuries in the musculoskeletal (M/S) system range from sprains to fractures.
Patients typically present with distress and pain; early pain management is crucial when feasible.

Mechanism of Injury (MOI)

Determine MOI by analyzing direction, magnitude, and duration of force applied to the injury.
A comprehensive review of MOI aids in predicting specific injury patterns.

Types of Forces

Direct Force: Breaks occur at the impact point when force exceeds soft tissue limits.
Indirect Force: Force travels through the skeleton to reach a weak point, leading to fractures.

Types of Fractures

Closed Fractures:
- Also known as simple fractures, no skin puncture occurs.
Compound Fractures:
- Open fractures where bone protrudes through the skin.

Pathological Fractures

Frequent in older individuals, often occurring from minor trauma (e.g., falls).
Conditions like cancer or osteoporosis increase fracture risk from minimal injuries.

Dislocations

Defined as abnormal separation of joint surfaces; can occur alone or with fractures.
Muscle spasms may lead to joint locking.

Sprains and Strains

Sprains: Injury to ligaments, can involve partial or complete tears.
Strains: Overstretching or tearing of muscle fibers and/or tendons.
Sprains can be mistaken for fractures; immobilization is typically advised.

Management of Musculoskeletal Injuries

Conduct an ABCDE assessment; identify time-critical injuries.
Check for neurovascular status (Motor, Sensory, Circulation - MSC) before and after any manipulation.
Remove tight clothing or jewelry; offer pain management as needed.

Six ‘P’s of Ischaemia

Pain: Severe pain not alleviated by splinting or pain relief.
Pallor: Indicates compromised blood flow.
Paralysis: Loss of movement in the affected limb.
Paraesthesia: Altered sensation.
Pulselessness: Absence of peripheral pulses.
Perishing Cold: Affected limb feels cold to touch.

Importance of Splinting

Reduces pain and hemorrhage, protects blood vessels and nerves.
Prevents further damage to surrounding tissues; supports the affected area.

Types of Splints for Injuries

Neck of Femur: Figure of eight splint with padding.
Shaft of Femur: Kendrick Traction splint; not for certain related fractures.
Patella Dislocation: Vacuum and long leg box splints.

Time-Critical Injuries

Mid shaft femoral fractures can result in significant blood loss, ranging from 500-2000 ml for open fractures.
Pelvic fractures can lead to over 1000 ml blood loss.

Complications from Musculoskeletal Injuries

Potential complications include bleeding, nerve/muscle/artery damage, infection, tissue loss, long-term disability, and compartment syndrome.

Conclusion

Musculoskeletal injuries can cause significant pain and distress; effective splinting improves circulation care during transport to medical facilities.
Continuous assessment of less visible life-threatening issues is essential in injury management.

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