Questions and Answers
Bruising is not a sign of pelvic injuries.
False
Hypovolemic shock can be a symptom of pelvic injuries.
True
Pelvic splints can be reused after cleaning.
False
Movement should be maximized when treating pelvic injuries.
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Altered sensation in one leg can be a sign of a pelvic injury.
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A pelvic splint should be removed once it has been applied.
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Immediate splinting of pelvic injuries is not necessary for proper care.
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Managing airway during pelvic injury treatment does not require consideration of the c-spine.
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Pelvic fractures account for 10-15% of all fractures in adults.
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Haemorrhage is the leading cause of death in 40% of pelvic trauma patients.
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A significant door intrusion into the passenger space is a minor concern in an RTC.
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Falls from high places can sometimes cause pelvic injuries.
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Vascular injuries related to pelvic fractures do not typically cause haemorrhage.
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Bladder rupture occurs in about 25% of urogenital injuries associated with pelvic fractures.
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Pelvic injuries are equally common in men and women.
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Simple falls can lead to pelvic injuries, especially in individuals with certain risk factors.
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46% of spinal injuries occur from falls that are less than 2 metres.
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Road traffic collisions account for 60% of spinal injuries.
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Compression and stretching of the spinal cord can result from dislocation of vertebrae.
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Neurogenic shock can occur after a spinal cord injury due to loss of sympathetic tone.
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A bulging disc is synonymous with a herniated disc.
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Cauda Equina Syndrome requires urgent decompression in all cases.
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Loss of motor function during spinal shock is temporary and recovery is unlikely.
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Infection can be a cause of spinal injuries.
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Hypotension is an uncommon sign associated with spinal injury.
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Spinal tumours can cause compression of the spinal cord.
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A third of falls resulting in spinal injuries are from heights greater than 2 metres.
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Saddle anesthesia is a clinical red flag for Cauda Equina Syndrome.
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In spinal injury cases, bladder dysfunction is a common clinical red flag.
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Respiratory difficulties can occur due to damage to the lower cervical cord.
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Stretching of the spinal cord can lead to spinal cord injury in the event of vertebral displacement.
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Study Notes
Pelvic Injuries
- Pelvic fractures make up 3-6% of all adult fractures and occur in 20% of polytrauma cases.
- Approximately 75% of pelvic injuries happen to men.
- Haemorrhage accounts for 40% of deaths in pelvic trauma patients.
Causes of Pelvic Injuries
- Common mechanisms include high-energy transfers (e.g., road traffic collisions), falls from height, and crush injuries.
- Simple falls can cause injuries, particularly in the elderly or those with degenerative bone diseases or undergoing radiotherapy.
Complications of Pelvic Injuries
- Increased pelvic volume from fractures can lead to significant haemorrhage.
- Other potential complications include vascular injuries, urogenital injuries (10% risk of bladder rupture), and concurrent intra-thoracic or intra-abdominal injuries.
Signs & Symptoms of Pelvic Injuries
- Symptoms include bruising, rectal/vaginal/urethral bleeding, deformity, swelling, limb shortening, hip/groin/lower back pain, hypovolemic shock, and altered sensation in one leg.
Management of Pelvic Injuries
- Immediate management includes following DRABC protocols and applying a pelvic splint.
- Control catastrophic haemorrhage, provide high-flow oxygen, and ensure pain relief.
- Avoid repeated examinations that may dislodge blood clots and do not remove pelvic splints once applied.
- Successful splinting allows for safe transport to a major trauma center (MTC).
Spinal Injuries
- Spinal injuries result from mechanisms such as hyperflexion, hyperextension, rotation, or compression, with combinations of these prevalent.
- Falls account for 46% of spinal injuries, particularly among older individuals, while road traffic collisions account for 40%.
Types of Spinal Injuries
- Types include vertebral dislocation, fracture, and displacement, all of which can compress or stretch the spinal cord, leading to Spinal Cord Injury (SCI).
Complications of Spinal Injuries
- Potential complications include damage to the spinal cord, spinal shock, neurogenic shock, respiratory difficulties, and Cauda Equina Syndrome, which requires urgent surgical intervention.
Signs & Symptoms of Spinal Injury
- Common signs include pain along the spine, loss of sensation or movement in limbs, and altered sensations such as pins and needles or electric shock feelings.
- Specific symptoms indicating lower back injury such as saddle anesthesia, bladder/bowel dysfunction, and lower limb weakness should be closely monitored.
Additional Considerations
- Spinal shock indicates complete loss of motor and potentially sensory function, with recovery possible over time.
- Neurogenic shock features poor tissue perfusion due to loss of sympathetic tone, affecting overall stability following spinal cord injury.
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Description
This quiz focuses on identifying the mechanisms of pelvic and spinal injuries, along with their signs, symptoms, and management strategies. Understanding these components is crucial for effective trauma care in emergency and urgent settings. Test your knowledge and improve your skills in managing these critical injuries.
