ITLS Extremity Trauma Management 3

Question 1

When splinting a fracture, which principle is fundamental to proper immobilization technique?

Accepted Answer

Immobilize the joint above and below the fracture site

Answer

Proper splinting requires immobilizing the joint above and below the fracture to prevent any movement at the fracture site during patient transport.

Question 2

A patient has sustained a traumatic amputation of three fingers. How should the amputated parts be managed for potential reimplantation?

Accepted Answer

Wrap in saline-moistened sterile gauze, place in a sealed bag, then place that bag in a container of ice water

Answer

Amputated parts should be wrapped in moist sterile gauze, sealed in a plastic bag, and placed in an ice water bath to cool without freezing, preserving tissue viability for up to 12-18 hours.

Question 3

What is the significance of a pelvic fracture in the trauma assessment, and what specific complication makes it particularly dangerous?

Accepted Answer

It can cause massive retroperitoneal hemorrhage that is difficult to control and is associated with high mortality

Answer

Pelvic fractures are among the most lethal musculoskeletal injuries because the pelvic ring's rich vascular supply can produce massive retroperitoneal hemorrhage that is not amenable to direct pressure or tourniquet application.

Question 4

A crush injury victim has had a concrete slab on his legs for 4 hours. Rescue workers are about to lift the slab. What potentially lethal complication may occur upon release?

Accepted Answer

Crush syndrome: reperfusion releases hyperkalemia, myoglobin, and lactic acid into central circulation

Answer

Crush syndrome occurs when prolonged compression of muscle tissue causes cellular death and accumulation of toxic metabolites. Upon release, reperfusion floods the systemic circulation with potassium, myoglobin, and lactic acid, causing cardiac arrest and renal failure.

Question 5

After applying a splint to a patient's fractured wrist, the fingers become pale, cold, and the patient reports increased numbness. What should you do?

Accepted Answer

Loosen the splint bandages and reassess circulation

Answer

Neurovascular compromise after splinting indicates the splint or wrappings are too tight. Loosening the bandages while maintaining immobilization typically restores circulation.

ITLS - International Trauma Life Support Practice Test

ITLS - International Trauma Life Support Practice Test

ITLS Extremity Trauma Management 3