ITLS Extremity Trauma Management 2

Question 1

A patient has a closed femur fracture with significant thigh swelling. How much blood can be lost into the thigh from this injury alone?

Accepted Answer

1000-1500 mL

Answer

A closed femur fracture can result in 1000-1500 mL of blood loss into the thigh, which represents a Class II to Class III hemorrhage and can cause hypovolemic shock.

Question 2

What is the correct application technique for a traction splint on a midshaft femur fracture?

Accepted Answer

Secure the ischial pad at the groin, apply manual traction to realign, then apply mechanical traction at the ankle

Answer

Traction splint application involves anchoring the ischial pad against the ischial tuberosity, applying manual traction to realign the limb, then transferring to mechanical traction via the ankle hitch until muscle spasm is overcome and the patient reports pain relief.

Question 3

During assessment of a forearm injury, you find the patient cannot extend their wrist or fingers and has numbness over the dorsal first web space. Which nerve is likely injured?

Accepted Answer

Radial nerve

Answer

The radial nerve controls wrist and finger extension and provides sensation to the dorsal first web space. Wrist drop with this sensory pattern indicates radial nerve injury, commonly associated with humeral shaft fractures.

Question 4

A patient has an open fracture of the tibia with bone visible through the wound. What is the correct prehospital management sequence?

Accepted Answer

Control bleeding, cover the wound with a sterile moist dressing, splint in position found, and transport

Answer

Open fractures are managed by controlling hemorrhage, covering the exposed bone with a sterile moist dressing to prevent desiccation, splinting without attempting reduction, and rapid transport for surgical management.

Question 5

What are the five P's of neurovascular compromise that ITLS providers must assess in extremity injuries?

Accepted Answer

Pain, Pallor, Pulselessness, Paresthesia, Paralysis

Answer

The five P's of neurovascular compromise are Pain (especially with passive stretch), Pallor, Pulselessness, Paresthesia (numbness/tingling), and Paralysis, assessed to detect compartment syndrome or vascular injury.

ITLS - International Trauma Life Support Practice Test

ITLS - International Trauma Life Support Practice Test

ITLS Extremity Trauma Management 2