PHTLS - Prehospital Trauma Life Support Prehospital Trauma Life Support Musculoskeletal Trauma 1

Question 1

Which of the following is the earliest and most reliable sign of developing compartment syndrome in a fractured extremity?

Accepted Answer

Pain that is disproportionate to the injury and worsened with passive stretch

Answer

Pulselessness distal to the fracture site

Answer

Paralysis of the affected limb

Answer

Pallor and mottling of the skin

Question 2

When managing an open (compound) fracture in the prehospital setting, what is the correct treatment of the wound before splinting?

Accepted Answer

Cover the wound with a moist sterile dressing and do not attempt to push exposed bone back into the wound

Answer

Pack the wound tightly with dry gauze and apply a circumferential pressure wrap

Answer

Irrigate the wound thoroughly with sterile saline before applying a dressing

Answer

Apply a tourniquet proximal to the wound regardless of bleeding severity

Question 3

A patient involved in a high-speed MVC is found with a suspected pelvic fracture. What is the maximum estimated internal blood loss possible from an unstable pelvic ring disruption?

Accepted Answer

More than 2,000 mL — potentially life-threatening hemorrhage

Answer

Up to 500 mL

Answer

Up to 1,000 mL

Answer

Up to 2,000 mL

Question 4

In which situation should a prehospital provider NOT attempt to realign a deformed extremity fracture before splinting?

Accepted Answer

When a joint is involved and any attempt at realignment produces resistance or causes severe pain

Answer

When the patient reports significant pain with the deformity

Answer

When pulses are absent distal to the fracture and transport time is less than 10 minutes

Answer

When the fracture is in the midshaft of the radius

Question 5

What is the correct prehospital approach when a long bone fracture is associated with an absent distal pulse?

Accepted Answer

Gently realign the limb toward anatomical position once, reassess pulses, then splint

Answer

Splint in the position of deformity and do not manipulate the limb

Answer

Apply a traction splint immediately to restore circulation

Answer

Apply a tourniquet and arrange air transport

Question 6

Which patient presentation is an absolute contraindication to the use of a traction splint?

Accepted Answer

Suspected femur fracture with an associated hip or knee injury

Answer

Mid-shaft femur fracture with severe pain and shortening

Answer

Femur fracture with a 2 cm wound over the thigh

Answer

Bilateral femur fractures in a hemodynamically unstable patient