- Prehospital Trauma Life Support Musculoskeletal Trauma Flashcards

What is the primary goal of splinting extremity fractures in the prehospital setting?

Answer: To prevent further injury, reduce pain, and minimize hemorrhage

Splinting prevents further soft tissue and neurovascular injury, reduces pain by limiting movement, and helps control hemorrhage.

A patient has a closed femur fracture. How much blood can be lost internally from this single injury?

Answer: 1,000-1,500 mL

A closed femur fracture can result in 1,000-1,500 mL or more of blood loss into the thigh compartment.

When is a traction splint indicated in prehospital trauma care?

Answer: For isolated midshaft femur fractures without hip or knee involvement

Traction splints are specifically indicated for isolated midshaft femur fractures, applying longitudinal traction to reduce muscle spasm and realign bone fragments.

What neurovascular assessment should be performed before and after splinting an extremity fracture?

Answer: Assessment of pulse, sensation, and motor function distal to the injury

Distal pulse, sensation, and motor function must be assessed before and after splinting to detect any neurovascular compromise.

How should an open fracture with exposed bone be managed in the prehospital setting?

Answer: Control hemorrhage, apply moist sterile dressing over the wound, and splint

Open fractures require hemorrhage control, covering with a moist sterile dressing to prevent further contamination and drying, and immobilization with a splint.

A trauma patient has a deformed ankle with no palpable dorsalis pedis pulse. What should the prehospital provider do?

Answer: Attempt gentle realignment to restore distal circulation, then splint

When a deformed extremity has absent distal pulses, gentle realignment with inline traction may restore blood flow.

What is compartment syndrome and why is it significant in musculoskeletal trauma?

Answer: Increased pressure within a fascial compartment that compromises circulation and nerve function

Compartment syndrome occurs when swelling within a rigid fascial compartment raises pressure above capillary perfusion pressure, threatening tissue viability.

Which of the following is a sign of vascular injury associated with an extremity fracture?

Answer: Expanding hematoma at the fracture site

An expanding hematoma near a fracture site suggests arterial injury, as blood continues to accumulate under arterial pressure.

A patient has bilateral femur fractures after a pedestrian versus vehicle collision. What is the primary concern?

Answer: Life-threatening hemorrhagic shock from combined blood loss of 2,000-3,000 mL or more

Bilateral femur fractures can result in combined blood loss exceeding 3,000 mL, potentially causing Class III-IV hemorrhagic shock.

What is the appropriate management of an amputated body part for possible reimplantation?

Answer: Wrap in moist sterile dressing, place in plastic bag, then on ice without direct contact

The amputated part should be wrapped in moist sterile gauze, sealed in a plastic bag, and placed on ice water to cool without direct freezing.

How should a fracture near a joint be splinted differently from a midshaft long bone fracture?

Answer: Splint the joint in the position found, immobilizing the bones above and below

Fractures near or involving joints should be splinted in the position found because attempts to straighten them risk further neurovascular injury.

Why does PHTLS classify musculoskeletal injuries as lower priority during the primary survey unless hemorrhage is life-threatening?

Answer: Airway, breathing, and circulatory emergencies are more immediately life-threatening

PHTLS prioritizes the ABCDE approach because airway obstruction, inadequate ventilation, and hemorrhage will kill the patient faster than most extremity injuries.