PHTLS Musculoskeletal Trauma 2

Question 1

A patient has a suspected femur fracture with a thigh that appears significantly swollen and tense. What is the primary concern regarding blood loss?

Accepted Answer

Up to 2,000 mL or more can be lost into the thigh

Answer

Up to 500 mL can be lost into the thigh

Answer

Up to 1,000 mL can be lost into the thigh

Answer

Up to 1,500 mL can be lost into the thigh

Question 2

When applying a traction splint to a mid-shaft femur fracture, which of the following is a contraindication?

Accepted Answer

Suspected hip fracture or dislocation

Answer

Open femur fracture with minimal contamination

Answer

Bilateral femur fractures

Answer

Patient in hemorrhagic shock

Question 3

A construction worker falls and presents with an angulated lower leg deformity, absent distal pulse, and pale foot. What is the MOST appropriate immediate action?

Accepted Answer

Attempt one gentle realignment to restore circulation, then splint

Answer

Splint in position of deformity and transport rapidly

Answer

Apply traction to fully reduce the fracture before splinting

Answer

Elevate the limb and apply ice before splinting

Question 4

Which assessment finding best indicates compartment syndrome developing in a forearm after a radius fracture?

Accepted Answer

Pain with passive stretch of the fingers that is out of proportion to the injury

Answer

Skin discoloration over the fracture site

Answer

Swelling limited to the fracture site

Answer

Decreased capillary refill in the ipsilateral hand only

Question 5

A patient with a pelvic fracture from a high-speed MVC is hypotensive and tachycardic. Which prehospital intervention is MOST appropriate to reduce ongoing hemorrhage?

Accepted Answer

Application of a pelvic binder at the level of the greater trochanters

Answer

Pneumatic antishock garment (PASG) inflation

Answer

Bilateral femoral traction splints

Answer

Pelvic compression using a long backboard and straps

Question 6

Which type of fracture pattern is MOST commonly associated with high-velocity gunshot wounds to long bones?

Accepted Answer

Comminuted fracture

Answer

Transverse fracture

Answer

Oblique fracture

Answer

Greenstick fracture

Question 7

During scene assessment of a motorcycle crash patient, you notice a wound over the lateral knee with visible bone. The patient reports knee pain and cannot bear weight. How should this wound be managed before splinting?

Accepted Answer

Cover with a moist sterile dressing, then splint to include joints above and below

Answer

Irrigate vigorously with normal saline to clean the wound

Answer

Pack the wound tightly with dry gauze and secure with a pressure bandage

Answer

Leave uncovered to prevent moisture buildup under the splint