Chapter 36

You are treating a patient who has an open wound directly over the fracture site. This is called a(n): -compound fracture. -open fracture. -laceration. -All of these.

open fracture.

Which one of the following questions is BEST asked when attempting to determine the degree of sensation in the hand of a patient who has suffered an elbow injury? -"Can you tell me if you have parethesia in your hand?" -"Can you tell me what finger I am touching?" -"Do you have feeling in your hand?" -"Does your hand feel as though it is asleep?"

"Can you tell me what finger I am touching?"

Which one of the following statements about traction splints is TRUE? -"Once the traction splint has been positioned under the leg, and the ankle hitch is applied, manual traction can be released." -"Once the mechanical traction has been applied, the ischial strap must be released to promote circulation into the affected leg." -"Mechanical traction should be applied until the mechanical traction is equal to the manual traction and the patient experiences a reduction in pain." -"Mechanical traction should be applied until the affected leg is approximately one to two inches longer than the unaffected leg."

"Mechanical traction should be applied until the mechanical traction is equal to the manual traction and the patient experiences a reduction in pain."

Your patient has an injury to the elbow and forearm. While you are conducting the reassessment, which one of the following statements made by the patient should concern you most? -"My arm seems to be bruising more." -"I am still having a hard time moving my arm." -"It hurts when I move my fingers." -"My hand feels like it is going to sleep."

"My hand feels like it is going to sleep."

Which one of the following statements shows that an AEMT understands field care of a patient with a possible joint dislocation? -"The care for a patient with a joint injury is identical to that of a fracture." -"If a distal pulse is absent, three attempts to straighten the joint can be made." -"If a joint injury is suspected, ice packs and not splints are indicated." -"Warm packs, not cold packs, are indicated for a patient with a possible joint injury."

"The care for a patient with a joint injury is identical to that of a fracture."

Which one of the following statements about different musculoskeletal injuries is TRUE? -A sprain is an injury to a joint with possible damage to or tearing of ligaments. -A dislocation occurs when the bone within a joint is broken. -A fracture occurs when a tendon connecting muscle to a bone is overstretched and injured. -Strains are injuries that occur to ligaments and the joints to which they are attached.

A sprain is an injury to a joint with possible damage to or tearing of ligaments.

Prior to and after applying a splint, the AEMT should assess: -neurological status of affected extremity. -ABCs. -distal circulatory status. -All of these.

All of these.

A nine-year-old boy has fallen from a swing. Assessment findings reveal no threats to the airway, breathing, or circulation, but do indicate deformity, pain, and swelling to his right wrist. The right radial pulse is strong and is accompanied by skin that is pink and warm to the touch. Which one of the following actions indicates that the AEMT is properly caring for this patient? -Maintaining the wrist below the level of the heart to decrease swelling -Applying cold packs to the wrist to reduce swelling -Straightening the wrist to promote blood flow to the hand -Massaging the wrist gently to decrease the pain

Applying cold packs to the wrist to reduce swelling

A patient exhibits swelling and deformity to the wrist. After splinting, which one of the following positions of the hand is MOST appropriate? -Hand in a fist with thumb inside fist -Fingers curled inward -Wrist flexed with fingers extended -Fingers extended and spread

Fingers curled inward

The AEMT recognizes that a splint applied too loosely can result in which one of the following? -Decreased pain to the fracture site -Conversion of an open fracture to a closed fracture -Laceration of previously intact blood vessels -New fractures along the bone

Laceration of previously intact blood vessels

While on standby at a semi-professional baseball game, you are summoned onto the field for a player complaining of severe leg pain after colliding with the catcher of the opposing team. The primary assessment shows no threats to the airway, breathing, or circulation. The secondary assessment reveals a severely deformed knee that is swollen and ecchymotic. The leg is pale and cool, and the patient cannot move his leg when asked to do so. In addition, you cannot palpate a pedal pulse. Which one of the following is your priority at this time? -Apply a traction splint and enough traction until a pulse returns. -Check the patient's radial or carotid pulse. -Make one attempt to straighten the leg to reestablish circulation. -Apply cold packs to the knee and transport immediately.

Make one attempt to straighten the leg to reestablish circulation.

You have been dispatched for a patient whose arm was caught in a grinding machine. Assessment reveals a deformed arm covered with a bloody towel. The patient is alert and anxious, and he has a patent airway. His breathing is adequate. Radial pulse is fast but strong. Which one of the following should you do next? -Perform a secondary assessment focusing on his arm. -Start positive pressure ventilation. -Begin IV therapy. -Insert an oropharyngeal airway and administer oxygen.

Perform a secondary assessment focusing on his arm.

A football player injured his knee during practice and is in pain. His left knee is swollen, ecchymotic, and flexed in an upward position. Your partner reports that the distal skin is warm, and he has located a weak pedal pulse. Which one of the following should you perform immediately? -Splint the knee in the position found prior to providing transport to the hospital. -Place the patient on a long spine board and apply the traction splint en route to the hospital. -Apply a traction splint and straighten the knee until the pain is decreased. -Realign and straighten the injured knee and then immobilize it by binding it to the other leg.

Splint the knee in the position found prior to providing transport to the hospital.

A young man riding a motorcycle was hit head on and ejected from the bike. Your scene size-up reveals him to be lying supine in the roadway with obvious deformity to his right thigh and left ankle, with blood noted to his pants in these areas. Patient assessment reveals he is unresponsive with snoring respirations and is breathing 16 times per minute. His radial pulse is moderate in strength, and his skin is warm and dry. Which one of the following actions should be performed FIRST? -Check for distal pulses in both lower extremities. -Take and maintain manual inline spinal stabilization. -Expose and splint both legs to prevent further injury. -Open the airway using the head-tilt; chin-lift.

Take and maintain manual inline spinal stabilization.

A female patient with osteoporosis stepped sideways on her foot and has suffered an open tibial fracture to the distal portion of her right leg. Which one of the following interventions indicates that appropriate care is being given for this injury? -The protruding bone is gently replaced back under the skin. -The bone end and soft-tissue wounds are covered with a sterile dressing. -A pressure dressing is tightly applied to the open wound prior to splinting. -The AEMT cleans dirt from within the wound and off the bone prior to splinting.

The bone end and soft-tissue wounds are covered with a sterile dressing.

Which of the following statements regarding the indication and application of traction splints is TRUE? -Traction splints prevent bone ends from overriding, lessen pain, and may help relax muscular contraction. -If the femur fracture is associated with instability about the ankle, apply the hitch to the lower leg three inches above the site of the fractured malleolus. -If the femur fracture is associated with pelvic instability, application of the PASG prior to the traction splint may minimize the potential bleeding. -Traction splints cannot be utilized in open femur fractures.

Traction splints prevent bone ends from overriding, lessen pain, and may help relax muscular contraction.

A patient with a closed fracture to the forearm has been properly splinted when which of the following are immobilized? -Elbow and forearm -Shoulder, elbow, and forearm -Wrist, forearm, and elbow -Wrist and forearm

Wrist, forearm, and elbow

You are called to the local school playground for a six-year-old who fell off the teeter-totter. Her only complaint is pain to her right knee. Following your initial assessment, you should perform: -a rapid secondary assessment. -a detailed physical exam. -a reassessment. -a focused secondary assessment.

a focused secondary assessment.

Management of a traumatic fracture of the femur should include: -stabilization of affected limb using a longboard and padding with pillows and blanket rolls, transport to emergency department. -application of traction using either the unipolar or bipolar device, supportive fluid therapy, transport to trauma center. -application of traction using a unipolar device, application of the PASG, supportive fluid therapy, transport to trauma center. -application of traction device, application of the PASG, immobilization using the longboard, transport to emergency department.

application of traction using either the unipolar or bipolar device, supportive fluid therapy, transport to trauma center.

You suspect that your patient has a possible pelvic fracture following a fall. The BEST way to splint this injury is: -to secure to a long backboard. -apply an improvised pelvic binder. -to place on padded stretcher and secure for comfort. -application of a traction splint.

apply an improvised pelvic binder.

While the clavicle is the MOST frequently fractured bone in the human body, it: -is unlikely to cause serious internal injury. -cannot be managed in a prehospital setting. -can be managed by immobilizing the distal extremity using an air or rigid splint. -can be managed by immobilizing the affected limb using a sling and swathe.

can be managed by immobilizing the affected limb using a sling and swathe.

When treating a patient with a musculoskeletal injury who also has soft-tissue involvement, the AEMT should: -rapidly splint the injury and bandage the wound to prevent infection. -splint the injury leaving the wound available for dressing and bandaging. -cover an open wound with the splint to assist bleeding control. -dress and bandage the open wound prior to splinting.

dress and bandage the open wound prior to splinting.

A patient has suffered an open crush injury to his elbow. As you approach, you note the patient sitting upright holding a towel to his elbow. The towel is soaked with blood, but the elbow does not appear to be actively bleeding. Your FIRST action in caring for this patient should be to: -place a sterile dressing over the injury. -apply oxygen through a nonrebreather mask. -evaluate the patient's airway. -examine the patient's elbow.

evaluate the patient's airway.

You have an 18-year-old woman who was hit in the arm by a softball. Upon inspection, you observe swelling and tenderness, but no deformity or crepitus. The patient has no external bleeding, but there is tissue discoloration. You suspect internal bleeding, and begin treatment which includes: -immobilization. -pain control. -hemorrhage control. -preventing contamination of the wound.

immobilization

You are evaluating a patient who is experiencing pain, deformity, and a loss of pulse to his left upper extremity following a riding accident. You suspect a dislocated shoulder. Based on this information, you should: -provide oxygen and paralytics to reduce the fracture site. -make multiple attempts at resetting the joint into socket. -splint the shoulder in position found and transport rapidly. -make one attempt to manipulate the joint while checking distal pulse.

make one attempt to manipulate the joint while checking distal pulse.

You are assessing a patient who has fallen from a ladder and is in severe pain from an angulated, midshaft femur. Although angulated, there is good circulation and sensation distal to the injury site. The patient is conscious and alert and complains of severe pain. The MOST correct treatment for this patient is: -treat for shock with oxygen, IV fluids, and secure patient to spine board. -oxygen, IV, traction splinting, and give analgesics for pain as indicated. -oxygen, IV, ladder splint as found, give analgesics for pain, and transport. -give morphine, splint the extremity as found, and transport.

oxygen, IV, traction splinting, and give analgesics for pain as indicated.

The potential effects of compartment syndrome when the object is removed from the patient include all of the following EXCEPT: -paradoxical movement. -paralysis. -pallor. -pulselessness.

paradoxical movement.

The term subluxation describes: -partial displacement of a joint. -gross dislocation of a joint. -a fracture with exposed bone ends. -bleeding into a muscle compartment.

partial displacement of a joint.

The basic principle to splinting a suspected fracture is: -splint the joint above and below the fracture site. -always use the traction splint when a femur is fractured. -splinting takes priority over bandaging to preserve limb function. -All of these are true.

splint the joint above and below the fracture site.

Angulated knee dislocations can be immobilized with: -a bipolar traction splint. -two medium rigid splints. -a swathe. -a unipolar splint.

two medium rigid splints.