EMT Chapter 30
A patient who sustains a femur fracture can lose approximately:
1 to 1.5 L of blood
How much blood loss can result from a femur fracture?
1500 mL
The skeletal system supports the body. Which statement about the skeletal system is TRUE?
A major element in motion is the body's joints, where the bones meet
Your patient has a severe angulated femur fracture. On your initial assessment of the injury site, you note that the patient has diminished sensation distally and weak pulses. The patient is in extreme pain and screaming loudly. You apply manual traction to the leg and straighten the injured leg out as much as you can. The patient notes some relief with this maneuver. Just before placing the hare traction splint, your partner notes that the patient has no feeling in her toes and the dorsalis pulse has disappeared. Your NEXT action should be to:
Attempt to reposition the leg manually by adding additional traction, thus attempting to pull the fractured bone heads apart and placing the leg in its natural position.
General rules of splinting include:
Covering all wounds, including open fractures, with sterile dressings before applying the splint
Ascertaining the forces to which the bone fracture patient's body was subjected and the direction in which those forces propelled the body is part of:
Determining the mechanism of injury
During your ongoing assessment of a patient with a bone or joint injury while en route to the hospital, be sure to:
Elevate the extremity if spinal injury is not suspected
The basic goal of splinting a fracture is to:
Immobilize the bone ends and two adjacent joints
When performing a physical examination on a patient with a musculoskeletal injury, remember that:
It is important to obtain a SAMPLE history during or after your physical examination
The various types of musculoskeletal injuries:
May cause injuries to body areas that are distant from the injury site
Muscle and bone are the two main components of the:
Musculoskeletal system
Realigning a bone in a fractured extremity may be necessary. Which statement about realignment is INCORRECT?
Realignment is not painful, but the injury site may be painful after realignment
Traction splinting a fractured femur will realign the bone and:
Reduce blood loss into the thigh
The mechanisms of injury, or forces that may cause bone and joint injury, include indirect force, which is:
The force striking one end of a limb, causing injury some distance away from the point of impact
What is MOST likely to occur if a splint is applied improperly?
The pulse distal to the splint may become weak or absent
Signs and symptoms of a bone or joint injury may include pain, tenderness, and crepitus, which is:
The sound or feeling of broken bone fragments grinding against each other
The body contains three kinds of muscles, each with a specific function. These muscles are:
Voluntary, involuntary, and cardiac muscles
Aside from the pain it causes, when is a dislocation of MOST concern?
When it involves tear of blood vessels
You are treating an elderly patient with osteoporosis. You note on examination that his left thigh has a significant hematoma and swelling. The patient has not been ambulating much today because of pain in his lower leg. From your assessment, it is likely that the patient has:
a femur fracture
You are unable to locate the pulse distal to a fracture. This may indicate damage to a(n):
artery
If your primary assessment reveals an unstable patient, splinting of individual extremity injuries:
becomes a low priority
The use of a traction splint in the presence of a pelvic fracture:
can cause internal hemorrhage
When assessing your trauma patient, you note that he is complaining of pain, paresthesia, and pressure in his lower right leg. Upon your examination, you note that his lower right leg is pale and does NOT have a pulse. These findings are indicative of:
compartment syndrome
When pressure in the space around the capillaries exceeds the pressure needed to perfuse the cells, the result is:
compartment syndrome
You have a patient with a closed fracture of the femur. During assessment, you note that the femoral area is very distended, with taut skin overlying the injury. The patient states that she has no feeling distal to the injury site, and the distal pulse is absent. In addition to the fractured femur, what other type of condition may exist?
compartment syndrome
You have applied a rigid splint to a patient's forearm, applied ice packs, and elevated the arm. The patient soon begins complaining of severe pain and loss of distal movement. You reassess and note that the previously present radial pulse has disappeared. After loosening the splint, you notice additional swelling and return of the pulse. After you rewrap the splint, the pulse remains but so does the severe pain. This is an indicator of:
compartment syndrome
The sound or feeling of a broken bone end rubbing on another broken bone end is called:
crepitus
An injury that occurs at the force of impact is caused by:
direct force
Colliding with the internal components of a car during a motor vehicle collision may result in a fracture caused by:
direct force
What type of orthopedic injury may have occurred when a joint is injured in such a way that it becomes fixed in an abnormal position, is resistive to motion, is extremelypainful, and will likely have noticeable deformity?
dislocation
When a bone is forced well beyond its normal position in a joint, this injury is called a:
dislocation
Fractures to which areas are considered critical injuries because of the associated risk of serious bleeding?
femur and pelvis
Guidelines for splinting long bone injuries include:
immobilizing the hand or foot in the position of function
An injury that occurs away from the force of impact is caused by:
indirect force
An elderly man trips on his carpet and falls to his hands and knees, fracturing the patella on his left leg and the neck of the humerus on his left arm. The fracture of his humerus would be a/n:
indirect force frature
What is the eventual outcome of undiagnosed compartment syndrome?
loss of tissue
The main reason an EMT splints a bone or joint injury is to prevent:
movement
Paresthesia distal to a fracture is an indicator of:
neurological involvement
Patients with a past medical history of cancer, osteoporosis, and other benign bone conditions such as congenital cysts are at risk for:
non traumatic fractures
Which condition will MOST likely have a nontraumatic bone fracture associated with it?
osteoporosis
Which of the following is one of the six Ps of a musculoskeletal injury?
pallor
A 42-year-old female patient complains of numbness in her left leg after falling. Which of the six Ps of musculoskeletal injury is she describing?
paresthesia
Because a nontraumatic fracture is typically caused by a degenerative disease, it is also known as a:
pathological fracture
Significant bleeding is most likely associated with a fracture of the:
pelvis
A 65-year-old male patient fell from the roof of his house. He is unconscious. You notice that he has an open fracture to his lower right leg and a deformity to his left upper arm. There is capillary bleeding associated with the leg fracture. You should first:
prepare for rapid transport
The functions of the musculoskeletal system include:
providing for movement
Failure to properly pad between an extremity and splinting material may lead to:
skin damage
Your patient states that while he was jogging, he stepped on the "side" of his ankle in a pothole. The ankle is swollen and deformed, but he has good pulses, motorfunction, and sensation. What is MOST likely the injury that this patient has sustained?
sprain
An 18-year-old male patient complains of left lower leg pain after falling from a skateboard. As you approach the patient, you notice that the leg is cyanotic distal to an obvious deformity. You should first:
take appropriate standard precautions
A 53-year-old man complains of an injury to his right lower leg. You notice an obvious deformity. Below the deformity you observe warm, flushed skin. This finding mayindicate:
that a vein is blocked
In general, you should NOT use a traction splint if:
the pelvis has been injured
You are treating a 17-year-old female patient who fell while playing basketball. Her right thigh is painful, swollen, and deformed, and she is in considerable pain. The MOST appropriate device for splinting her injury would be a:
traction splint
