EMT Chapter 31 - Questions

Which of the following are goals of in-line traction? 1.Avoid neurovascular compromise 2.Stop bleeding 3.Stabilize the fragments to prevent movement 4.Align the limb for splinting

1, 3, and 4

List the injuries from least to most severe based on the musculoskeletal injury grading system. (1 = least severe, 5 = most severe). -Displaced pelvic fracture Bilateral femur fracture Pelvic fracture with hemodynamic instability Dislocated fingers Nondisplaced long bone fracture

1.Dislocated fingers 2.Nondisplaced long bone fracture 3.Displaced pelvic fracture 4.Bilateral femur fracture 5.Pelvic fracture with hemodynamic instability

In which situations should you splint the limb in the position of deformity? 1.When distal pulses are absent 2.When you encounter resistance or extreme pain when applying traction 3.When the deformity is the result of a dislocation and is severe 4.When the fracture is an open fracture

2 and 3

What is an example of a direct injury?

A passenger fractures her patella after it strikes the dashboard

A construction worker's arm was severed just above the elbow when a steel girder fell on it. The stump is covered with a blood-soaked towel. The patient's skin is cool, clammy, and pale. The EMT should:

Apply a tourniquet just below the shoulder

A 76-year-old male experienced sudden pain to his left thigh when he was standing in line at the grocery store. Your assessment reveals ecchymosis and deformity to the distal aspect of his left femur, just above the knee. Distal circulation and sensory and motor functions are intact. You should:

Apply padded board splints to both sides of the legs

Name the service that these steps belong to: 1. Expose the injured limb and check pulse, motor, and sensory function. Place the splint beside the uninjured limb, adjust the splint to proper length, and prepare the straps. 2. Support the injured limb as your partner fastens the ankle hitch about the foot and ankle. 3. Continue to support the limb as your partner applies gentle in-line traction to the ankle hitch and foot. 4. Slide the splint into position under the injured limb. 5. Pad the groin and fasten the ischial strap. 6. Connect the loops of the ankle hitch to the end of the splint as your partner continues to maintain traction. Carefully tighten the ratchet to the point that the splint holds adequate traction. 7. Secure and check support straps. Assess pulse and motor and sensory functions. 8. Secure the patient and splint to the backboard in a way that will prevent movement of the splint during patient movement and transport.

Applying a Hare traction splint

Name the service that these steps belong to: 1. After exposing the injured area, check the patient's pulse and motor and sensory functions. Adjust the thigh strap so that it lies anteriorly when secured. 2. Estimate the proper length of the splint by placing it next to the uninjured limb. Fit the ankle pads to the ankle. 3. Place the splint at the inner thigh, apply the thigh strap at the upper thigh, and secure snugly. 4. Tighten the ankle harness just above the malleoli. Secure the cable ring against the bottom of the foot. 5. Extend the splint's inner shaft to apply traction of about 10% of body weight. 6. Secure the splint with elasticized cravat bandages. 7. Secure the patient to a backboard. Check pulse and motor and sensory function.

Applying a Sager traction splint

Name the service that these steps belong to: 1. Provide gentle support and in-line traction for the limb. Assess distal pulse and motor and sensory function. 2. Place the splint alongside or under the limb. Pad between the limb and the splint as needed to ensure even pressure and contact. 3. Secure the splint to the limb with bindings. 4. Assess and record distal neurovascular function.

Applying a rigid splint

Name the service that these steps belong to: 1. Assess distal pulse and motor and sensory function. Your partner will stabilize and support the injury. 2. Place the splint and wrap it around the limb. 3. Draw the air out of the splint through the suction valve, and then seal the valve. Assess distal pulse and motor and sensory function.

Applying a vacuum splint

Name the service that these steps belong to: 1. Assess distal pulse and motor and sensory function. Support the injured limb and apply gentle traction as your partner applies the open, deflated splint. 2. Zip up the splint, inflate it by pump or by mouth, and test the pressure. Check and record distal neurovascular function.

Applying a zippered air splint

Name the service that these steps belong to: 1. Access distal pulse and motor and sensory function. Your partner should support the injured limb. Place your arm through the splint to grasp the patient's hand or foot. 2. Apply gentle traction while sliding the splint onto the injured limb. 3. Your partner will inflate the splint by pump or by mouth. Assess distal pulse and motor and sensory function.

Applying an unzippered air splint

You have applied a zippered air splint to a patient's left arm. During transport, the patient complains of increased numbness and tingling in his left hand. You reassess distal circulation and note that it remains present. Your MOST appropriate action should be to:

Assess the amount of air in the splint and let air out as necessary

What is the primary goal of in-line traction?

Avoid further neurovascular compromise

What structure is regulated by smooth muscle?

Blood vessels

Name the service that these steps belong to: 1. Cover the wound with a dry, sterile dressing, and apply pressure to control bleeding. Assess distal pulse and motor and sensory function. If bleeding cannot be controlled, quickly apply a tourniquet. 2. Apply a splint and elevate the extremity about 6 inches (15 cm), or slightly above the level of the heart. Assess distal pulse and motor and sensory function. 3. Apply cold packs if there is swelling, but do not place them directly on the skin. 4. Position the patient for transport and secure the injured area.

Caring for musculoskeletal injuries

When assessing a patient with a possible fracture of the leg, the EMT should:

Compare it to the uninjured leg

A disruption of a joint in which the bone ends are no longer in contact is known as what?

Dislocation

Which sign/symptom would you give a high index of suspicion that a patient may have compartment syndrome?

Disproportionate pain

(T/F) Fractures of the proximal femur usually involve the hip joint.

False

(T/F) If you are unable to restore the distal pulse on scene, you should splint the limb in a straight position and provide prompt transport to the hospital.

False

What type of fracture only passes partway through the shaft of a bone?

Greenstick

A 17-year-old football player collided with another player and has pain to his left clavicle. He is holding his arm against his chest and refuses to move it. Your assessment reveals obvious deformity to the midshaft clavicle. After assessing distal pulse, sensory, and motor functions, you should:

Immobilize the injury with a sling and swathe

During your secondary assessment of a 19-year-old female with multiple trauma, you note bilateral humeral deformities and a deformity to the left midshaft femur. Her skin is diaphoretic and her pulse is rapid and weak. Your partner has appropriately managed her airway and is maintaining stabilization of her head. The MOST appropriate treatment for this patient includes:

Immobilizing her to a backboard and rapidly transporting

What type of fracture does not run completely through the bone?

Incomplete

Which MOI causes a fracture or dislocation at a distant point?

Indirect force

When splinting a possible fracture of the foot, it is MOST important for the EMT to:

Leave the toes exposed

What is a correct statement regarding shoulder dislocations?

Most shoulder dislocations occur anteriorly

Name a musculoskeletal injury that would be deemed one of the LEAST severe.

Nondisplaced pelvic fracture

What type of fracture breaks the bone at an angle across the bone?

Oblique

What type of fracture is a nearly complete break due to weakness of the bone from osteoporosis, cancer, or infection?

Pathologic

What fracture has the greatest potential for internal blood loss and shock?

Pelvis

The MOST reliable indicator of an underlying fracture is:

Point tenderness

What is the most reliable indicator of an underlying fracture?

Point tenderness

When assessing distal circulation in a patient's lower extremities, which pulse should you palpate?

Popliteal

A 30-year-old man complains of severe pain to his right tibia following an injury that occurred the day before. The patient's leg is pale and he is unable to move his foot. The EMT should suspect that:

Pressure in the fascial compartment is elevated

The primary purpose for splinting a musculoskeletal injury is to:

Prevent further injury

Applying ice and elevating an injured extremity are performed in order to:

Reduce pain and swelling

The pectoral girdle consists of the:

Scapulae and clavicles

In the musculoskeletal injury grading system, under which category would you place a laceration of a major nerve or blood vessel?

Serious

What would you use to stabilize an AC separation?

Sling and swathe

You are attending to a patient with a nondisplaced elbow fracture. She has a strong pulse and good capillary refill. How should you address this type of injury?

Splint from the shoulder joint to the wrist joint to stabilize the entire arm

A 31-year-old male fell and landed on his left elbow. Your assessment reveals that the elbow is grossly deformed, his forearm is cool and pale, and the distal pulse is barely palpable. His vital signs are stable and he denies any other injuries. Your transport time to the closest appropriate hospital is approximately 12 minutes. You should:

Splint the elbow in the position found and transport

Name the service that these steps belong to: 1. Support the injured limb and move the hand into the position of function. Place a soft roller bandage in the palm. 2. Apply a padded board splint on the palmar side with fingers exposed. 3. Secure the splint with a roller bandage.

Splinting a hand and wrist

A ___ is a musculoskeletal injury in which there is partial or temporary separation of the bone ends as well as partial stretching or tearing of the supporting ligaments.

Sprain

Skeletal muscle is also referred to as ___ muscle.

Striated

What is a drawback of an air splint?

Temperature changes affect air pressure in the splint

(T/F) A fracture of the femoral shaft is best stabilized with a traction splint, such as a Sager splint.

True

(T/F) Lateral and medial dislocations to the knee are less common than posterior dislocations and are less likely to injure the popliteal artery.

True