Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
21 Cards in this Set
- Front
- Back
|
Are MSK injuries life or limb threatening
|
Rarely
|
|
|
If a pt has a bad msk injury what does it suggest
|
Significant traumatic force
|
|
|
What can fractures cause
|
Shock due to blood loss
|
|
|
What can crush injuries cause
|
Rhabdomyolysis resulting in renal failure
|
|
|
What can swelling in the fascial compartment cause
|
Compartment syndrome
|
|
|
Which bones can cause shock
|
Long bones (i.e. femur can cause up to 2 L of internal blood loss)
Try to align and immobilize |
|
|
How do you control external blood loss
|
Direct pressure or tourniquet
|
|
|
What are some life threatening MSK injuries
|
1. Pelvic disruption with hemorrhage
2. Long bone fracture |
|
|
How do you identify limb threatening injuries
|
1. Skin integrity (its the barrier to infection and fluid loss)
2. Neuromuscular function 3. Circulation to limbs (pulses) 4. Skeletal and ligament intergity |
|
|
Which investigations would you do
|
X-rays
MRI an CT can be done later on once life threatening injuries are treated |
|
|
What is the MOI for pelvic fractures
|
MVC
Getting hit by a car Fall from greater than 12 feet |
|
|
Why are pelvic fractures so dangerous
|
Has a big venous network without valves and hemorrhage can be massive
|
|
|
What are the signs of a pelvic fracture
|
1. Instability of pelvic ring on palpation
2. Unexplained hypotension 3. Swelling and bruising of the flank, perineum and peri-rectal area |
|
|
How do you treat a pelvic fracture
|
1. Fluid and blood resuscitation
2. Pelvic stabilization with a sheet wrapped around the pelvis |
|
|
1. What are the signs of a major arterial bleed
2. How do you treat it |
1. Brisk or pulsatile bleed, cool or pulseless distal extremity
2. Tourniquet and prompt surgical intervention |
|
|
What happens in a Crush Syndrome
|
Myoglobin is released from injured muscle which is toxic to renal tubules
|
|
|
How do you treat Crush Syndrome
|
Fluid resuscitation with alkaline fluid (bicarb with D5W)
|
|
|
What are 4 limb threatening injuries and how do you treat them
|
1. Open fracture and joint injury.
Treatment: irrigation, antibiotic, tetanus, ortho 2. Vascular injury (cool, slow cap refill, diminished asymmetric pulses) Treatment: Consult vascular surgery 3. Compartment Syndrom (pain out of proportion, Pain, Pallor, Paresthesia) Treatment: Plastics or ortho 4. Neurologic injury secondary to fracture dislocation Treatment: assess distal motor and sensory function => realign => reassess nerve function |
|
|
How do you assess non limb threatening injuries
|
Inspect for contusions and lacerations, test ROM and strength
|
|
|
What do patients usually sue for
|
Non life/limb threatening conditions
|
|
|
What are the associated injuries of the following:
1. Scapula/rib 1-3 2. Calcaneal fracture 3. Fractured humerus 4. Knee dislocation/tibial fracture 5. Pelvic fracture 6. Lumbar spine fracture 7. Open fracture |
1. Aortic or major thoracic injury
2. Lumbar spine fracture 3. Brachial artery, Median, ulnar, radial nerve 4. Popliteal artery and nerves 5. Abdominal/chest/head injury 6. Abdominal injury 7. 70% risk of non-skeletal injury |
