musculoskeletal injuries

Question 1

what are the 5 P of fracture

Answer 1

• Pain- severe pain?
• Paralysis- partial/full loss of ability to move?
• Paresthesia- loss sensation, tingling?
• Pallor- has limb lost it’s colour , pale cyanotic?
• Pulselessness- absence of distal pulse?

Question 2

what the approx internal blood loss for rib, radius/ulna, humerus, tibia/fibula, femur, pelvis

Answer 2

rib -> 125 ml
radius/ulna -> 250-500 ml
humerus -> 500-750 ml
tibia/fibula -> 500-1000 ml
femur -> 1000-2000 ml
pelvis -> 1000 ml - massive

Question 3

where are the location of pain in the ankle that would required an x-ray if pain in malleolar zone

Answer 3

post. edge or lateral malleolus (6cm), post edge (6cm) or tip of medial malleolus + can’t weight bear

Question 4

where are the location of pain in the ankle that would required an x-ray if pain in mid foot zone

Answer 4

navicular, base of 5th metatarsal + inability to weight bear

Question 5

Ottawa knee injury -> a knee x-ray is only required for knee injury patient with any of these finding

Answer 5

• age 55 or older
• isolated tenderness of patella (no bone tenderness other than patella)
• tenderness of head of fibula
• inhability to flex to 90
• inability to bear weight both immediately and in the emergency department for 4 steps

Question 6

TX for closed fx

Answer 6

-PMSC pre and post splinting
-Apply gentle in-line traction and to splint in “near anatomical” position without pain
-Pathological angulations: attempt to
splint in near anatomic position without resistance.
-Prevent shock, supplemental oxygen prn.

Question 7

when do splint a limb as found (without repositioning)

Answer 7

joint fracture, open fracture of long bone

Question 8

what do you do with an severe long bone deformity (close fracture)

Answer 8

Splint as is or realign-same outcome (short duration). Therefore, re-position in order to splint and provide safe, comfortable transport

Question 9

how do you re-align a long bone

Answer 9

apply traction, imagine the position where the normal injured limb would and then gently pull along that line until the injured limb is in that position

Question 10

TX for open fx

Answer 10

• bandage wound/exposed bone to prevent infection
• MSC pre and post splinting
• Splint in “near anatomical” position without pain - Pathological angulations: attempt to splint in
  near anatomic position without resistance/force
  against exposed bone.
• Prevent shock, supplemental oxygen prn.
• Arrange for appropriate transport as required

Question 11

what do you do with digit luxation

Answer 11

gentle reduction/splint

Question 12

what acronym do we use on field for sprain eval

Answer 12

HOPPS

Question 13

what acronym do we use off field for sprain eval

Answer 13

HOPPSS

Question 14

position of limb found with posterior hip dislocation

Answer 14

adduction + internal rotation

Question 15

position of limb found with anterior hip dislocation

Answer 15

abduction + external rotation

Question 16

which sling do you use for clavicle fracture

Answer 16

tubular

Question 17

indication to use femoral traction splint

Answer 17

mid-third closed femoral fracture only

Question 18

how munch do you traction femoral splint if the patient is conscious

Answer 18

traction to comfort

Question 19

how munch do you traction femoral splint if patient is unconscious

Answer 19

10% of body weight -> max 15 lbs