Week 3 - Geraldine Lewis 1 Flashcards

1
Q

What does ATS stand for? What is it used for?

A
  • Australasian Trauma Scale

- Used to help ED physicians rank patients in order of who they are going to treat

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2
Q

What are ATS scores based on?

A
Pain score
Airway
Breathing
Circulation
Disability
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3
Q

What are examples of a score of 1 on ATS?

A

Unresponsive, cardiac arrest, severe shock, severe behavioural disorder with immediate threat of danger violence

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4
Q

What are some examples of scores of 2 on ATS?

A

Acute stroke, severe stridor, major multi-trauma

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5
Q

What is compartmental syndrome?

A

Localised swelling of soft tissue enclosed by fascia that cuts off expansion - this can lead to a block in blood supply, which can cause irreversible ischaemic injury if pressure if not released

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6
Q

What are the eight bones of the wrist?

A
Scaphoid
Lunate
Triquetral
Pisiform
Trapezium
Trapezius
Capitate 
Hamate
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7
Q

Where do you look on a wrist exam?

A

On flexor and extensor side, as well as medial and lateral sides.
Assess for radial and ulnar deviation

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8
Q

Where do you palpate on a wrist exam?

A
  1. Palpate along distal radius, then into the snuff box. Continue down 1st metacarpal and onto the thumb.
  2. Then check 2nd, 3rd, 4th and 5th metacarpals for any pain.
  3. Move to ulnar side, feel around the ulnar styloid, and carry up the distal ulnar
  4. Feel across carpal bones
    Assess for pain around phalangeal joints
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9
Q

How do you assess for mobility in a wrist exam

A
  • adduction/abduction of the fingers

- opposition of the thumb, thumb to little finger, thumb to index finger, flexion and extension of the thumb

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10
Q

What are the special tests in a wrist exam?

A

Collateral ligament assessment

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11
Q

How would you assess for integrity of radial collateral ligament of the wrist?

A

See if passive ulnar deviation causes pain

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12
Q

How would you assess strength in the wrist/hand?

A

Ask patient to keep fist closed while you try to open in

As patient to flex, extend and deviate the wrist - actively, and against resistance

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13
Q

What do you need for good fracture healing?

A
Immobilization
Absence of infection
Adequate vascular supply
Good general health for healing
Precise anatomical reduction
Minimal necrosis
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14
Q

What does ‘reduction’ of a fracture mean?

A

That you’re manipulating it back into a normal position. Can be closed or open – open means surgery and tools are used

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15
Q

Describe Bier’s block for a closed reduction

A
  1. 1% lidocaine (no epinephrine), 1:1 with saline.
  2. Intravenous catheter inserted
  3. Complete isolation of area being blocked, two tourniquets are used - both arterial, both taped in place
    Pressure cuff also used, pressure taken up to about 300 systolic
    Reduction performed
    Deflate tourniquet after at least 20 minutes to avoid bolus into systemic circulation
    Remove catheter
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16
Q

Can patients with multiple lacerations have Bier’s block used on them?

A

Yes

17
Q

How are fractures categorised?

A
  1. Anatomical location
  2. Direction of fracture i.e. oblique/transverse
  3. Linear or comminuted
  4. Whether impacted
  5. Whether open or closed
  6. Whether pathological
18
Q

What is alignment and how is it described?

A

The alignment of a fracture is the relationship of the axes of the fragments of a long bone - the degree to which they are angulated
Described in degrees of angulation of the distal fragment in relation to the proximal fragment

19
Q

Describe a dinner fork/Colle’s fracture of the wrist

A

This is a fracture of the distal radius in the forearm with dorsal (posterior) and radial displacement of the wrist