ITLS CH 14
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What is a ligament?
connects bone to bone
What is a tendon?
connects muscle to bone
What is a sprain?
joint and ligament injury
What is a strain?
muscle or a muscle and tendon injury caused by over extension
Types of closed/compound fractures
Types of closed fractures
greenstick, spiral, transverse, simple
Potential danger of fractures
Hemorrhagic shock, Neurovascular compromise (assess distal PMS)
Closed femur fractures can lose how much blood?
- loss of 1 L of blood
- bilateral femur fractures life threatening (load & go)
Complications of closed pelvic fractures
- extensive bleeding into abdomen or retroperitoneal
- usually fractures in several places
- 500cc blood loss for each fracture
- may lacerate bladder or lg. pelvic blood vessels(abdominal aorta, femoral artery)
What risk do both of these fractures present?
pulmonary embolism, TIA, MI
Injuries involving joints
Dislocations with neurovascular compromise are?
true emergency though not life threatening
How are dislocations managed?
check PMS distal to affected joint, splint in position found
What are the complications of amputations?
- disabling & sometimes life threatening
- potential for massive hemorrhage(most often bleeding controlled with ordinary pressure)
How are amputations managed?
- cover with damp sterile dressing, elastic wrap
- uniform reasonable pressure across stump
- torniquet as an absolute last resort to controll bleeding
- retrieve amputated part(s)
How would you manage the amputated parts?
- wrap in moist gauze
- place in plastic bag and seal
- place in another plastic bag with ice water
- transport part with patient
How would you treat an open wound?
- remove gross contamination
- small wounds-flush with saline
- sterile dress and bandage(pressure dressing if needed to control bleed)
In an obvious exsanguinating hemorrhage, what changes during the initial assessment?
ABC becomes CAB
A neurovascular injury is?
nerves and blood vessels are compromised, usually in the flexor area of major joints from dislocations and/or fractures
How are impaled objects treated?
- do not remove unless airway is obstructed
- stabilize in place with bulking dressing and trasport in place
What is Compartment Syndrome?
swelling in the forearm or lower leg that compresses nerves & vessels
S/S of Compartment Syndrome?
- early: pain, paresthesia
- late: 5 P's---pain, pallor, pulselessness, parathesia, paralysis
Common injury associated with falls landing on feet?
foot, lumbar spine
Common injury associated with a MOI where the Patient was in the sitting postion?
Common injury from a fall onto the wrist?
What injury is common from a fall onto the ankle?
ankle, proximal fibula
The MOI history involves the shoulder, what is the common inury?
shoulder, neck, chest
The MOI history involves the pelvis, what is the common injury?
The MOI is a car crash, what is used to help in determining the injuries that would be commonly found?
injuries would be based on the direction in which the car was hit
What are the 4 rules of splinting?
- stabilize in the postition found
- realign ONLY if there is no distal PMS
- immobilize the joint above and below
- check distal PMS before and after splinting
When and how would you splint a patient that is a load and go?
- temporarily splint with a long spine board
- additional splints once in transport
What type of splint does an open fracture require?
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