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What is a ligament?
connects bone to bone
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What is a tendon?
connects muscle to bone
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What is a sprain?
joint and ligament injury
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What is a strain?
muscle or a muscle and tendon injury caused by over extension
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Types of closed/compound fractures
simple, comminuted
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Types of closed fractures
greenstick, spiral, transverse, simple
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Potential danger of fractures
Hemorrhagic shock, Neurovascular compromise (assess distal PMS)
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Closed femur fractures can lose how much blood?
- loss of 1 L of blood
- bilateral femur fractures life threatening (load & go)
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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)
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What risk do both of these fractures present?
pulmonary embolism, TIA, MI
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Dislocations are?
Injuries involving joints
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Dislocations with neurovascular compromise are?
true emergency though not life threatening
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How are dislocations managed?
check PMS distal to affected joint, splint in position found
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What are the complications of amputations?
- disabling & sometimes life threatening
- potential for massive hemorrhage(most often bleeding controlled with ordinary pressure)
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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)
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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
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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)
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In an obvious exsanguinating hemorrhage, what changes during the initial assessment?
ABC becomes CAB
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A neurovascular injury is?
nerves and blood vessels are compromised, usually in the flexor area of major joints from dislocations and/or fractures
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How are impaled objects treated?
- do not remove unless airway is obstructed
- stabilize in place with bulking dressing and trasport in place
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What is Compartment Syndrome?
swelling in the forearm or lower leg that compresses nerves & vessels
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S/S of Compartment Syndrome?
- early: pain, paresthesia
- late: 5 P's---pain, pallor, pulselessness, parathesia, paralysis
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Common injury associated with falls landing on feet?
foot, lumbar spine
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Common injury associated with a MOI where the Patient was in the sitting postion?
knee, hip
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Common injury from a fall onto the wrist?
wrist, elbow
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What injury is common from a fall onto the ankle?
ankle, proximal fibula
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The MOI history involves the shoulder, what is the common inury?
shoulder, neck, chest
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The MOI history involves the pelvis, what is the common injury?
pelvic, shock
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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
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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
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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
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What type of splint does an open fracture require?
rigid
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