First Aid Musculoskeletal Injury Management 5 — Questions and Answers
Question 1: A football player is hit directly on the outer thigh and develops a large, firm, painful bruise. This injury is most likely a:
- Contusion (charley horse) (Correct answer)
- Grade II quadriceps strain
- Femur stress fracture
- Deep vein thrombosis
Correct answer: Contusion (charley horse)
A direct blow to the thigh causes a muscle contusion (charley horse), resulting in localized bleeding within the muscle tissue.
Question 2: When should you NOT apply compression to a musculoskeletal injury?
- When there is a suspected fracture with significant deformity or bone protrusion (Correct answer)
- When the injury occurred more than 2 hours ago
- When the patient reports moderate pain
- When the injury is to an upper extremity
Correct answer: When there is a suspected fracture with significant deformity or bone protrusion
Compression should be avoided over open wounds, suspected fractures with deformity, or if it causes increased pain or circulation changes.
Question 3: A patient has fallen and reports neck pain but no neurological symptoms. Before EMS arrives, you should:
- Instruct the patient to stay still and manually stabilize the head and neck in line with the spine (Correct answer)
- Place the patient in the recovery position
- Apply a soft cervical collar from a first aid kit
- Perform a detailed neurological exam by asking them to move all limbs
Correct answer: Instruct the patient to stay still and manually stabilize the head and neck in line with the spine
Manual inline stabilization of the cervical spine is the safest method for a first aider to protect a potentially injured spine until EMS arrives.
Question 4: A gymnast falls and injures their wrist. There is tenderness in the 'anatomical snuffbox' (base of thumb). This finding strongly suggests:
- Scaphoid fracture (Correct answer)
- De Quervain's tenosynovitis
- Thumb metacarpal fracture
- Wrist sprain
Correct answer: Scaphoid fracture
Anatomical snuffbox tenderness after a FOOSH injury is the classic sign of a scaphoid fracture, which requires X-ray or MRI to confirm.
Question 5: Which of the following is the MOST important reason to remove rings and bracelets from an injured hand or wrist immediately after the injury?
- Swelling can make them impossible to remove later, cutting off circulation (Correct answer)
- Metal jewelry conducts cold from ice packs and worsens the injury
- Jewelry interferes with splinting materials
- Rings carry bacteria that increase the risk of wound infection
Correct answer: Swelling can make them impossible to remove later, cutting off circulation
Rapid swelling after a hand or wrist injury can cause rings and bracelets to act as tourniquets, compromising distal circulation.
Question 6: A young child is carried in by a parent who reports the child cried out suddenly and now refuses to use their right arm, which hangs limply. There is no reported trauma. This presentation is classic for:
- Nursemaid's elbow (radial head subluxation) (Correct answer)
- Clavicle fracture
- Shoulder dislocation
- Brachial plexus injury
Correct answer: Nursemaid's elbow (radial head subluxation)
Nursemaid's elbow occurs when the radial head slips out of the annular ligament, typically after a child is pulled or lifted by the hand, causing a limp, painful arm.
Question 7: After providing first aid for a musculoskeletal injury, when should you advise the patient to seek immediate medical attention?
- If there is significant deformity, numbness, severe swelling, or inability to bear weight (Correct answer)
- Only if the pain does not resolve within 24 hours
- Only if the skin is broken over the injury site
- If the patient is over 60 years of age regardless of injury severity
Correct answer: If there is significant deformity, numbness, severe swelling, or inability to bear weight
Deformity, neurovascular compromise, severe swelling, or inability to weight-bear are red-flag signs indicating a potentially serious injury requiring emergency evaluation.
First Aid Musculoskeletal Injury Management 5
A football player is hit directly on the outer thigh and develops a large, firm, painful bruise.
This injury is most likely a: