Trauma Management & Intervention Flashcards

Which spinal injury pattern is associated with a hyperextension mechanism in an elderly patient with cervical spondylosis?

Answer: Central cord syndrome

Central cord syndrome results from hyperextension in patients with pre-existing cervical spondylosis, causing greater weakness in the upper extremities than the lower extremities.

A 9-year-old pedestrian struck by a car presents with a femur fracture at the proximal third. Compared to an adult, the child's fracture pattern differs because:

Answer: Children's bones are more pliable and often produce incomplete (greenstick) fractures

Pediatric bones contain more collagen and are more pliable than adult bones, making greenstick and plastic deformation fractures common rather than complete transverse breaks.

In a patient with suspected traumatic brain injury (TBI), which ventilation target is recommended to avoid secondary brain injury during transport?

Answer: EtCO2 of 35–45 mmHg (normocapnia)

Normocapnia (EtCO2 35–45 mmHg) is the target for TBI patients; hypocapnia causes cerebral vasoconstriction and ischemia, while hypercapnia worsens intracranial hypertension.

A patient with a traumatic amputation of the right forearm is in hemorrhagic shock. After tourniquet application, the next priority is:

Answer: Wrap the amputated part in moist saline gauze, place in a bag, and keep on ice without direct contact

Amputated parts should be wrapped in moist saline gauze, sealed in a bag, and kept cool on ice without direct contact to preserve viability for potential reimplantation.

Which sign indicates increasing intracranial pressure (ICP) and impending cerebral herniation?

Answer: Unilateral fixed and dilated pupil with decreasing GCS and hypertension with bradycardia

A unilateral fixed dilated pupil (blown pupil) with decreasing GCS and Cushing's response (hypertension + bradycardia) indicates uncal herniation compressing CN III.

A patient with multiple rib fractures on the right side breathes paradoxically — the right chest wall moves inward on inspiration. This defines:

Answer: Flail chest

Flail chest occurs when three or more adjacent ribs are each fractured in two places, creating a free-floating segment that moves paradoxically with respiration.

When applying a traction splint to a mid-shaft femur fracture, a contraindication to its use is:

Answer: Suspected hip or knee injury on the same extremity

Traction splints are contraindicated when there is a concurrent hip, knee, or ankle injury on the same limb, as axial traction would stress those joints and worsen injury.