ITLS Extremity Trauma Management 3

Question 1

When splinting a fracture, which principle is fundamental to proper immobilization technique?

Accepted Answer

Immobilize the joint above and below the fracture site

Answer

Immobilize only the joint above the fracture

Answer

Apply the splint as tightly as possible to prevent movement

Answer

Straighten all fractures before splinting

Question 2

A patient has sustained a traumatic amputation of three fingers. How should the amputated parts be managed for potential reimplantation?

Accepted Answer

Wrap in saline-moistened sterile gauze, place in a sealed bag, then place that bag in a container of ice water

Answer

Place directly in a bag of ice to freeze them

Answer

Submerge the parts in warm saline solution

Answer

Apply direct pressure to the amputated parts and keep them at body temperature

Question 3

What is the significance of a pelvic fracture in the trauma assessment, and what specific complication makes it particularly dangerous?

Accepted Answer

It can cause massive retroperitoneal hemorrhage that is difficult to control and is associated with high mortality

Answer

It commonly causes urinary tract infections

Answer

It indicates minor force and low risk of associated injuries

Answer

It primarily affects mobility and has no acute life-threatening complications

Question 4

A crush injury victim has had a concrete slab on his legs for 4 hours. Rescue workers are about to lift the slab. What potentially lethal complication may occur upon release?

Accepted Answer

Crush syndrome: reperfusion releases hyperkalemia, myoglobin, and lactic acid into central circulation

Answer

Sudden pain causing vasovagal syncope

Answer

Immediate hemorrhagic shock from the crushed limbs

Answer

Fat embolism from the marrow of crushed bones

Question 5

After applying a splint to a patient's fractured wrist, the fingers become pale, cold, and the patient reports increased numbness. What should you do?

Accepted Answer

Loosen the splint bandages and reassess circulation

Answer

This is normal after splinting; continue transport

Answer

Remove the splint entirely and leave the fracture unsupported

Answer

Apply heat to the fingers to restore circulation

Question 6

What mechanism of injury commonly causes a scapular fracture, and what does this fracture indicate about the energy of the trauma?

Accepted Answer

Extremely high-energy impact, indicating likely associated thoracic injuries including pulmonary contusion, rib fractures, and great vessel injury

Answer

Low-energy falls with direct impact to the shoulder blade

Answer

Repetitive stress from overhead activities

Answer

Minimal force is needed; it is a common osteoporotic fracture