Musculoskeletal and Soft Tissue Trauma - NREMT: AEMT Level

Complete loss of joint surface contact. Dislocations happen when bones in a joint are forced out of alignment, resulting in no contact between articular surfaces.

Partial loss of joint surface contact. Subluxations are partial dislocations where joint surfaces remain in partial contact but are misaligned.

Fracture with intact overlying skin. Closed fractures maintain skin integrity over the break, reducing immediate infection risk compared to open types.

Fracture with an open wound to the fracture site. Open fractures breach the skin, exposing the bone and increasing risks of contamination and bleeding.

Comminuted fracture. Comminuted fractures result from high-impact trauma that shatters the bone into multiple fragments.

Greenstick fracture. Greenstick fractures occur in flexible pediatric bones, bending like green wood without complete separation.

Torus (buckle) fracture. Torus fractures involve compression forces causing the cortex to buckle without full breakage, typical in immature skeletons.

Spiral fracture. Spiral fractures arise from rotational stress, creating a helical break pattern along the bone's length.

Avulsion fracture. Avulsion fractures happen when strong muscle contractions or ligament pulls detach a bone piece at the attachment site.

Massive hemorrhage. Pelvic fractures can disrupt major blood vessels, leading to significant internal bleeding and hypovolemic shock.

Hemorrhage and infection risk. Open fractures expose the site to external contaminants, heightening infection potential alongside blood loss.

Pulse, motor function, and sensation distal to injury. Distal checks evaluate circulation, movement, and feeling to detect neurovascular compromise from injury or swelling.

Pain out of proportion to the injury. Compartment syndrome causes intense pain from pressure buildup in fascial compartments, preceding other signs like paresthesia.

Direct pressure and pressure dressing. Direct pressure controls bleeding by compressing vessels, with dressings maintaining pressure on unstable fractures.

Tourniquet placed proximal to the bleeding site. Tourniquets occlude arterial flow when pressure fails, preventing exsanguination in severe limb trauma.

Immobilize the joint above and the joint below. Splinting stabilizes the fracture by immobilizing adjacent joints, minimizing movement and further tissue damage.

Ligaments. Sprains occur when ligaments, which connect bones at joints, are stretched or torn due to excessive force.

Wrap moist sterile, bag it, then place on ice slurry. Proper preservation maintains tissue viability by preventing drying, contamination, and freezing during transport.

Superficial (first-degree) burn. Superficial burns affect only the epidermis, causing erythema and pain without deeper tissue involvement.

Partial-thickness (second-degree) burn. Partial-thickness burns damage the dermis, forming blisters and eliciting severe pain from exposed nerve endings.

Full-thickness (third-degree) burn. Full-thickness burns destroy all skin layers, resulting in insensate, tough tissue due to nerve destruction.

Brush off dry chemical, then irrigate copiously. Removing dry chemicals prevents further reaction, followed by irrigation to dilute and wash away the agent.

Shoulder dislocation. Shoulder dislocations alter the joint's rounded shape, causing deformity and pain from humeral head displacement.

Reassess alignment; if allowed, gently realign once and resplint. Absent pulses indicate vascular compromise; realignment may restore flow if protocols permit, followed by resplinting.