1
TCRN Review - Extremity and Wound
Trauma (Musculoskeletal Trauma, Surface
and Burn Trauma)
List some special considerations for abrasions. -
Correct answer- Pain control - full thickness
abrasions may be associated with nerve damage
and may have less pain
Evaporative heat loss - consider warming
measures
Evaporative fluid loss - consider need for fluid
replacement
Scarring - anesthetize wound and aggressively
remove debris
Define contusion. - Correct answer- Rupture of
subcutaneous blood vessels with extravasation of
erythrocytes.
Define hematoma. - Correct answer- Rupture of
artery or vein that will continue to expand until
the pressure in the tissue exceeds the pressure in
the ruptured vessel.
1
, 2
Contusions and hematomas have the potential for
what significant complication? - Correct answer-
Compartment Syndrome
List 2 special considerations related to contusions
/ hematomas. - Correct answer- Potential for
enough blood loss to cause hypovolemia, especially
in areas of the body with greater dispensability
(like the thigh).
Blood is a medium for bacterial growth, therefore
wounds with contusions and hematomas may
have a greater risk for infection.
What are the treatments for contusions /
hematomas? - Correct answer- Elevation
Application of Ice Packs
Puncture wounds have a high rate of _____. -
Correct answer- Infection
What treatment should be done with puncture
wounds? - Correct answer- Soaking
2
, 3
At time of discharge, what teaching should be
given to a patient who sustained a puncture
wound? - Correct answer- Soak wound 2-3 times
per day for 2-4 days
What type of bites tend to be deep wounds
involving crushing of the tissue or avulsion? -
Correct answer- Dog Bites
Are larger bites or smaller bites more susceptible
to infection? - Correct answer- Smaller. The larger
size of wounds allows bacteria to exit, decreasing
the incidence of infection.
How many hours after a cat bite does infection
usually start? - Correct answer- 12 hours
What complications are often associated with cat
bites? - Correct answer- Abscess, Cellulitis,
Osteomyelitis
Smaller puncture wounds traps bacteria
increasing rate of infectious complications.
What type of bites have very high infection rates? -
Correct answer- Human bites
3
, 4
How many days after a human bite does infection
usually start? - Correct answer- 1-2 days after bite
What diseases can be associated by human bite? -
Correct answer- Hepatitis B, Hepatitis C and
potentially HIV
Teeth marks over knuckles from "punching
someone" are associated with _____. - Correct
answer- Fractures of the third and fifth
metacarpal, osteomyelitis and joint infection.
Wounds caused by high pressure devices
(paintball gun, grease gun) can cause _____. -
Correct answer- Compartment Syndrome
If a device triggers releasing foreign matter into the
wound, it may travel deep into the tissue
separating fascial planes and causing _____. -
Correct answer- Compartment Syndrome
_____ requires high triage prioritization and
potential surgical intervention. - Correct answer-
Compartment Syndrome
4
TCRN Review - Extremity and Wound
Trauma (Musculoskeletal Trauma, Surface
and Burn Trauma)
List some special considerations for abrasions. -
Correct answer- Pain control - full thickness
abrasions may be associated with nerve damage
and may have less pain
Evaporative heat loss - consider warming
measures
Evaporative fluid loss - consider need for fluid
replacement
Scarring - anesthetize wound and aggressively
remove debris
Define contusion. - Correct answer- Rupture of
subcutaneous blood vessels with extravasation of
erythrocytes.
Define hematoma. - Correct answer- Rupture of
artery or vein that will continue to expand until
the pressure in the tissue exceeds the pressure in
the ruptured vessel.
1
, 2
Contusions and hematomas have the potential for
what significant complication? - Correct answer-
Compartment Syndrome
List 2 special considerations related to contusions
/ hematomas. - Correct answer- Potential for
enough blood loss to cause hypovolemia, especially
in areas of the body with greater dispensability
(like the thigh).
Blood is a medium for bacterial growth, therefore
wounds with contusions and hematomas may
have a greater risk for infection.
What are the treatments for contusions /
hematomas? - Correct answer- Elevation
Application of Ice Packs
Puncture wounds have a high rate of _____. -
Correct answer- Infection
What treatment should be done with puncture
wounds? - Correct answer- Soaking
2
, 3
At time of discharge, what teaching should be
given to a patient who sustained a puncture
wound? - Correct answer- Soak wound 2-3 times
per day for 2-4 days
What type of bites tend to be deep wounds
involving crushing of the tissue or avulsion? -
Correct answer- Dog Bites
Are larger bites or smaller bites more susceptible
to infection? - Correct answer- Smaller. The larger
size of wounds allows bacteria to exit, decreasing
the incidence of infection.
How many hours after a cat bite does infection
usually start? - Correct answer- 12 hours
What complications are often associated with cat
bites? - Correct answer- Abscess, Cellulitis,
Osteomyelitis
Smaller puncture wounds traps bacteria
increasing rate of infectious complications.
What type of bites have very high infection rates? -
Correct answer- Human bites
3
, 4
How many days after a human bite does infection
usually start? - Correct answer- 1-2 days after bite
What diseases can be associated by human bite? -
Correct answer- Hepatitis B, Hepatitis C and
potentially HIV
Teeth marks over knuckles from "punching
someone" are associated with _____. - Correct
answer- Fractures of the third and fifth
metacarpal, osteomyelitis and joint infection.
Wounds caused by high pressure devices
(paintball gun, grease gun) can cause _____. -
Correct answer- Compartment Syndrome
If a device triggers releasing foreign matter into the
wound, it may travel deep into the tissue
separating fascial planes and causing _____. -
Correct answer- Compartment Syndrome
_____ requires high triage prioritization and
potential surgical intervention. - Correct answer-
Compartment Syndrome
4
