Spinal, Fracture and Pain

Which of the following is a correct principle of spinal motion restriction (SMR)?

• Move the head and neck gently to align with the shoulder and hip

• Immobilise the extremities only after the head is secured

• Apply a cervical collar without checking for distal pulses

• Maintain neutral head alignment and check distal pulse, movement, sensation before and after immobilisation

Which of the following signs is most suggestive of a base of skull fracture?

• Deformity over the mandible

• Periorbital ecchymosis ("Raccoon eyes")

• Swelling over the zygomatic arch

• Nasal congestion and nosebleed

A 22-year-old athlete presents with foot pain after training. Which finding supports a stress fracture?

• Diffuse bruising and joint instability

• Pain on light palpation

• Point tenderness at 2nd metatarsal

• Inability to dorsiflex the ankle

Which patient is most at risk for hypovolemic shock from fracture bleeding?

• Toddler with greenstick radius fracture

• Teenager with fibular fracture

• Adult with comminuted femur fracture

• Elderly woman with nasal fracture

Which is a correct step when using a rigid splint?

• Apply traction until bones realign

• Pad bony prominences and bind

• Cover fingers/toes completely

• Splint only the fracture site

A patient has an open forearm fracture with bleeding. What is the correct initial management?

• Push bone back into skin

• Apply ice before dressing

• Cover wound with sterile dressing and control bleeding

• Use tourniquet immediately

A splinted limb turns pale with weak pulse and increased pain. What is the best action?

• Reassure and continue transport

• Remove the splint entirely

• Loosen/adjust splint and reassess CPMS

• Apply second splint

What is the best pain assessment tool for a non-verbal 2-year-old?

• Numeric Pain Rating Scale

• Visual Analogue Scale

• FLACC Scale

• Wong-Baker FACES

A 35-year-old trauma patient (pain 8/10) needs IM Tramadol. Which is the best injection site?

• Deltoid

• Dorsogluteal

• Ventrogluteal

• Vastus lateralis

A patient using Penthrox reaches RSS 4. What should you do next?

• Stop and reassess

• Continue use and increase breathing

• Add IM Tramadol

• Switch to Entonox