Injury Patterns & Mechanisms
A patient lands on an outstretched hand and presents with wrist pain and deformity. The force applied was primarily axial loading with extension at the wrist.
What is a distal radius fracture (Colles-type mechanism)?
An isolated, closed forearm fracture presents with normal vital signs, intact distal circulation, movement, and sensation, and pain that improves with positioning. The patient is stable, has no red flags, and requires transport for further care without urgency.
What is a lower acuity patient (CTAS 4) with routine transport and splinting?
A narrative states: “Patient stable. Transported.” No vital signs, reassessment, or supporting findings are documented. The record provides an outcome, but no evidence of how that conclusion was reached or maintained.
What is documentation that lacks objective support for stability and is not defensible?
A superficial scraping injury caused by friction that damages the epidermis and may involve capillary bleeding.
What is an abrasion?
Bright red, pulsatile bleeding that reflects high-pressure vessel injury.
What is arterial bleeding?
A long bone fracture shows a diagonal fracture line after a combined bending force.
What is an oblique fracture?
An extremity injury presents with an absent distal pulse, pallor, cool skin, and increasing pain. These findings indicate a time-sensitive complication that significantly changes both priority and urgency of transport.
What is neurovascular compromise requiring high-priority transport?
A patient refuses transport after assessment. The form includes vital signs and a signature, but there is no documentation of risks explained, patient understanding, or capacity considerations.
What is incomplete refusal documentation lacking informed decision-making and defensibility?
This type of injury involves irregular tearing of soft tissue and is commonly associated with blunt trauma rather than sharp force.
What is a laceration?
This physiological process begins when blood loss reduces circulating volume, leading to decreased perfusion and oxygen delivery.
What is hypovolemic shock?
A patient involved in a rotational sports injury presents with a fracture that wraps around the shaft of the bone.
What is a spiral fracture?
A patient with an isolated femur deformity develops tachycardia and hypotension despite no visible external bleeding. These findings suggest a hidden but life-threatening condition influencing both treatment and transport decisions.
What is suspected internal hemorrhage leading to shock and rapid transport?
A narrative describes a patient as “uncooperative” and “difficult,” but provides no observable behaviours or examples to support those labels. The wording introduces interpretation without evidence.
What is subjective, non-objective documentation that increases professional risk?
A localized collection of blood within tissue that forms a contained pocket, distinguishing it from diffuse bleeding.
What is a hematoma?
Early signs of this compensatory state include tachycardia, pale cool skin, and anxiety despite normal blood pressure.
What is compensated shock?
A patient is struck directly on the thigh and develops a fracture with multiple bone fragments.
What is a comminuted fracture caused by direct high-energy trauma?
A patient presents with an obvious lower limb deformity but is also found to have decreased level of consciousness and irregular respirations. Despite the visible extremity injury, these findings shift focus away from musculoskeletal management.
What is prioritizing the primary survey (airway and breathing) over the extremity injury?
A paramedic documents treatments performed but does not include patient response, reassessment findings, or any indication of whether the intervention had an effect.
What is failure to document treatment response, limiting clinical reasoning and continuity of care?
A patient presents with intact skin but deep tissue discoloration and swelling following blunt trauma. This reflects bleeding beneath the skin without disruption of the surface.
What is a contusion?
Large muscle groups such as the thigh can hold significant volumes of blood, making this type of bleeding difficult to detect visually.
What is internal hemorrhage?
A fall from height results in a fracture where bone ends are driven into each other, often appearing stable but still requiring immobilization.
What is an impacted fracture from axial loading?
A patient presents with a laterally displaced patella following a low-energy mechanism. There is no suspicion of associated fracture, and distal circulation, movement, and sensation are intact. This presentation meets criteria for a specific intervention within paramedic scope, provided appropriate authorization is in place.
What is performing a patellar reduction under the appropriate medical directive?
A call includes delayed transport due to scene safety concerns. The documentation states only “delay due to scene” without describing the hazard, impact on care, or decision-making process.
What is missing contextual justification for operational decisions, reducing defensibility under review?
This injury involves forceful tearing away of tissue, often exposing underlying structures and carrying a high risk of hemorrhage and contamination.
What is an avulsion?
At the cellular level, reduced oxygen delivery leads to this metabolic shift, resulting in lactic acid production and eventual organ dysfunction.
What is anaerobic metabolism?