NREMT Paramedic Cognitive ExamTraumaMedium
A 70-year-old female fell down five stairs. She complains of pain to her left hip and cannot move her left leg. Her left leg appears shortened and internally rotated. Pulses are present and strong in both feet. What is the most appropriate prehospital management for this injury?
- AImmobilize the left leg in the position found with pillows and blankets
- BAttempt to gently reduce the dislocation before splinting
- CImmobilize the patient on a long backboard
- DApply a traction splint to the left leg
Show answer & explanationAnswer & explanation
Correct answer: A. Immobilize the left leg in the position found with pillows and blankets
The patient's presentation (fall, hip pain, shortened and internally rotated leg) is classic for a posterior hip dislocation. The most appropriate prehospital management is to immobilize the injury in the position found to prevent further damage, using soft padding like pillows and blankets.
Why the other options are wrong
- B. Attempting to reduce a hip dislocation in the prehospital setting is beyond the scope of paramedic practice and can cause significant harm.
- C. While spinal precautions are generally taken with falls, immobilizing the entire patient on a rigid backboard is not the primary or most appropriate splinting for a dislocated hip and can cause discomfort.
- D. Traction splints are used for mid-shaft femur fractures, not hip dislocations, and could worsen the injury.
Hip Dislocation Management
Prehospital management of a suspected hip dislocation involves immobilizing the affected leg in the position found, providing pain management, and rapid transport.
- Posterior hip dislocations are most common (shortened, internally rotated leg).
- Anterior hip dislocations present with external rotation and abduction.
- Never attempt reduction in the prehospital setting.
Memory trick: Splint Smart: Assess, Align, Immobilize, Reassess