Transcript Emergency care for Musculoskeletal system Lecture

Emergency care for
Musculoskeletal system
The Musculoskeletal system consists of:
- Bones (skeleton)
- Joints
- Cartilages
- Ligaments
The Skeletal System Divided into
- Axial skeleton
- Appendicular skeleton – limbs and girdle
Musculoskeletal
System
Functions of Bones
 Support of the body
 Protection of soft organs
 Movement due to attachment to skeletal
muscles
 Storage of minerals and fats
 Blood cell formation
Types of Muscles
• Skeletal muscles
are voluntary
• Smooth muscles
are involuntary
• Cardiac muscle is
involuntary
• All muscle activity
controlled by
nervous system
Types of Musculoskeletal
Injuries
- Fractures
- Dislocations
- Sprains
- Muscle injuries
Mechanisms of Injury to
Musculoskeletal System
- Direct force: force applied directly to body
- Indirect force: force transferred from original body site along an
extremity to another point, e.g. after falling on outside stretched
hands.
- Twisting forces: part of body forced to move in unnatural direction,
Such injuries are often seen in football and skiing accidents where a
person's foot is caught and twisted with enough forces to fracture a
leg bone.
- Force of Powerful Muscle Actions: For example, violent cough may
cause rib fracture
- Aging and bone disease: Can increase the risk of fractures
(pathologic fractures), with bones breaking even minor accidents
Fractures
Definition: A break in the continuity of bone
Types of bone fractures
 Closed (simple) fracture – break that does not penetrate the
skin
 Open (compound) fracture – broken bone penetrates
through the skin
 Complicated: This can occur when either an
open or closed fracture causes further injury e.g. broken bone
that cuts a blood vessel or punctures the lung
According to their appearance in X-ray
Dislocations
• One or more bones at joint
displaced from normal position
• Ligaments holding bone are
torn
• Sometimes accompanied by
bone fractures or other injuries
• Patient cannot use the joint due
to pain/structural damage
• Nearby nerves may be injured
Sprains
• Sprain: This is a torn ligament at a joint or
ligament twisting /tearing
• Typically occur when joint over twisting
• Ankles, knees, wrists, fingers most common
• Considerable swelling often occurs rapidly
Muscle Injuries
• Strain: This is a torn or over stretched muscle.
• Muscle cramp or contusions
• Usually less serious than fractures/joint
injuries
Signs and Symptoms
- Pain at the site of the injury
- Swelling and discoloration
- Tenderness
- Loss of movement or feeling
- Deformity
- Shock.
Assessment of Musculoskeletal
Injuries
• Perform standard assessment
• Ask patient what happened/what he/she felt
• If large forces involved, consider potential for
spinal injury
• Expose injury site
• Immediate
medical
treatment
if
no
circulation/possible nerve damage
• Assess for Circulation, Sensation, And
Movement Below the Injury Site
• Check pulse below injury
• Check skin color and temperature.
• Does patient feel touch, tingling sensation,
numbness.
Preventing Movement
• Movement causes injury, pain, swelling
• Bone movement further injures soft tissues
• Movement generally increases blood flow may increase internal bleeding/ swelling
• Manually stabilize or splint injured area
Emergency Care of Musculoskeletal
Injuries
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Perform standard patient care
Control any life threats
Allow patient to be in position of comfort
Cover open wounds with sterile dressing
Apply cold pack
Stabilize injured extremity manually
Support above and below injury
• After dealing with life-threatening conditions, identify and immobilize all
fractures by splinting
• Follow local protocol :
R.I.C.E.
Rest
Ice Compress
Elevate
Splints
• A splint is a device used to immobilize a fracture
Aims of using splint
• Helps prevent further injury
• Reduces pain
• Minimizes bleeding and swelling
Types of Splints
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Rigid splints
Soft splints
Air splints (inflatable splints)
Anatomic splints
Rigid Splint
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Board
Plastic or metal
Rolled newspaper or magazine
Thick cardboard
Soft Splint
• Pillow
• Folded blanket or
towel
• Triangular bandage
folded into sling
Anatomic Splint
• Bandage injured
leg or finger to
uninjured one
Wrist (Volar) Splint
Lower Leg Splint
Long Leg Splint
Finger Splints
Which kinds of shock could be
happened in fracture??
12What are the types of fracture?
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