Transcript Ch. 11-Musculoskeletal Injuries

Ch. 11-Musculoskeletal Injuries
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11.1 The Musculoskeletal System
1. It gives shape or form to the body.
2. It supports the body, allowing it to stand erect.
3. It provides the basis for locomotion, or movement, by
giving muscles a place to attach, and it contains joints
(where bones are joined together by ligaments) that
allow movement.
4. It forms protection for major body organs, such as the
brain (skull), the heart and lungs (rib cage), pelvic
organs, and the spinal cord (vertebrae).
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Sprains
Signs and symptoms
include:
 Pain
 Swelling
 Deformity
 Discoloration of the skin
 Inability to use the
affected part normally
First Aid Care (RICE)
1. Rest—have the victim stay off the injured part
completely and not use the joint at all.
2. Ice—cold relieves pain and prevents or reduces selling
and inflammation. Immediately put cold packs,
crushed ice, or cold towels on the injured area, or
immerse it in ice water for 20 to 30 minutes at a time
every 2 hours.
3. Compression—to limit internal bleeding and compress
fluid from the injury site, wrap a compression
bandage (usually an elastic one) in an overlapping
spiral that supports the entire injured area.
4. Elevation—limits circulation, reduces swelling, and
encourages lymphatic drainage.
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Vocab
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Sprain- An injury in which ligaments are stretched and
partially or completely torn
Dislocation- An injury in which the joint comes apart
and stays apart; the bone ends are no longer in contact
with each other
Strain- An injury to a muscle that occurs when the
muscle is stretched beyond its normal range of motion,
causing the muscle to tear
Cramp- Uncontrolled spasm of a muscle
Contusion- A bruise to the tissue of a muscle
Paresthesia- Pricking or tingling sensation
that indicates loss of circulation
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Dislocations
Signs and symptoms
include:
 pain
 feeling of pressure over
the involved joint
 loss of motion in the joint
 deformity
First Aid Care
Activate the EMS system immediately, then:
1. Immobilize all dislocations in the position
found. Splint above and below the
dislocated joint with an appropriate
splint that will keep the joint immobile.
2. Use the RICE method.
3. Treat for shock; keep the victim warm
and quiet and in the position most
comfortable.
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Strains
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1. Place the victim in a comfortable position
that takes pressure off the strained muscles.
2. Apply cold directly to the strained area, as
described in step 2 of the RICE system.
3. Activate the EMS system or transport the
victim to a medical facility.
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Cramps
1. Have the victim gently stretch the cramping muscle;
gradual lengthening of the muscle can relieve the
cramp by lengthening the muscle fibers.
2. Apply steady, firm pressure to the cramping muscle
with the heel of your hand.
3. Apply an ice pack over the cramped muscle.
4. Try using an acupressure point: pinch the upper lip
hard to relieve cramping of a calf muscle.
5. If the cramp occurs during or after heavy physical
activity, have the victim drink a commercial
electrolyte drink or lightly salted water (1⁄4
teaspoon of salt dissolved in7 a quart of water).
PROGRESS CHECK
1. An injury in which ligaments are stretched and partially or
completely torn is a ____________.
(sprain/strain/dislocation)
2. A soft-tissue injury or muscle spasm around a joint
is a ____________. (sprain/strain/dislocation)
3. You should care for sprains and dislocations as if
they were ____________.
(life threatening/fractures/strains)
4. Treat a cramp with ____________.
(gentle massage/firm massage/stretching)
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11.3 Injuries to Bones
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Closed (simple), in which the overlying skin is
intact; no wound is nearby.
Open (compound), in which the skin over the
fracture site has been damaged or broken, either
by the ends of the bone or by the blow that broke
the bone; the bone might or might not protrude
through the wound and you might or might not be
able to see the bone through the wound. The
greatest threat in a compound fracture is to the
soft tissue and organs that lie around the
bone ends.
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Mechanisms of Injury
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Direct Force
Indirect Force
Twisting Force
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First Aid Care for fractures
1. Gently remove any clothes that cover the injured area. Cut
clothing at the seams to avoid unnecessary movement of the
injured area.
2. Support the injured part; gently remove clothing and jewelry
around the injury site without moving the injured area.
3. Cover any open wounds with sterile dressings to control bleeding
and prevent infection. Gently wipe away dirt and debris, and
irrigate the exposed bone end with clean water.
4. Assess blood flow and nerve function.
5. If there is severe deformity or angulation, apply minimal
traction—a firm, steady pull to bring the limb into more normal
alignment—except for crushing injuries; immobilize joints above
and below the fracture.
6. Check distal pulses and capillary refill and sensation after
the splint is in place to make sure circulation is still
adequate.
7. Use the RICE procedure.
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PROGRESS CHECK
1. In assessing for fractures, it is important to consider the ____________
as well as the signs and symptoms. (history/mechanism of injury/pain)
2. Though fractures may be the most obvious and dramatic injuries
suffered by a victim, they are often not the most ____________ ones.
(life-threatening/easy-to-manage/painful)
3. Before you try to identify fractures, you should complete ____________.
(artificial ventilation/chest compressions/the primary survey)
4. The most important first aid care for suspected fracture is
____________. (control of bleeding/immobilization/replacing bone ends)
5. ____________ helps minimize damage to soft tissue, surrounding
nerves, and blood vessels by broken bone ends.
(Immobilization/Splinting/Compression)
6. If the forearm is fractured, you should also immobilize the __________.
(upper arm/shoulder/wrist and elbow)
7. You ____________ try to straighten the wrist, elbow, knee, or
shoulder. (should/should not)
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Rules for Splinting
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Do not splint if it will cause more pain for the victim.
Both before and after you apply the splint, assess the pulse and sensation
below the injury.
Immobilize the joints both above and below the injury.
Splint an injury in the position you found it.
Remove or cut away all clothing around the injury site with a pair of
bandage scissors so you won’t accidentally move the fractured bone ends
and complicate the injury. Remove all jewelry around the fracture site.
Cover all wounds, including open fractures, with sterile dressing before
applying a splint
If there is a severe deformity or the distal extremity is cyanotic or lacks
pulses, align the injured limb with gentle traction before splinting, following
the guidelines above.
Never intentionally replace protruding bone ends.
Pad the splint to prevent pressure and discomfort to the victim.
Apply the splint before trying to move the victim.
When in doubt, splint the injury.
If the victim shows signs of shock, maintain body temperature
as needed, align the victim in the normal anatomical position and
arrange for immediate transport without
taking the time to apply a
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splint.
Types of Splints
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Rigid Splints
Traction Splints
Improvised Splints
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Hazards of Improper Splinting
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Compress the nerves, tissues, and blood vessels under the
splint, aggravating the existing injury and causing new
injury
Delay the transport of a victim who has a life-threatening
injury
Reduce distal circulation, threatening the extremity
Aggravate the bone or joint injury by allowing movement of
the bone fragments or bone ends or by forcing bone ends
beneath the skin surface
Cause or aggravate damage to the tissues, nerves, blood
vessels, or muscles as a result of excessive bone or joint
movement
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Special Considerations in Splinting
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Splinting a Long Bone
Splinting a Joint
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PROGRESS CHECK
1. You should not apply a splint if it will cause more
____________ for the victim. (pain/disability/deformity)
2. You should assess the victim’s ____________ both
before and after you apply a splint.
(breathing/pulses/level of consciousness)
3. You should immobilize ____________ both above
and below the injury. (bones/joints/tissues)
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