15.9 Bone and Joint Injuries Pages 419-423 LEQ: How does the type of injury dictate the type of first aid?

Bone and Joint Injuries Bone and Joint injuries are very common in accident and falls Injuries can also occur together or by themselves Examples: Fractures, Dislocations, Sprains, and Strains

FRACTURE Breaking of the Bone Closed or Simple: No open wound present Compound or Open: Open wound watch for hemorrhaging and infection

S/S of Fractures Deformity Limited motion or loss motion Pain and tenderness at the site Swelling and discoloration, Protrusion of the bone through the skin The victim may hear the bone snap, feel crepitation (grinding), and have abnormal movement of the parts

TYPES of FX

Spiral FX

Spiral Fx in Infant – Indicative of child abuse

What type of fx is this?

How about this one?

Plates/screws

TX for Fractures FX Treatment for fractures is directed at maintaining respirations, treating for shock, keeping the broken bone from moving, and preventing further injury. Using Splints, Slings, and Air Splints, you can prevent the injured body part from moving When Splinting, splint above and below the break You must get EMS and medical help ASAP

Pelvic Fractures Requires a lot of force to break Pelvis contains major arteries so internal bleeding may occur DO NOT MOVE THE PELVIS! Create a Pelvic Sling https://www.youtube.com/watch?v=wyLGa0nkBxA

Dislocation When the end bone moves out of place or is out of normal position in the joint Frequently accompanied by tearing or stretching of ligaments, muscles, and other soft tissue

S/S Deformity Limited or abnormal movement Swelling Discoloration, Pain, tenderness, Shortening or lengthening of the affected arm or leg

Dislocated Shoulder

Dislocated Shoulder

Elbow Dislocation https://www.youtube.com/watch?v=afm20-RZxto

First Aid Same as Fractures Ensure the patients body extremity is immobilized Movement of the injured part can lead to additional injury to nerves, blood vessels, and other tissue in the area

Sprain Injury to tissue surrounding a joint and it usually occurs when the part is forced beyond its normal range of motion Ligaments, tendons, and other tissues are usually stretched or torn Common sites are ankles and wrists

S/S Swelling, pain, discoloration, and sometimes impaired movement Frequently resemble fractures and dislocations If in doubt, treat it as a fracture

First Aid Application of cold (ice with barrier 15 on 15 off) to decrease swelling and pain, elevation of the affected part and rest An elastic bandage can be applied for support and if swelling is severe or there is a question of fracture/dislocation treat it as a fracture

Strain Overstretching of a muscle due to overexertion of heavy lifting Frequent sites for strains is the back **REMEMBER GOOD BODY MECHANICS

S/S Sudden pain, swelling, and bruising

TX Rest and support Bed rest on a very firm or boarded mattress is recommended for a back strain Cold can be used initially to reduce swelling (first 24 hrs) then warm and wet applications can be used as treatment because warm relaxes the muscles Medical help should be sought if the patient is unable to move or in extreme pain

Splints pg 421 Used to immobilize fractures, dislocations, and other similar injuries that are present or suspected Splints can be created using anything that provides support and does not further injure the patient (such as cardboard, newspapers, blankets, pillows, boards, and other similar materials)

Splints should immobilize the injury above and below the site while preventing movement or further injury Splints should be padded especially over boney areas Strips of cloth, roller gauze, triangular bandages can be folded, or any other object that can be stretched and tied Splints must be applied in a manner that does not put pressure directly over the site of injury If an open wound exists, use sterile dressing and apply pressure

Air Splints To test whether the splint is properly inflated, use a thumb to apply slight pressure to the splint; an indentation mark should result.

NEVER make an attempt to replace a broken bone or reduce a fracture or dislocation. Do not move the patient and splint wherever you find them if the scene is safe

After Splinting You must monitor circulation and nerve endings when the splint is in place. Skin should be warm to touch and watch for any edema, cyanosis, numbness or tingling, and always check the pulse IF any S/S of changes in circulation occurs or numbness occurs, loosen the splint while still supporting the area

Slings pg 422 & 424 Always position the hand higher than the elbow which promotes circulation and decreases edema Always check circulation Capillary Refill Test on Finger tips can be performed If FX is suspected, try to limit the movement of the limb as much as possible Make sure the sling is tied comfortably around the neck Another sling could be used to tie the arm to the body

CAUTION Neck and Spine injuries can be life threatening and my result in permanent paralysis so avoid moving the patient at all cost until EMS arrives Watch for SHOCK since most bone injuries can result in shock