First Aid for Colleges and Universities 10 Edition Chapter 11 © 2012 Pearson Education, Inc. Musculoskeletal Injuries Slide Presentation prepared by Randall Benner, M.Ed., NREMT-P

Learning Objectives Describe common findings with musculoskeletal injuries. Describe and demonstrate first aid care for –Sprains –Dislocations –Strains –Cramps Differentiate between an open and closed injury to the bone. © 2012 Pearson Education, Inc.

Learning Objectives Describe how to assess a painful, swollen, deformed extremity. Describe and demonstrate first aid care for a victim with a fracture. State the reasons for splinting. List the general rules of splinting. List the complications of splinting. © 2012 Pearson Education, Inc.

Introduction Muscle and bone injuries are common emergencies. Injuries range from simple to life-threatening. The ability of the First Aider to discern the level of emergency, and provide efficient and appropriate care, can prevent further injury and in some cases spare victims from permanent disability or death. © 2012 Pearson Education, Inc.

The Musculoskeletal System Functions of the skeletal system –Gives shape to the body –Supports the body –Provides the foundation for locomotion or movement –Protects major body organs © 2012 Pearson Education, Inc.

The Musculoskeletal System Components of the musculoskeletal system –Bones –Joints –Muscles –Tendons –Ligaments © 2012 Pearson Education, Inc.

Common Injuries Sprains –Injury to the ligaments © 2012 Pearson Education, Inc.

Common Injuries Strains –Injury to the muscles © 2012 Pearson Education, Inc.

Common Injuries Fractures –Injury to the bones © 2012 Pearson Education, Inc.

Common Injuries Dislocations –Injury to the joints © 2012 Pearson Education, Inc.

Common Injuries Contusions –Bruising of muscle tissues © 2012 Pearson Education, Inc.

Sprains, Dislocations, Strains, and Cramps Sprain symptoms –Pain and swelling –Deformity –Skin discoloration –Loss of function Sprain management –Rest, Ice, Compression, Elevation (RICE) –Active EMS or transport victim to medical facility. © 2012 Pearson Education, Inc.

Sprains, Dislocations, Strains, and Cramps Dislocation symptoms –Pain, tenderness, deformity –Difficulty or inability to move joint –Possible loss of motion or pulses below injury Dislocation management –Assess quality of the victim’s pulse and sensory condition. –Immobilize in the position found. –Provide RICE interventions. –Treat for shock and activate EMS. –Do NOT try to straighten ("reduce") the dislocation. © 2012 Pearson Education, Inc.

Sprains, Dislocations, Strains, and Cramps Example of joint immobilization (cravat with pad and sling) © 2012 Pearson Education, Inc.

Sprains, Dislocations, Strains, and Cramps Cramp symptoms –Uncontrolled muscle spasms –Diminishment in voluntary function –Pain or pressure sensations Cramp management –Do not massage cramps. –Stretch the affected muscle and apply steady pressure. –Apply ice pack to muscle, consider electrolyte drink. –Activate EMS or arrange transport. © 2012 Pearson Education, Inc.

Sprains, Dislocations, Strains, and Cramps Muscle contusion symptoms –Pain and tenderness –Swelling –Discoloration (may occur hours later) Muscle contusion management –Rest, Ice, Compression, Elevation (RICE) –Active EMS or transport to medical facility. © 2012 Pearson Education, Inc.

Injuries to Bones What is a bone fracture? –Crack or break in the bone Closed or open © 2012 Pearson Education, Inc.

Types of Fractures Varies based on damage to bone © 2012 Pearson Education, Inc.

Examples of Fractures © 2012 Pearson Education, Inc. Closed fracture of the humerus. Open fracture of the fibula. Closed fracture (observe the deformity).

Mechanisms of Injury Direct force Indirect force Twisting force © 2012 Pearson Education, Inc.

Sprains, Dislocations, Strains, and Cramps Bone injury symptoms –Deformity, loss of function –Pain and tenderness –Visible signs of injury –Swelling, discoloration, crepitus (grating) Bone injury management –Uncover and manually stabilize. –Treat overlying soft tissue trauma. –Assess motor, sensory, blood-flow capacities. –Stabilize with equipment, if possible. –Treat with RICE procedures. © 2012 Pearson Education, Inc.

Immobilizing a Bone Injury © 2012 Pearson Education, Inc. An open tibia fracture.

Immobilizing a Bone Injury © 2012 Pearson Education, Inc. Support and stabilize the limb above and below the injury, control bleeding, locate a pulse, and apply a splint.

Splinting What is a splint? –Any device used to immobilize a fracture or dislocation –Can be made from almost any rigid material –The First Aider should use splints only when properly trained and equipped to do so © 2012 Pearson Education, Inc.

Splinting General rules for splinting –Perform only when trained to do so. –Expose injured site and cover open wounds. –Do not cause more pain or injury. –Immobilize joints above and below the injury site. –Splint the injury in position found, prior to moving the patient. –Pad the splint for comfort. –Treat the patient for shock, if present. © 2012 Pearson Education, Inc.

Types of Splinting by Body Area © 2012 Pearson Education, Inc.

Types of Splints Traction Splints –Used by EMTs for immobilizing fractures to the thigh (femur) Improvised Splints –First Aider will likely need to create improvised splints from various objects found on-scene. –May also use self-splints by securing an injured body part to an uninjured body part © 2012 Pearson Education, Inc.

Rigid Splints Made of inflexible material Used for long bone and joint immobilization © 2012 Pearson Education, Inc.

Rigid Splints Made of inflexible material Can be made from other materials in an emergency © 2012 Pearson Education, Inc.

Hazards of Improper Splinting Compression and damage to nerves and blood vessels –Poor distal perfusion (blood-flow from extremities) to injury site –Movement of bone ends if splint too lose –Aggravation of bones or injury site © 2012 Pearson Education, Inc.

Splinting a Long Bone –Manually stabilize the bone. –Assess pulse, sensory, and motor functions below the injury site. © 2012 Pearson Education, Inc.

Splinting a Long Bone –Measure the splint. –Splint should immobilize bone and joints above and below the injury site. © 2012 Pearson Education, Inc.

Splinting a Long Bone © 2012 Pearson Education, Inc.

Splinting a Joint –Manually stabilize the bone. –Assess pulse, sensory, and motor functions below the injury site. –Immobilize injury in the position found. © 2012 Pearson Education, Inc.

Splinting a Joint –Measure the splint. –Splint should immobilize the bones above and below the joint © 2012 Pearson Education, Inc.

Summary Injuries to the musculoskeletal system are often graphic and painful, but rarely fatal. First aid care consists of immobilization as appropriate, RICE treatment, monitoring, and reassurance. Never attempt to straighten ("reduce") a dislocation. Improper treatment can result in additional pain and unnecessary complications. © 2012 Pearson Education, Inc.