1. 15.9 Bone and Joint Injuries
Pages
LEQ: How does the type of injury dictate the type of first aid?

2. 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

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

4. 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

7. TYPES of FX

8. Spiral FX

9. Spiral Fx in Infant – Indicative of child abuse

10. What type of fx is this?

11. How about this one?

12. Plates/screws

13. 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

14. 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

15. 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

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

17. Dislocated Shoulder

18. Dislocated Shoulder

19. Elbow Dislocation

20. 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

21. 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

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

24. 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

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

26. S/S
Sudden pain, swelling, and bruising

28. 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

29. 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)

30. 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

31. 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.

32. 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

33. 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

34. 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

35. 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