Injuries to Muscles and Bones

1. Injuries to Muscles and Bones Lesson 14

2. Musculoskeletal System Review • Bones • Muscles • Tendons • Ligaments

3. Primary Functions of Musculoskeletal System • Provides shape/support for body • Muscles acting on bones allow movement • Bones protect vital internal organs

4. Types of Muscles • Skeletal muscles are voluntary • Smooth muscles are involuntary • Cardiac muscle is involuntary • All muscle activity controlled by nervous system

5. 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 • Twisting forces: part of body forced to move in unnatural direction

6. Factors Involved in Injuries • The greater the force: • the more severe the injury • fracture/joint dislocation more likely • Patient’s age and health status

7. Types of Musculoskeletal Injuries • First Responders not responsible for determining type of musculoskeletal injury: • Fractures • Dislocations • Sprains • Muscle injuries

8. Fractures • The bone may be completely broken or only cracked • Closed fracture - skin not broken • Open fracture - open wound at site

9. Dislocations

10. Dislocations • One or more bones at joint displaced from normal position • Ligaments holding bone are torn • Result from strong forces • Sometimes accompanied by bone fractures or other injuries

11. Dislocations continued • Patient cannot use the joint due to pain/structural damage • Serious bleeding may result • Nearby nerves may be injured • With severe dislocation, joint/limb will look deformed

12. Sprains • Joint injury involving ligament stretching/tearing • Typically occur when joint overextended • Can be mild or severe • Ankles, knees, wrists, fingers most common • Considerable swelling often occurs rapidly

13. Muscle Injuries • Strains, contusions, cramps • Usually less serious than fractures/joint injuries • Many causes

14. Recognizing Musculoskeletal Injury • Sometimes injury type is obvious • Often you will recognize musculoskeletal injury is present • Emergency care is same regardless of injury type • Usually not life threatening • May be serious and result in pain/disability

15. 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 • Amount of pain/swelling not indicator of injury severity • Immediate medical treatment if no circulation/possible nerve damage

16. Assess for Circulation, Sensation, And Movement (CSM) Below the Injury Site • Check pulse below injury • Check skin color and temperature. • Touch fingers/toes • Does patient feel touch, tingling sensation, numbness. • Have patient wiggle fingers/toes

17. Signs and Symptoms

18. Signs and Symptoms • Abnormal sensation (numbness, tingling) • Inability to move area • Difference in temperature

19. 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

20. Emergency Care of Musculoskeletal Injuries • 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 • Don’t replace protruding bones

21. Emergency Care of Musculoskeletal Injuries Continued • Stabilize injured extremity manually • Support above and below injury • If appropriate, splint extremity • Follow local protocol re: oxygen