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Emergency care for Musculoskeletal system The Musculoskeletal system consists of: - Bones (skeleton) - Joints - Cartilages - Ligaments The Skeletal System Divided into - Axial skeleton - Appendicular skeleton – limbs and girdle Musculoskeletal System Functions of Bones Support of the body Protection of soft organs Movement due to attachment to skeletal muscles Storage of minerals and fats Blood cell formation Types of Muscles • Skeletal muscles are voluntary • Smooth muscles are involuntary • Cardiac muscle is involuntary • All muscle activity controlled by nervous system Types of Musculoskeletal Injuries - Fractures - Dislocations - Sprains - Muscle injuries 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, e.g. after falling on outside stretched hands. - Twisting forces: part of body forced to move in unnatural direction, Such injuries are often seen in football and skiing accidents where a person's foot is caught and twisted with enough forces to fracture a leg bone. - Force of Powerful Muscle Actions: For example, violent cough may cause rib fracture - Aging and bone disease: Can increase the risk of fractures (pathologic fractures), with bones breaking even minor accidents Fractures Definition: A break in the continuity of bone Types of bone fractures Closed (simple) fracture – break that does not penetrate the skin Open (compound) fracture – broken bone penetrates through the skin Complicated: This can occur when either an open or closed fracture causes further injury e.g. broken bone that cuts a blood vessel or punctures the lung According to their appearance in X-ray Dislocations • One or more bones at joint displaced from normal position • Ligaments holding bone are torn • Sometimes accompanied by bone fractures or other injuries • Patient cannot use the joint due to pain/structural damage • Nearby nerves may be injured Sprains • Sprain: This is a torn ligament at a joint or ligament twisting /tearing • Typically occur when joint over twisting • Ankles, knees, wrists, fingers most common • Considerable swelling often occurs rapidly Muscle Injuries • Strain: This is a torn or over stretched muscle. • Muscle cramp or contusions • Usually less serious than fractures/joint injuries Signs and Symptoms - Pain at the site of the injury - Swelling and discoloration - Tenderness - Loss of movement or feeling - Deformity - Shock. 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 • Immediate medical treatment if no circulation/possible nerve damage • Assess for Circulation, Sensation, And Movement Below the Injury Site • Check pulse below injury • Check skin color and temperature. • Does patient feel touch, tingling sensation, numbness. 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 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 Stabilize injured extremity manually Support above and below injury • After dealing with life-threatening conditions, identify and immobilize all fractures by splinting • Follow local protocol : R.I.C.E. Rest Ice Compress Elevate Splints • A splint is a device used to immobilize a fracture Aims of using splint • Helps prevent further injury • Reduces pain • Minimizes bleeding and swelling Types of Splints • • • • Rigid splints Soft splints Air splints (inflatable splints) Anatomic splints Rigid Splint • • • • Board Plastic or metal Rolled newspaper or magazine Thick cardboard Soft Splint • Pillow • Folded blanket or towel • Triangular bandage folded into sling Anatomic Splint • Bandage injured leg or finger to uninjured one Wrist (Volar) Splint Lower Leg Splint Long Leg Splint Finger Splints Which kinds of shock could be happened in fracture?? 12What are the types of fracture? 123-