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Sec1.fa7 bone, joint & muscle injuries

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Sec1.fa7   bone, joint & muscle injuries Sec1.fa7 bone, joint & muscle injuries Presentation Transcript

  • BONE, JOINT & MUSCLE INJURIES
  • INTRODUCTION
    • Skeleton is a framework of bones.
    • Functions
      • Supports the tissues of the body.
      • Protects the vital organs.
      • Acts as levers that change magnitude and direction of forces generated by muscles.
  • TYPES OF INJURY
    • Fracture
    • Dislocation
    • Muscle strain
    • Torn ligaments
  • FRACTURES
    • A break, split or crack in a bone
    • 2 main categories of fractures
      • Open fracture
      • Closed fracture
    • Causes
      • Direct force
      • Indirect force
  • TYPES OF FRACTURES
  • DISLOCATIONS
    • Displacement of bones at a joint
  • ASSESSMENT OF BONE, JOINT & MUSCLE INJURIES
    • Note as many features as possible without moving the injured part unnecessarily.
    • Try to visualise how the injury was caused.
    • Compare the shape, position and appearance of the injured part with the uninjured side.
    • If in doubt about the severity of an injury, treat it as a fracture.
  • ASSESSMENT OF BONE, JOINT & MUSCLE INJURIES
    • Recognition of Fracture
      • Pain at or near the site of injury
      • Tenderness at or near site of fracture
      • Swelling & redness at or near site of injury
      • Loss of function
      • Deformity
      • Casualty feels or hear the break occur
      • Coarse grating sound is heard or felt
        • DO NOT try to produce this deliberately!
  • ASSESSMENT OF BONE, JOINT & MUSCLE INJURIES
    • Recognition of Dislocation
      • Pain at or near the site of injury
      • Difficult or impossible normal movement
      • Loss of power
      • Swelling
      • Deformity or abnormal mobility
      • Tenderness
      • Discolouration and bruising
  • CLOSED FRACTURES & DISLOCATIONS
    • Recognition
      • Pain, increased by movement
      • Shortening or unnatural shape to the limb
      • Tenderness, swelling & bruising at the site
    • There would have been a violent blow or fall and there might have been a snapping sound on impact.
  • CLOSED FRACTURES & DISLOCATIONS
    • Treatment
      • Carefully stabilise and support the injured part with your hands, holding above and below the injury.
      • If necessary, gently straighten a bent limb so you can immobilise it. Always pull straight and steadily in the natural line of the bone. Stop if pain is too great.
      • Use towels and bandages to immobilise the injured limb.
      • Immobilise lower limb fractures against the sound leg, with padding between them.
  • CLOSED FRACTURES & DISLOCATIONS
    • Treatment
      • Immobilise upper limb fractures against the trunk in a sling.
      • Call for an ambulance and treat for shock. Raise the injured limb if possible, without causing pain or further injury.
      • Every 10 minutes, check circulation beyond the bandages and loosen them if necessary.
      • DO NOT move casualty until the injury is supported and immobilised (unless it is dangerous to stay at the scene)
      • DO NOT let casualty eat or drink anything.
  • OPEN FRACTURES
    • Recognition
      • Pain, increased by movement
      • Shortening or unnatural shape to the limb
      • Wound, with broken end of bone visible
    • There would have been a violent blow or fall and there might have been a snapping sound on impact.
  • OPEN FRACTURES
    • Treatment
      • Working from the uninjured side, cover the wound with a sterile dressing.
      • Apply pressure around the bone to control bleeding.
      • Place cotton wool or padding over and around the dressing.
      • If bone protrudes from the wound, treat as an embedded object.
      • Build up non-fluffy padding around the bone untill it is higher than the bone.
  • OPEN FRACTURES
    • Treatment
      • Bandage dressing and padding securely to control bleeding but without restricting circulation.
      • Immobilise the injured part, as for a closed fracture.
      • Call for an ambulance and treat for shock.
      • Every 10 minutes, check circulation beyond the bandages and loosen them if necessary.
      • DO NOT move the casualty until the injury is supported and immobilised (unless it is dangerous to stay at the scene).
  • OPEN FRACTURES
    • Treatment
      • DO NOT move the casualty until the injury is supported and immobilised (unless it is dangerous to stay at the scene).
      • DO NOT let the casualty eat or drink anything.
      • DO NOT press directly on a protruding bone end.
  • INJURIES TO THE FACE AND JAW
    • Recognition
      • Distortion of the eye sockets, nose, upper teeth and palate.
      • Swelling and bruising.
      • Bleeding may occur from the nose or mouth or tissue.
      • Also signs of head and neck injury.
  • INJURIES TO THE FACE AND JAW
    • Treatment
      • Open & clear casualty’s airway.
      • Place the casualty in recovery position.
      • Remains in the recovery position, if you have to carry the casualty on stretcher.
      • If jawbone is injured, place soft padding under the head to keep weight off the jaw.
      • DO NOT apply a jaw bandage.
  • INJURIES TO THE UPPER LIMB FRACTURED COLLAR BONE
    • Recognition
      • Pain & tenderness at the site of the injury.
      • Pain, increased by movement.
      • Casualty may support the arm at the elbow and incline the head to the injured side.
  • INJURIES TO THE UPPER LIMB FRACTURED COLLAR BONE
    • Treatment
      • Place the injured arm across the chest and ask the casualty to support at the elbow.
      • Apply an elevation sling.
      • Place soft padding between the injured arm and the body.
      • Support with a broad bandage.
  • INJURIES TO THE UPPER LIMB DISLOCATED SHOULDER
    • Recognition
      • Pain, increased by movement.
      • Reluctance to move.
      • Casualty often supports the arm and inclines the head to the injured side.
      • A flat, angular look to the shoulder.
  • INJURIES TO THE UPPER LIMB DISLOCATED SHOULDER
    • Treatment
      • Place the injured arm across the chest gently at an angle that causes the least pain.
      • Support the injured arm with an arm sling.
      • Send casualty to the hospital, keeping the casualty in a seated position.
      • DO NOT replace the bone in position.
  • INJURIES TO THE UPPER LIMB FRACTURED UPPER ARM
    • Recognition
      • Pain, increased by movement.
      • Tenderness over the fracture site.
      • Rapid swelling.
      • Bruising.
  • INJURIES TO THE UPPER LIMB FRACTURED UPPER ARM
    • Treatment
      • Ask the casualty to sit down.
      • Gently place the injured arm across casualty’s chest in the position that is most comfortable.
      • Ask the casualty to support the injured arm, if possible.
      • Place the affected arm in an arm sling.
  • INJURIES TO THE UPPER LIMB FRACTURED UPPER ARM
    • Treatment
      • Place soft padding between the arm and the chest.
      • Secure the limb to the chest by tying a broad bandage around the chest and over the sling.
      • Send the casualty to hospital, keeping the casualty in a seated position.
  • INJURIES AROUND THE ELBOW
    • Recognition
      • Pain, increased by movement.
      • Tenderness over the fracture site.
      • Possible swelling and bruising.
      • Fixed elbow if the head of the radius is fractured.
  • INJURIES AROUND THE ELBOW
    • Treatment for an elbow that can bend
      • Treat as for a fracture of the upper arm.
      • Check the affected wrist pulse every 10 minutes.
    • Treatment for an elbow that cannot bend
      • Lay casualty down.
      • Place padding, such as cushions or towels around the elbow for comfort and support.
  • INJURIES TO THE FOREARM & WRIST
    • Recognition
      • Pain, increased by movement.
      • Tenderness over the fracture site.
      • Possible swelling & bruising.
  • INJURIES TO THE FOREARM & WRIST
    • Treatment
      • Ask the casualty to sit down.
      • Gently stabilise and support the injured forearm across casualty’s chest.
      • If necessary, carefully expose and treat any wound.
      • Place a triangular bandage between the chest and the injured arm, as for an arm sling.
      • Gently surround the forearm in soft padding.
  • INJURIES TO THE FOREARM & WRIST
    • Treatment
      • Tie the arm and its padding in an arm sling to support it.
      • If necessary, secure the limb to the chest using a broad bandage. Tie it over the sling, positioning it close to the elbow.
      • Send the casualty to hospital and keeping casualty in a seated position.
      • Can also use splint to support the injured forearm.
  • INJURIES TO THE HAND & FINGERS
    • Treatment
      • Remove any rings before the hand begins to swell.
      • Keep the hand raised to reduce swelling.
      • Protect the injured hand by wrapping it in folds of soft padding.
      • Gently support the affected arm in an elevation sling.
  • INJURIES TO THE HAND & FINGERS
    • Treatment
      • If necessary, secure the arm to the chest by tying a broad bandage around the chest and over the sling.
      • Send casualty to hospital, keeping casualty in a seated position.
      • Use the sound finger as a splint.
  • FRACTURES OF THE RIBCAGE
    • Recognition
      • Sharp pain at the site of fracture.
      • Pain on taking a deep breath.
      • Shallow breathing.
      • Paradoxical breathing
        • Chest moves in during inhalation, out during exhalation
      • An open wound over the fracture through which you might hear air being “sucked” into the chest cavity.
      • Features of internal bleeding and shock.
  • FRACTURES OF THE RIBCAGE
    • Treatment for a fractured rib
      • Support the limb on the injured side in an arm sling.
      • Send casualty to hospital.
  • FRACTURES OF THE RIBCAGE
    • Treatment for open/multiple fractures
      • Immediately cover and seal any wounds to the chest wall.
      • Place casualty in the most comfortable position.
        • Half-sitting, head, shoulders and body turned towards the injured side.
      • Support the limb on the injured side in an elevation sling.
  • FRACTURES OF THE RIBCAGE
    • Treatment for open/multiple fractures
      • Call for an ambulance.
      • If casualty becomes unconscious, place casualty in recovery position, uninjured side uppermost.
  • SPINAL INJURY
    • Causes
      • Falling from a height.
      • Falling awkwardly while doing gymnastics.
      • Diving into a shallow pool and hitting the bottom.
      • Being thrown from a horse or from a motorbike.
      • Being in a collapsed rugby scrum.
      • A heavy object falling across the back.
      • Injury to the head or face.
  • SPINAL INJURY
    • Recognition
      • When only the bones of the spinal column are damaged, there may be:
        • Pain in the neck or the back at the level of injury
        • A step, irregularity, or twist in the normal curve of the spine.
        • Tenderness on gently feeling the spine.
  • SPINAL INJURY
    • Recognition
      • When the spinal cord is also damaged, there may be:
        • Loss of control over limbs; movement may be weak or absent.
        • Loss of normal sensation.
        • Abnormal sensations such as burning or tingling.
        • Breathing difficulties.
  • SPINAL INJURY CHECKING FOR SPINAL CORD INJURY
    • Examine the casualty carefully in the position found
      • Ask helper to maintain support at casualty’s head.
      • Ask casualty to move limbs to test for loss of power.
      • Touch casualty without casualty knowing to test for loss of sensation.
  • SPINAL INJURY
    • Treatment for a conscious casualty
      • DO NOT move the casualty from the position found, unless he or she is in danger or becomes unconscious.
      • Reassure the casualty and tell casualty not to move.
      • Stabilise and support casualty’s head in neutral position by placing your hands over casualty’s ears. Maintain this support throughout.
  • SPINAL INJURY
    • Treatment for a conscious casualty
      • If you suspect neck injury, get a helper to place rolled-up blankets or articles of clothing on both sides of the casualty’s neck and shoulders.
      • Call for an ambulance.
      • You may apply a collar if the neck is injured.
  • SPINAL INJURY
    • Treatment for an unconscious casualty
      • Check ABC & perform CPR if necessary.
      • Maintain airway.
      • Call for an ambulance.
      • Keep casualty’s head, trunk and toes in a straight line at all times.
      • Check for pulse and breathing regularly.
  • FRACTURED PELVIS
    • Recognition
      • Inability to walk or even stand.
      • Pain & tenderness in the region of the hip, groin or back. Increased when the casualty moves.
      • Blood at the urinary orifice especially in a male casualty.
      • The casualty may not be able to pass urine or may find this painful.
      • Signs of shock & internal bleeding.
  • FRACTURED PELVIS
    • Treatment
      • Help casualty to lie on his or her back.
      • Straighten casualty’s leg or if it is more comfortable, help casualty to bend his or her knees slightly and support them.
      • Immobilise his legs by bandaging them together, placing padding between the bony points.
      • Call for an ambulance.
      • DO NOT bandage the legs together if this causes intolerable pain.
  • INJURIES TO THE LOWER LIMB HIP & THIGH FRACTURE
    • Recognition
      • Pain at the site of the injury.
      • Inability to walk.
      • Signs of shock.
      • Shortening of the thigh.
      • A turning outwards of the knee and foot.
  • INJURIES TO THE LOWER LIMB HIP & THIGH FRACTURE
    • Treatment
      • Lay the casualty down gently.
      • Ask helper to stabilise and support the injured limb.
      • Gently straighten the lower leg and apply traction at the angle, if appropriate.
      • Call for an ambulance.
      • Treat shock but do not raise casualty’s legs.
  • INJURIES TO THE LOWER LIMB HIP & THIGH FRACTURE
    • Treatment
      • If ambulance is delayed, immobilise the limb by securing or splinting it to the uninjured limb.
      • Gently bring the casualty’s sound limb alongside the injured one.
      • Maintaining traction throughout at the ankle.
      • Insert padding between the thighs, knees and ankles.
      • Tie the bandages around casualty’s ankles and knees & above and below the fracture.
      • Release traction only when all bandaging knots are tied.
  • INJURIES TO THE LOWER LIMB HIP & THIGH FRACTURE
    • Treatment for transporting a casualty over distance
      • Place a leg splint, from the armpit to the foot, against side.
      • Pad between the legs and between the splint and body.
      • Secure the splint and the body with bandages.
  • INJURIES TO THE LOWER LIMB KNEE JOINT
    • Recognition
      • A recent twist or blow to the knee.
      • Pain, spreading from the injury to become deep-seated in the joint.
      • If the bent knee has “locked”, acute pain on attempting to straighten the leg.
      • Rapid swelling at the knee joint.
  • INJURIES TO THE LOWER LIMB KNEE JOINT
    • Treatment
      • Help casualty to lie down.
      • Place soft padding under the injured knee to support it in the most comfortable position.
      • Hold padding in place with bandage.
      • Send casualty to hospital.
  • INJURIES TO THE LOWER LIMB KNEE JOINT
    • Treatment
      • DO NOT attempt to straighten the knee forcibly.
      • DO NOT give anything by mouth.
      • DO NOT allow the casualty to walk.
  • INJURIES TO THE LOWER LIMB LOWER LEG
    • Recognition
      • Localised pain.
      • A recent blow or wrench of the foot.
      • Inability to walk.
      • Open wound may occur.
  • INJURIES TO THE LOWER LIMB LOWER LEG
    • Treatment
      • Stabilise and support the injured leg.
      • Gently expose and treat any wound if necessary.
      • Straighten the leg using traction.
      • Support the leg with your hands until the ambulance arrives.
  • INJURIES TO THE LOWER LIMB LOWER LEG
    • Treatment
      • If ambulance is delayed:
        • Bring the sound limb to the injured leg.
        • Insert padding between the knees and ankles and between the calves.
        • Tie the bandages firmly around ankles and knees, then above and below the fracture.
  • TREATMENT FOR SOFT TISSUE INJURIES
    • R EST
    • I CE
    • C OMPRESS
    • E LEVATE