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Sec1.fa7 bone, joint & muscle injuries

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Sec1.fa7 bone, joint & muscle injuries

  1. 1. BONE, JOINT & MUSCLE INJURIES
  2. 2. 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.
  3. 3. TYPES OF INJURY  Fracture  Dislocation  Muscle strain  Torn ligaments
  4. 4. FRACTURES  A break, split or crack in a bone  2 main categories of fractures  Open fracture  Closed fracture  Causes  Direct force  Indirect force
  5. 5. TYPES OF FRACTURES
  6. 6. DISLOCATIONS  Displacement of bones at a joint
  7. 7. 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.
  8. 8. 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!
  9. 9. 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
  10. 10. 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.
  11. 11. 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.
  12. 12. 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.
  13. 13. 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.
  14. 14. 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.
  15. 15. 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).
  16. 16. 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.
  17. 17. 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.
  18. 18. 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.
  19. 19. 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.
  20. 20. 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.
  21. 21. 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.
  22. 22. 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.
  23. 23. INJURIES TO THE UPPER LIMB FRACTURED UPPER ARM  Recognition  Pain, increased by movement.  Tenderness over the fracture site.  Rapid swelling.  Bruising.
  24. 24. 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.
  25. 25. 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.
  26. 26. 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.
  27. 27. 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.
  28. 28. INJURIES TO THE FOREARM & WRIST  Recognition  Pain, increased by movement.  Tenderness over the fracture site.  Possible swelling & bruising.
  29. 29. 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.
  30. 30. 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.
  31. 31. 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.
  32. 32. 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.
  33. 33. 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.
  34. 34. FRACTURES OF THE RIBCAGE  Treatment for a fractured rib  Support the limb on the injured side in an arm sling.  Send casualty to hospital.
  35. 35. 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.
  36. 36. 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.
  37. 37. 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.
  38. 38. 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.
  39. 39. 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.
  40. 40. 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.
  41. 41. 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.
  42. 42. 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.
  43. 43. 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.
  44. 44. 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.
  45. 45. 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.
  46. 46. 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.
  47. 47. 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.
  48. 48. 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.
  49. 49. 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.
  50. 50. 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.
  51. 51. 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.
  52. 52. 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.
  53. 53. 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.
  54. 54. 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.
  55. 55. 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.
  56. 56. TREATMENT FOR SOFT TISSUE INJURIES  REST  I CE  COMPRESS  ELEVATE

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