Self Explanatory.

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Musculoskeletal Injuries

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Outline
 Review of the Musculoskeletal System
 Injuries to Muscles and Bones
 Spinal Injuries
 Head Injuries
 Splinting

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Musculoskeletal Injuries
 Injuries to muscles, bones, and their
associated ligaments
 Occur frequently
 Can be isolated or one of multiple injuries
 May be quite painful and dramatic
 Don’t forget priorities
 Are not usually life threatening

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Musculoskeletal Injuries
The goal of the Emergency Medical
Responder is to manage the
musculoskeletal injuries and to prevent
further damage, which is important in
minimizing permanent disability and
reducing pain.

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Review of the
Musculoskeletal System

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Function
 Provides shape
 Protection of
internal organs
 Movement

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Can you
identify?
 cranium
 mandible
 Vertebrae
 Ribs
 Pelvis
 femur
 Humerus
 Patella
 phalanges

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The
Spinal
Column
Cervical (7)
Thoracic (12)
Lumbar (5)
Sacral (5)
Coccyx (4)

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The Thorax
Sternum
Xiphoid
process
Manubrium
Ribs

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The Pelvis
Ilium
Ischium
Pubic
symphysis
Acetabulum

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Humerus
Ulna and Radius
Scapula
Femur
Patella
Tibia
Fibula

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Muscles
 Voluntary, or skeletal
 Involuntary, or smooth
 Cardiac

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Injuries to Muscles and
Bones

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Injuries
 Primary mechanisms responsible
 Direct force
 Indirect force
 Torsion, or twisting force

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Injuries
 Classification of
musculoskeletal
injuries
 Open
 Closed

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Injuries
 What do you
observe in this
photo?

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Injuries
 Swelling can be
seen in the ankle

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Signs and Symptoms
• Deformity / Angulation
• Pain/Tenderness
• Grating
• Swelling
• Bruising
• Exposed bone ends
• Locked joint

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Open Fracture

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Management
 Scene size-up
 Use body substance isolation precautions
 If no threats to life or possibility of spinal injury,
allow the patient to assume a comfortable
position
 Apply a cold pack to the injury site
 Stabilize the extremity

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Stabilization
 Provide support
above and below the
site of the injury
 Cover open wounds
with a dry, sterile
dressing
 Pad the area to
prevent pressure
 When in doubt,
stabilize

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Musculoskeletal Injuries
Failure to stabilize an injured extremity can
result in increased pain for the patient and
possible additional tissue damage.

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Musculoskeletal Injuries
 Do not attempt to straighten an angulated
extremity
 Never replace protruding bone ends back
into wound
 If in doubt…STABILIZE!!

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Spinal Injuries

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Spinal Injuries
 May cause
permanent
disability or even
death
 It is critical to
recognize
mechanisms of
injury that can
produce spinal
trauma

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Mechanisms of Injury
 Any mechanism that
produces violent
impact on head, neck,
torso or pelvis
 Incidents that
produce sudden
forces to neck or
torso
 Any fall
 Ejection or fall from
motorized or
otherwise powered
transportation device
 Shallow-water diving
incidents
 Assume with any
unresponsive trauma
patient

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Signs and Symptoms
 Concerning mechanism of injury
 Altered mental status/unresponsive
 Loss of sensation/movement in any extremity
 “Pins and needles” feeling
 Pain/tenderness in neck/back
 Difficulty breathing
 Loss of bowel/bladder control

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Assessment
 Consider the MOI
 Maintain manual stabilization of the head and neck
 Ask:
 What happened?
 Does your neck or back hurt?
 Where does it hurt?
 Are you able to move your hands and feet

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Unresponsive Patient
 Use jaw-thrust maneuver
 Assist breathing if needed
 Obtain information from witnesses
 The primary complications to which you should
be alert are ineffective breathing and paralysis

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Spinal Injuries
 Make sure the scene is safe
 Use body substance isolation
 Establish and maintain
manual control of the head
and neck

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Spinal Injuries
 Use jaw-thrust
 Assess all 4 extremities for
pulse, ability to move, and
sensation

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Head Injuries

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Head Injuries
 Classified as either open or closed
 Open when there is a laceration or
penetrating wound to the forehead or scalp
 May be significant bleeding
 Usually can be controlled

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Head Injuries
 Watch for external signs of injury to the
skull
 Can be bleeding within the skull

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Scalp Injuries
 Can bleed
significantly

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Traumatic Brain Injury (TBI)
 Often immediately life threatening
 May cause
 Altered mental status
 Unresponsiveness with loss of airway control
 Abnormal breathing or respiratory arrest
 Vomiting
 Changes in blood pressure and pulse rate

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Management
 Ensure scene safety and take BSI
 Maintain the airway with jaw-thrust maneuver
 Assess breathing and assist ventilations as
needed
 Control bleeding
 Monitor mental status
 Ongoing assessment
 Package as a C-spine patient
 Transfer to advanced care

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Splinting

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Splinting
 Stabilize

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Splinting
 Check distal
circulation,
motion, and
sensation

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Splinting
 Apply splint
 Re-check
circulation,
motion, and
sensation after
splint is applied

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QUESTIONS

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__________ 1. All of the following are part of the
musculoskeletal system except:
A. bones. C. cartilage.
B. joints. D. skin.

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__________ 2. The sound or feel of broken
bone fragments
grinding together is referred to as
A. crepitus. C. assonance.
B. stridor. D. dissonance.

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__________ 3. There are three kinds of muscle: voluntary,
involuntary, and
A. periosteum. C. cardiac.
B. flexible. D. skeletal.

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__________ 4. The bones of the upper extremities include all
of the following except the:
A. radius. C. femur.
B. humerus. D. carpal.

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__________ 5. Tissues or fibers that cause
movement of the body parts or organs are called:
A. periosteum. C. cartilage.
B. muscles. D. tendons.

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__________ 6. Use of a traction splint is indicated
for a painful, swollen, deformed
A. ankle. C. elbow.
B. hip. D. femur.

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_________ 7. The displacement of a bone from its normal
position in a joint is a:
A. fracture. C. dislocation.
B. sprain. D. strain.

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__________ 8. The splint best suited for easing pain of
muscle spasm associated with fractures of the femur is a (n)
_____ splint.
A. air-inflatable C. vacuum
B. traction D. none of the above

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__________ 9. The term for a prickling or tingling feeling
that indicates some loss of sensation is:
A. paresthesia. C. paraplegia.
B. anesthesia. D. quadriplegia.

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__________ 10. The bones of the lower extremities
include all of the following except the:
A. pelvis. C. femur.
B. patella. D. scapula.