1. Chapter Musculoskeletal Injuries Twenty-Three

3. Skeletal System: Torso

4. Pelvis and Lower Extremities

5. Upper Extremities

6. Ball-and-Socket Joint Hinge Joint

9. I NJURIES TO BONES

10. Mechanisms of Injury

11. Types of Musculoskeletal Injuries

19. Tell new EMT-Bs to always immobilize a stable patient in the spot where he or she is found. However, the actual extremity will need to be moved into a “splintable” position, which is straight enough to fit on a padded board. As the saying goes, “immobilize them where they lie not as they lie.” P RECEPTOR P EARL

22. Types of Splints

25. Assess distal pulse, motor function, and sensation (PMS). Stabilize extremity manually. Long-Bone Splinting

26. Make sure splint extends several inches beyond joints above/below injury.

27. Apply splint. Immobilize joints above/below injury. Secure entire extremity to splint.

28. Secure foot or hand in position of function.

29. Reassess distal PMS.

30. Joint Immobilization Stabilize injured area manually.

31. Assess distal PMS .

32. Immobilize injury site and bones above/below.

33. Reassess distal PMS.

34. If distal extremity is cyanotic or pulseless, align with gentle traction.

39. Pelvic Wrap Prepare backboard.

40. Pelvic Wrap Logroll patient & bring sheets around patient.

41. Pelvic Wrap Secure sheets without over-compressing.

42. Use traction splint to immobilize a painful, swollen, or deformed thigh with no joint or lower leg pain. Traction Splinting

44. Stabilize leg manually. Assess distal PMS. Direct application of manual traction. Traction Splinting

45. Adjust splint length and position. Apply proximal securing device.

46. Apply distal securing device. Apply mechanical traction.

47. Position/fasten support straps. Reevaluate proximal/distal securing devices. Reassess distal PMS.

48. Secure patient and splint to long board.

49. Tell new EMT-Bs to remember: when a bone breaks, it bleeds. Therefore, a patient with multiple breaks can easily be in shock from significant blood loss. In the first 2 hours of an uncomplicated simple fracture of the tibia and fibula, a patient can lose a pint of blood. A fractured femur can cause a 2-pint blood loss. A pelvic fracture can cause a 3-to 4-pint loss. P RECEPTOR P EARL

50. 1. List signs and symptoms of musculoskeletal injuries. 2. Name the bones in the arms and legs. 3. Explain how to splint a fractured femur. 4. Explain what is meant by “position of function.” R EVIEW QUESTIONS