The document discusses musculoskeletal injuries, including injuries to muscles, bones, and associated ligaments. It covers various types of musculoskeletal injuries, signs and symptoms, management of injuries, spinal injuries, head injuries, and splinting techniques. The goal for emergency responders is to manage musculoskeletal injuries, prevent further damage, minimize disability, and reduce pain.

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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.