MUSCULOSKELETAL SYSTEM
Musculoskeletal Injury is a Common Type of Call for the EMT. Largely Not Life-Threatening There are Rare Occasions. Prompt Identification and Treatment are Crucial in Reducing Pain, Preventing Further Injury, and Minimizing Permanent Damage.
MUSCULOSKELETAL SYSTEM
- Femur Longest
- Inner Ear Smallest
- Long
- Arms & Legs
- Short
- Hands & Feet
- Flat
- Sternum / Ribs
- Irregular
- Vertebrae
MUSCULOSKELETAL SYSTEM
- Cartilage
- Provides Flexibility
- End of Bones
MUSCULOSKELETAL SYSTEM
- Tendons
- Connect Muscle to Bone
MUSCULOSKELETAL SYSTEM
- Ligaments
- Connect Bone to Bone
3 TYPES of MUSCLES
- Smooth Muscles Involuntary
- Organ Walls & Digestive Tract
- Controlled By the Autonomic Nervous System
- Cardiac Muscle Myocardium
- Capable of Producing Its Own Electrical Stimuli
- Skeletal Muscle Voluntary
- Major Muscle Mass
- Provides for Movement
- Gives Shape
- Usually Under Conscious Control
BONE & JOINT INJURY
- Mechanism of Injury
- Direct Force
- Indirect Force
- Twisting Force
BONE & JOINT INJURY
- Fractures
- Open Break in Continuity of Skin
- Closed No Break in Skin
- Dislocations
- Joints "Come Apart"
- Sprains
- Stretching & Tearing of Ligaments
- Strains
- Overexertion of Muscle
BONE & JOINT INJURY
- All musculoskeletal injuries may present with the same symptoms & signs; care is directed at minimizing injury, not determining which type!
BONE & JOINT INJURY
- Signs & Symptoms
- Deformity or Angulation
- Pain and Tenderness
- Grating / Crepitus
- Swelling
BONE & JOINT INJURY
- Signs & Symptoms
- Bruising / Discoloration
- Exposed Bone Ends / Compound Fracture
- Joint Locked in Position
- Nerve & Blood Vessel Compromise
EMERGENCY CARE
- BSI & O2
- C-Collar if Needed
- Control Life-Threats
- PMS Prior & After
- Splint
- Apply Cold Pack
- Reduces Swelling
- Elevate if Possible
SPLINTING
- Prevents Movement of Bone Ends & Fragments
- Minimizes Complications
- Damage to Muscles, Nerves, & Blood Vessels
- Keeps Closed Fracture from Becoming Open Fracture
- Keeps Bone Ends from Compressing Vessels
- Reduces Tissue Damage from Bone Ends
- Reduces Pain
- Reduces Chance of Paralysis from Spinal Injury
GENERAL RULES of SPLINTING
- Assess PMS Before & After
- Immobilize Joint Above & Below Injury
- Expose Area Cut Clothing
- Cover Open Wounds w/ Sterile Dressing
- Pad Splint to Reduce Discomfort
- Splint Before Moving Pt. If No Life-Threat
- When in Doubt - Splint
GENERAL RULES of SPLINTING
- If Injury Involves Bone
- Immobilize Joints Distal & Proximal
- If Injury Involves Joint
- Immobilize Bones Distal & Proximal
GENERAL RULES of SPLINTING
- If Distal Extremity is Cyanotic or Lacks Pulse
- Align w/ Gentle Traction Before Splinting
- Unless Resistance is Felt
- Maintain Traction Until Splint is Secure
GENERAL RULES of SPLINTING
- Protruding Bone Ends
- Do Not Intentionally Replace
- Cover w/ Sterile Dressing
- Signs of Shock (Hypoperfusion)
- Align Anatomically & Immobilize on Spine Board.
HAZARDS of IMPROPER SLINTING
- Splinting Someone to Death
- Take Care of Life-Threats
- Compression of Nerves, Tissues, & Vessels
- Delay of Transport of Life-Threats
- Splint Too Tight, Occluding Distal Circulation
- Excessive Movement During Splinting
- Causing Tissue Damage
SPECIAL CONSIDERATIONS
- BSI
- Manual Stabilization
- Assess PMS
- Severe Deformity or Circulation Compromise
- Gentle Traction
- Measure Splint
- Apply Splint & Secure
- Above & Below Injury
- Above & Below Joint
- Minimum 4 Contacts
- Hands & Feet in Position of Function
- Reassess PMS
SPECIAL CONSIDERATIONS
- BSI
- Manual Stabilization
- Assess PMS
- Circulation Compromise
- Gentle Traction if No Resistance
- Measure Splint
- Apply Splint
- Immobilize the Bone Above & Below Joint
- Minimum 4 Contacts
- Reassess PMS
PELVIC INJURY
- Pelvic fracture
- Hip dislocation
- Maintain strong suspicion of spinal injury.
- Minimize motion of injured area.
- Assess distal PMS.
- Attempt to straighten lower extremities into anatomical position.
- Pad between extremities with blanket.
- Apply PASG if patient is hypotensive.
- Place patient on spine board. (Use caution with log-roll!)
- Reassess distal PMS.
- Care for shock.
- Transport.
- Pelvic wrap is an option.
- Perform patient assessment.
- Treat for shock.
- When correctly placed, sheet will appear lower than iliac "wings."
TRACTION SPLINTING
- Indications
- Painful, Swollen, or Deformity to Mid-Thigh Not Involving Joints or Lower Leg.
TRACTION SPLINTING
- Contraindications
- Injury is Close to Knee
- Injury Involving Knee
- Injury to Hip
- Injury to Pelvis
- If Traction Would Complete Amputation
- Lower Leg or Ankle Injury