Musculoskeletal (MSK) injuries Flashcards
Fracture
partial or complete break or disruption in a bone
- can cause hypovolemic shock if there is an associated hemorrhage
Dislocation
displacement or separation of a bone from its normal position at a joint
- Close prox. to vessels + nerves = increase risk
Sprain
Partial or complete tearing of ligaments + other tissues at a join
- typically not associated w/ emergency (3rd can be)
Strain
stretching or tearing of muscle or tendon
- not associated w/ an emergency
closed fracture
skin not disrupted at # site
open fracture
skin is open/broken at # site
complete fracture
discontinuity btwn 2+ bone fragments
incomplete fracture
bone is not broken all the way through
complicated fracture
broken bone has injured internal organ
- muscular, ligamentous, intra-articular, neurovascular and visceral issues
uncomplicated fracture
a fracture that has only a minimal amount of soft tissue injury.
Occult
is not visibly demonstrated, but is suspected based on clinical examination
MSK s/s
pain
swelling
deformity
discoloration
inability to use affected part (or unwillingness)
fracture s/s
significant deformity, crepitus, snap/pop sound at time of injury, MOI is severe trauma, mod-severe swelling and discoloration, unable to move body part
bone protruding out, loss of sensation/circ in extremity, cool to touch, pelvic, tibia, humerus or femoral # = s/s for RTD
Principle of Care for MSK injuries
Protect (crutches)
Optimal Loading (massage, strength, and mobilization)
Ice (10 mins max) Compression (helps lymph vessels)
Elevation (reduce swelling)
Emergency Care for MSK injuries
- O2 as needed (based on breathing, skin, SpO2)
- control open wound bleeds
- immobilize in position found
- elevate if not cause further injury
- ice for 20min unless distal circ is impaired
Immobilizing MSK injuries purpose
-decrease risk of pain, hemorrhage, potential circ loss
-prevent further damage and closed # from opening
stable/support = feel better = decrease shock risk
Call EMS for MSK injuries when…
Impaired walking/breaking
multiple major MSKs suspected
Loss of circulation +/or sensation
Severe bleeding
Involves spine/skull
upper extremity injuries
most common MOI is FOOSH
- min mvmnt, immobilize, support
- PS checks before and after splint
- patient holding arm against body (Dont Move)
Shoulder injuries
clavicle (most common), scapular, humerus
Clavicular Injuries
15% lateral, 80% middle (sticks out most), 5% medial
- most frequently broken, often due to a fall
- C/O pain in shoulder radiate to arm
- holds arm to chest
- triangle bandage, 4S, sling and swathe, tubular sling
Acromioclavicular Separation
dislocation of the acromioclavicular joint
6 grades of ligament sprains
shoulder dislocation
glenohumeral dislocation or subluxation
- post.: humerus head behind scapula and prominent coracoid; hold in add and IR
- ant: see humeral head and divot; hold abd and ER
General treatment for shoulder injuries
- Position of comfort
- fill any holes
- sling & swathe is most effective
- PS before & after
Apply ice - Treat for shock
humeral fracture
- surgical neck
- mid-shaft
- supracondylar
- noticeable deformity and damage vessels + nerves if moved
- control external bleeding + immobilize arm from the shoulder to wrist
humeral fracture treatment
- sling and swathe
- short board or commercial splint for more stability
- PS before and after splint
- ice
- shock treatment
elbow injuries
- sprains, #s, dislocations
- be aware of proximity to nerves/blood vessels (median nerve and brachial artery)
elbow dislocation
- elbow locked in flexed position
- ant: see condyles, not olecranon fossa
- post: see olecranon fossa
elbow injury treatment
- do not move elbow joint
- splint from shoulder to hands in position found
- sling and swathe, ice, treat for shock, and PS before/after
Forearm, Wrist + Hand Injuries
- # of the ulnar and radius (common together)
- can appear in an “S” shape (dinner fork)
- Radial artery and nerves (hemorrhage or loss of movement)
Treatment of Forearm, Wrist + hand
- control external bleeding
- immobilization
- soft splint to immobilize hand
- buddy tape fingers
-PS before/after
Wrist-hand position of function
Have to place something in the hand (roll of gauze) in order to keep it in a position of function
Fractures of the Humorous
-Close prox to femoral artery = Life-threatening
- limb may appear shorter fo to contracture of muscles
Fracture vs Dislocation
- limb appears shorter
dislocated = internally rotated
Posterior vs anterior hip dislocations
Anterior = externally rotated, abducted
Posterior = flexed, internally rotated, adducted
treatment for femoral fracture
- Mid-shaft # = immobilize from axilla-foot
- Femoral # w/ no PS = traction splint
- can cause serious internal bleeding
- shock: monitor BP, SpO2
- check + re-check PS
- Ice, RTD
patella dislocation
dislocated laterally
- hams and quads muscle guard into flexed position (fill cap when splinting)
- (first time) call EMS even if it still goes back in place
Knee injury treatments
- control external bleeds, wrap w figure 8
- if knee can ext, splint in ext; if not in position found
- ice, RTD, shock
Ankle and foot injuries
sprains, strains, fractures
- **pain, swell, unable walk 4 steps = red flag
- apply Ottawa Ankle Rules (for 18yrs and older)
ankle and foot injury treatment
control bleeding, ice (20 minutes max), shock, immobilize, elevate
types of splints and principles
rigid (ex: speed splint)
anatomic (ex: tie legs together)
soft (ex: pillows w triangle bandages)
traction (prox femur #; no more 30lbs and 10%BW)
- include joints above and below injured cites (rule of 1/3s)
