WEEK9-Minor trauma Flashcards
what are the 3 steps for a muscular skeletal assessment
look,feel.move
how to LOOK during msk assessment
expose area
if injury is on appendage (protruding part of the body) compare to other side is there a difference in length shape etc
asses type of injury (potential fracture wound)
is patient guarding or self immobilising the affected area
look above and below the injury (is there any structural change)
whats a wound
a break in the skin
chronic/acute types of wounds
example of a chronic wound
pressure ulcers
diabetic wounds
venous wounds
surgical wounds
radiation poisoning
example of acute wounds
abrasions
puncture
incisions
gunshot
burns and scalds
types of wounds
abrasion:- superficial- affect epidermis, bleeding is minimal but abrasion can cover large areas and often have dirt in it
avulsion:- partial/full traumatic loss of soft tissue. skin tear or fragile skin
amputation:- a protruding part is lost either by cutting/crushing/shearing
ear, finger etc
puncture/penetrating:- when a wound is deeper than wide. usually from object piercing/penetrating
laceration:- caused by a cut, ragged and irregular in appearance. from ripping shearing and bursting
incision:- neat and clean wound edge created by a sharp object. like a razor or scissors
what is a fracture
described as a break in the continuity of a bine (different to a sprain and dislocation)
what is a sprain
a stretch or tear of a ligament
what is a strain
describes the stretching and tearing of a muscle or tendon
what is a dislocation
when a bone is entirely displaced from the joint causing the articulating surfaces to no longer be intact.
if joint is only partially dislocated= subluxation, causes articulating surfaces to only be in partial contact.
can patients have a fracture and dislocation
yes
what are the indications of a fracture
erythema:- redness caused by increased blood flow
bruising:- smaller blood vessels under skin being ruptured when they are under trauma
deformity:- distortion of the bones shape from its normal alignment, length or size
swelling:- increased movements of fluid with macrophages and other pro-inflammatory components to try and promote healing
discolouration:- changes in colour to area (Blue, white, purple), indicates poor circulation
broken skin/open:- protruding bones meaning an oblique displaced fracture
what can burns be caused by
heat
electricity
chemicals
what are the clinical features of varying burn depths
superficial burn= damage to epidermis- leading to pain, dry and erythema
superficial partial thickness= damage to epidermis and superficial dermis leading to intense pain, clear Bisters and weeping
deep partial thickness= epidermis and deep dermis. leading to intense pain, red, clear, weeping and haemorrhagic blisters
full thickness= epidermis and dermis and fat/muscle/nerve. leading to no pain in the primary burn area (surrounding area painful) white, charring and leathery
how to FEEL during msk assessment
if suspected fracture, palpate and check for:
whether it elicits pain and where
any crepitus) grinding, crunching, popping)
any obvious fluid
temperature (very hot or very cold)
any obvious changes in comparison
then check above and below
how to MOVE during a msk assessment
is fracture is suspected move and assess area:
whether it elicits pain
any crepitus (grinding, crushing or popping)
range of movement (rom) reduced
active movement: ask the patient to move the affected area are they able to
passive movement: take affected area and gently rotate.
against resistance: if 2 stages are normal, try getting patient to move affected area while resistance is applied
what is a foreign body
a substance or object thats not part of the human body.
if an object is embedded, this should be left in as it may be plugging a bleed
stabilise the object as much as possible, apply pressure from either side if heavy bleeding occurs
whats the ai of irregation
aim is to remove foreign material like dirt or grit. this will decrease bacterial contamination of the wound and will remove cellular debris/ exudate from the surface of the wound
what is irrigation
using sterile water/saline pushed over the wound using a small amount of pressure to clean it
when dont you irrigate
if your unsure of the depth then avoid irrigation.
because it could push dirt and bacteria deeper in
if actively bleeding also don’t irrigate because can prevent clotting
what to do with a burn
remove source of burn, clothing must be removed. Powders or other contact agents should be brushed off
wound should be cooled/irrigated,
run under water for 10-20 mins
use a cold flannel/ wet gauze if its a smaller burn
dressing should occlude the wound to keep it clean and cover the raw nerve endings,
clingfilm if possible
why use bandages
bandages cover wounds to protect it from further damage or from bacteria entering.
minor wounds= melonin dressings. moisten with sterile saine to prevent lysing of tissues.
if bleeding continues through the 1st dressing, add more dressings applying pressure and elevation
dressing pads can either be bandaged or taped in place
what is immobilisation (sling)
arm sling= fast and effective way to immobilise an injury to wrist, hand and elbow
helps keep injuries isolated, prevents any further injury to the tissue and blood vessels. prevents pain.
what is immobilisation (vacuum splint)
a vacuum splint can be moulded around the patients injury and then they will have the air removed using a pump and therefore will keep its shape
come in multiple sizes and used for suspected fractures. can help prevent damage from further movement and help prevent additional pain from movement.
what are the pre and most management checks
you must assess the motor, sensory and circulatory function and compare to see if anything has changed
note down the most furthest away part of the limb:
colour
temperature
capillary refill time
pulse site
if patient can feel you touching the area
if patient can move the area
why do we conduct pre and post management checks
looks at the peripheral circulation
moving/splinting the injury can cause changes in the circulation
changes could mean blood supply is restricted
if this occurs take it off and re apply
