15.9 Bone and Joint Injuries

Pages 419-423LEQ: How does the type

of injury dictate the type of first aid?

Bone and Joint Injuries

Bone and Joint injuries are very common in accident and falls

Injuries can also occur together or by themselves

Examples: Fractures, Dislocations, Sprains, and Strains

FRACTURE

Breaking of the BoneClosed or Simple: No open

wound presentCompound or Open: Open

wound watch for hemorrhaging and infection

S/S of Fractures

Deformity Limited motion or loss motion Pain and tenderness at the site Swelling and discoloration, Protrusion of the bone through

the skinThe victim may hear the bone

snap, feel crepitation (grinding), and have abnormal movement of the parts

TYPES of FX

Spiral FX

Spiral Fx in Infant – Indicative of child abuse

What type of fx is this?

How about this one?

Plates/screws

TX for Fractures FX Treatment for fractures is directed at

maintaining respirations, treating for shock, keeping the broken bone from moving, and preventing further injury.

Using Splints, Slings, and Air Splints, you can prevent the injured body part from moving

When Splinting, splint above and below the break

You must get EMS and medical help ASAP

Pelvic Fractures Requires a lot of force to break

Pelvis contains major arteries so internal bleeding may occur

DO NOT MOVE THE PELVIS!

Create a Pelvic Sling

https://www.youtube.com/watch?v=wyLGa0nkBxA

Dislocation

When the end bone moves out of place or is out of normal position in the joint

Frequently accompanied by tearing or stretching of ligaments, muscles, and other soft tissue

S/SDeformityLimited or abnormal

movementSwelling Discoloration, Pain, tenderness, Shortening or lengthening

of the affected arm or leg

Dislocated Shoulder

Dislocated Shoulder

Elbow Dislocation

https://www.youtube.com/watch?v=afm20-RZxto

First Aid

Same as Fractures Ensure the patients body

extremity is immobilized Movement of the injured part

can lead to additional injury to nerves, blood vessels, and other tissue in the area

SprainInjury to tissue surrounding a joint

and it usually occurs when the part is forced beyond its normal range of motion

Ligaments, tendons, and other tissues are usually stretched or torn

Common sites are ankles and wrists

S/SSwelling, pain, discoloration,

and sometimes impaired movement

Frequently resemble fractures and dislocations

If in doubt, treat it as a fracture

First AidApplication of cold (ice with barrier 15 on

15 off) to decrease swelling and pain, elevation of the affected part and rest

An elastic bandage can be applied for support and if swelling is severe or there is a question of fracture/dislocation treat it as a fracture

Strain

Overstretching of a muscle due to overexertion of heavy lifting

Frequent sites for strains is the back

**REMEMBER GOOD BODY MECHANICS

S/S

Sudden pain, swelling, and bruising

TX Rest and support Bed rest on a very firm or boarded

mattress is recommended for a back strain

Cold can be used initially to reduce swelling (first 24 hrs) then warm and wet applications can be used as treatment because warm relaxes the muscles

Medical help should be sought if the patient is unable to move or in extreme pain

Splints pg 421Used to immobilize fractures,

dislocations, and other similar injuries that are present or suspected

Splints can be created using anything that provides support and does not further injure the patient (such as cardboard, newspapers, blankets, pillows, boards, and other similar materials)

Splints should immobilize the injury above and below the site while preventing movement or further injury

Splints should be padded especially over boney areas

Strips of cloth, roller gauze, triangular bandages can be folded, or any other object that can be stretched and tied

Splints must be applied in a manner that does not put pressure directly over the site of injury

If an open wound exists, use sterile dressing and apply pressure

Air Splints

To test whether the splint is properly inflated, use a thumb to apply slight pressure to the splint; an indentation mark should result.

NEVER make an attempt to replace a broken bone or reduce a fracture or dislocation. Do not move the patient and splint wherever you find them if the scene is safe

After SplintingYou must monitor circulation and nerve

endings when the splint is in place.Skin should be warm to touch and

watch for any edema, cyanosis, numbness or tingling, and always check the pulse

IF any S/S of changes in circulation occurs or numbness occurs, loosen the splint while still supporting the area

Slings pg 422 & 424

Always position the hand higher than the elbow which promotes circulation and decreases edema

Always check circulation Capillary Refill Test on Finger tips can be

performed If FX is suspected, try to limit the movement of

the limb as much as possible Make sure the sling is tied comfortably around

the neck Another sling could be used to tie the arm to

the body

CAUTIONNeck and Spine injuries can be

life threatening and my result in permanent paralysis so avoid moving the patient at all cost until EMS arrives

Watch for SHOCK since most bone injuries can result in shock