Musculo Skeletal Injury

MUSCULO-SKELETAL INJURY

ANATOMY  Skeleton

– framework, support  Joint – point of articulation, connection that allows motion  Ligament- strengthen & holds bones into position  Muscle- contractile organ for moving  Tendon- connective tissue which anchors muscle to bone

PHYSIOLOGY  Support  Protection  Movement  Blood

formation

FRACTURE  Closed

– does not penetrate the skin  Open – penetrates skin  Greenstick – incomplete, bent on the other side  Transverse – forms right angle to bones axis  Oblique – the break slopes  Comminuted – bone fragmented in 3 or more

DISLOCATION  Separation

of bones where it meets a joint

STRAIN ~ muscle ~ overuse ~ with swelling

vs

SPRAIN ~ ligament ~ twisted ~ w/o swelling

SIGNS and SYMPTOMS  Pain  Deformity  Discoloration  Loss

of function  Swelling

MANAGEMENT  Protect  Rest  Immobilize  Cold

compress  Elevate

SPLINTING Objective ~ to immobilize injured part ~ to lessen pain ~ to prevent further damage ~ to reduce risk of bleeding ~ to reduce risk of loss of circulation

BASIC PRINCIPLES  Splint

only it if can be done without adding more pain to the patient  Splint injury on the position you found it  Apply splint so that it immobilizes the affected part  Recheck circulation before and after splinting

TYPES OF SPLINTS  Rigid  Anatomical  Soft

splints

COMMON MEDICAL EMERGENCY

STROKE  Cardiovascular

accident  Blood flow to the brain is interrupted  Risks- smoking, old age, HPN, high blood cholesterol, drugs

SIGNS and SYMPTOMS [CVA]  Sudden

weakness or numbness of face, arm or leg, unilateral  Slurring of speech  Confusion  Difficulty seeing with one or both eyes  Severe headache with no known cause  Fainting/unconsciousness

MANAGEMENT [CVA]  CHECK

ABC, begin CPR or rescue breathing if necessary  Make client as comfortable as possible  DO NOT GIVE ANYTHING BY MOUTH  In unconscious, place in recovery position  Stay with the client until medical help arrives

DIABETIC EMERGENCIES  Insulin

irregularity  3P’s of diabetes  Types – –

Insulin Shock (hypoglycemia) Diabetic Coma (Diabetic Ketoacidosis)

INSULIN SHOCK  Too

much insulin/ too low sugar  Cause: taking too much medication, by failing to eat, heavy exercise  S\Sx- fast breathing, dizziness, weakness, change in LOC, visual difficulty, sweating, numbness of hands and feet, hunger.

MANAGEMENT [INSULIN SHOCK]  Administer

fluids with high simple sugar concentration  Offer hard candy  Rest  Seek medical help immediately

DIABETIC KETOACIDOSIS  Diabetic

coma  Too much sugar, too little insulin  Cause: eating too much sugar, failing to take insulin on time, infection  S\Sx- drowsiness, deep & fast breathing, thirst, dehydration, fever, acetone or fruity odor breath

MANAGEMENT [DKA]  Fluid

replacement

 Rest  Seek

medical help immediately  Monitor ABC and vital signs

SEIZURE  Sudden

uncontrolled muscle contraction  Usually caused by disorder in brain’s electrical activity Types: ~ Grand Mal – unconsciousness, tonic, clonic ~ Absence – brief loss of consciousness ~ Partial or Myoclonic – isolated, unusual sights, smells, sounds

MANAGEMENT [SEIZURE]  Cushion

head with soft material  Loosen tight clothing  Do not restrict movements  Do not give anything per orem  Do not put anything in the client’s mouth before and during seizure

EPISTAXIS  Nose

bleeding  Cause: trauma, extremes in temperature, bleeding problems  Management: direct pressure on nose bridge, cold compress, tilt head forward

DIARRHEA  Increase

in number and consistency of stool  S/Sx- skin goes back slowly when pinched, thirsty, sunken eyes, minimal or absent tears, irritable, lethargic  Management- fluid & electrolyte replacement, oral rehydration solution, transfer immediately to the nearest hospital

MYOCARDIAL INFARCTION  Heart

attack – sudden or prolonged interruption of coronary circulation which lead to myocardial ischemia and alteration of normal cardiac function  S\Sx: chest pain not relieved by rest or nitroglycerine radiating to jaw, neck, left arm and back; nausea, dizziness, cold sweat

MANAGEMENT [ MI ]  Ask

for medical assistance  Start CPR if there is no pulse  Monitor VS & ABC  Relieve client’s anxiety

HEAT CRAMPS  Muscle

spasms occur mostly due to profuse sweating causing severe pain because of overexertion, poor circulation and lactic acid build up  S\Sx- muscle pain, normal body temp, elevated BP, normal mental status and consciousness

MANAGEMENT [HEAT CRAMPS]  Remove

client from the hot environment  Cool client with moist towels  Administer saline solutions as client desire  Gently return the affected muscle to its normal anatomical position  Do not massage

HEAT EXHAUSTION  Most

common heat related injury  S\Sx- profuse sweating, pale, cool, clammy skin, thirst, body temp normal or below normal, nausea, vomiting, dizziness, fatigue, rapid pulse

MANAGEMENT [HEAT EXHAUSTION]  Get

the client out of the sun into a shady or air-conditioned room  Lay the person down and elevate legs  Loosen tight clothing  Give saline solution as desire  Monitor VS and seek medical attention

HEAT STROKE  Hyperthermia

with accompanying physical and neurologic symptoms which can lead to brain damage  S\Sx- elevated temp, absence of perspiration, dry & reddish skin, rapid weak pulse, mental confusion, anxiety, weakness, unconsciousness

MANAGEMENT [HEAT STROKE]  Remove

client from the source of heat  Check ABC  Rapidly cool patient  Seizure precaution  Seek medical attention immediately

HYPOTHERMIA  Generalized

cooling of the body  Life threatening  S/Sx- skin cold to touch, shivering, muscle rigidity, weakness, cyanosis of lips, ears, nose, fingers & mucous membranes, incoherent, confusion, drowsiness, apathy, unconsciousness

MANAGEMENT [HYPOTHERMIA]  Remove

wet clothing and dry the client  Apply external heat  Monitor VS  Seek medical help immediately

FROST BITE  Local

cooling of distant parts of the body (earlobes, nose, fingers, toes)  So severe, it constricts blood supply which causes tissue damage  S\Sx- cyanosis of the affected part, burning pain, numbness, amputation

MANAGEMENT [FROST BITE]  Remove

client from cold environment, remove wet or cold clothing  Re-warm the affected part  Do not massage, apply ice water or apply extreme heat  Cover the warmed part and bring to the nearest medical facility

 fin