bone & joint injuries monica hall rn, ae-c, bsn. general info injuries to bones and joints are...
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Bone & Joint Injuries Monica Hall RN, AE-C, BSN
General Info
Injuries to bones and joints are common in accidents and falls
This includes a variety of injuries
Examples of joint & bone injury
Fractures
Dislocations
Sprains
Strains
Fracture
A break in a bone Two types Closed (simple) – fracture is a bone break is
not accompanied by an external or open wound on the skin
Open (compound) – fracture is a bone break that is accompanied by an open wound on the skin
Signs and Symptoms of Fracture
Can vary
Each person will not exhibit all
Common sign & symptoms:
Deformity
Limited motion or loss of motion
Pain and tenderness at the fracture site
Swelling and discoloration
Protrusion of bone ends through the skin
Victim heard a bone break or snap or felt a grating sensation (crepitation)
Abnormal movements within a part of the body
Basic Principles of treatment for fractures
Maintain respirations Treat for shock Keep the broken bone from moving Prevent further injury Use devices such as splints and slings to
prevent movement of the injured part Obtain medical help whenever a fracture is
evident or suspected
Videos of Fracture
https://www.youtube.com/watch?v=UWM2G35mE0Y
https://www.youtube.com/watch?v=e421jNbbk90
Dislocation
When the end of a bone is either displaced from a joint or moved out its normal position within a joint
Frequently associated with tearing or stretching of ligaments, muscles, and other soft tissue
Signs & Symptoms of Dislocation
Deformity Limited or abnormal movement Swelling Discoloration Pain and tenderness A shortening or lengthening of the affected
arm or leg
Dislocation Treatment
Basically the same as fractures No attempt should be made to reduce the
dislocation (replace the bone in the joint) Immobilize the affected part in the position
found by using splints and/or slings (movement of the injured part can lead to additional injury to nerves, blood vessels, and other tissue in the area)
Obtain medical help immediately
Dislocation Video
https://www.youtube.com/watch?v=CmvUVztaxdQ
Sprains
An injury to the tissues surrounding a joint; it usually occurs when the part if forced beyond its normal range of movement
Ligaments, tendons, and other tissues are stretched or torn
Common sites for sprains include the ankles and wrist
Sprains (Signs & Symptoms)
Swelling Pain Discoloration Sometimes impaired motion
Ankle Sprain Video
https://www.youtube.com/watch?v=v2NKUIOQ4zA
Strain
Overstretching of a muscle, it is caused by overexertion or lifting
Backs are the most frequent site
Signs/Symptoms of Strain
Sudden pain
Swelling
Bruising
Strain treatment
Encourage the victim to rest the affected muscle while providing support
Recommend bedrest with a backboard under the mattress for a strained back
Apply cold application to reduce the swelling After the swelling has decreased, apply warm,
wet applications because warmth relaxes the muscles
Obtain medical help for severe strains and back injuries
Neck and Spine Injuries
Most dangerous types of injuries to bones and joints
If a victim with such injury is moved, permanent injury resulting in paralysis can occur
If at all possible avoid any movement of a person with potential neck or spinal injuries
Wait until a backboard, cervical collar, and adequate help for transfer arrives
Videos
https://www.youtube.com/watch?v=W-BmKXU12yE
https://www.youtube.com/watch?v=zz7Xm5yTkH4
Splints
Devices used to immobilize injured parts Can be used in fractures, dislocations, and
other similar injuries are present or suspected Commercial splints are available such as air
or inflatable splints, padded boards and traction splints
Can also be made from cardboard, newspapers, pillows, etc.
Basic principles of splints
Should be long enough to immobilize the joint above and below the injured part
Should be padded especially over bony areas and over the site of injury
Can be secured in place with triangular bandages, strips of cloth, roller gauze, or similar materials
Must be applied in a way to not cause pressure over the site of injury
If an open wound is present, use a sterile dressing to apply pressure and control bleeding
Basic principles of splints – cont. Never make an attempt to replace broken bones or
reduce a fracture or dislocation – do not move the victim, splint wherever you find the victim
Pneumatic splints are available but must be used with caution – there are air and vacuum
Traction splints provide a pulling or traction effect on the injured bone – only trained people would apply
After a splint is applied, one should check circulation Check skin temperature (should be warm) Skin color (pale or blue indicates poor circulation) Any swelling, numbness, or tingling Check pulse
Splint Video
https://www.youtube.com/watch?v=b_pjE_tAtgg
Slings
Generally used to support the arm, hand, forearm, and shoulder
Many different types Commercial slings usually have a series of
straps that extend around the neck and/or thoracic region
A common first aid sling is the triangular bandage
May be used to provide immobility if a fracture of the arm or shoulder is suspected
Basic Principles of Slings Always position where hand is higher than the elbow
(promotes circulation, prevents swelling, and decreases pain) Check circulation frequently (skin temperature, color,
tingling, amount of pain, and numbness) – nail beds is an easy way to check, when pressing them should blanch (turn white) then return to the normal pink color immediately
If applying sling due to potential fracture, used caution not to move area and cause increased injury while trying to apply sling
If using a triangular bandage, tie knot to either side of spinal column and pad knot
If sling is for shoulder injury, can secure limb to body after applying sling with bandage around thoracic region
Sling Video
https://www.youtube.com/watch?v=9Cifk_ohsDo
Summary
Victims with injury to bones or joints can also experience shock
Be alert for signs of shock and treat as indicated These injuries cause emotions to soar – reassure All first aid measures are directed toward
decreasing pain Obtain medical help The only definite medical dx of a closed fx is a x-ray Always if suspected injury is noted, treat as if it is a
true injury
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