Musculoskeletal Injuries
Temple College
EMS Professions
ECA
Muscles
• Maintain posture,
allow movement
• 3 types:
– Skeletal (Striated)
– Smooth
(Involuntary)
– Cardiac
Bones
•Support against gravity
•Movement
•Protection
•Production of blood cells
•Storage of minerals
Joints
• Motion
• Flexibility
Musculoskeletal Injuries
• Fracture
– Break in bones continuity
• Dislocation
– Displacement of bone ends from joint
• Sprain
– Tearing of ligaments
• Strain
– Tearing of muscle
Forces of MOI
•Direct
•Indirect
•Twisting
•High-energy
Fractures
•Closed/simple
•Open/compound
•Non-displaced
•Displaced
Types of Fractures
•Greenstick
–Fraying
•Comminuted
–Shattered
•Pathologic
–Disease
•Epiphyseal
–Growth plate
Types of Fractures
• Open - break in the continuity of the skin
• Closed - no break in the continuity of the
skin
Signs and Symptoms
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Deformity or angulation
Pain and tenderness
Grating
Swelling
Bruising
Exposed bone ends
Joint locked into position
General Rules
• Determine if problem with circulation or
nerves
• Immobilize the joint above and below the
injury.
• Remove or cut away clothing.
• Cover open wounds with a sterile dressing.
• If there is a severe deformity or the distal
extremity is cyanotic or lacks pulses, align
with gentle traction before splinting.
General Rules
• Do not intentionally replace the protruding
bones.
• Pad each splint
• Splint the patient before moving when feasible
and no life threats.
• When in doubt, splint the injury
• If in shock, immobilize using long board
Reasons to Immobilize
• Prevent motion of bone fragments, bone
ends or joints.
• Minimize the following complications:
– Damage to muscles, nerves, or blood vessels
caused by broken bones.
– Conversion of a closed fracture to open
fracture
– Interruption of blood flow
– Excessive bleeding
– Increased pain
– Paralysis of extremities
Hazards of Improper Splinting
• Compression of nerves, tissues and
blood vessels
• Delay in transport of a patient with life
threatening injury
• Reduced Distal Circulation
• Aggravation of the injured area
• Cause or aggravate tissue, nerve, vessel
or muscle
Equipment
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Rigid splints
Traction splints
Pneumatic splints (air, vacuum)
Improvised splints, pillow
Long Bone Splinting Procedure
• Take Body substance isolation
• Apply manual stabilization to bone.
• Assess pulse, motor and sensory
function.
• If severe deformity or the distal
extremity is cyanotic or lacks pulses,
align with gentle traction before
splinting.
Splinting Procedure
• Measure splint.
• Apply splint immobilizing the bone and
joint above and below the injury.
• Secure entire injured extremity.
• Immobilize hand/foot in position of
function.
• Reassess pulse, motor, and sensation
after application of splint and record.
Splinting a Joint
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Body substance isolation
Apply manual stabilization to joint
Assess pulse, motor and sensory function.
Align with gentle traction if distal extremity is
cyanotic or lacks pulses and no resistance is
met.
• Immobilize the site of injury.
• Immobilize bone above and below the site of
injury.
• Reassess pulse, motor and sensation
Traction Splinting
• Indications
– Mid Shaft Femur Fracture
– Open or Closed
• Contraindications
– Injury is close to the knee
– Injury to the knee exists
– Injury to the hip
– Injured pelvis
– Partial amputation
– Lower leg or ankle injury.
Traction Splint
Ischial pad
Length-adjustment sleeve
Ischial strap
Support straps
Winch
“S”-hook
Ankle harness
Heel stand
“D”-ring
Traction Splinting Procedures
• Assess pulse, motor, and sensation distal
to the injury
• Body substance isolation
• Perform manual stabilization of the
Femur
• Apply manual traction
• Prepare/adjust splint to proper length.
• Position splint under injured leg.
Traction Splint Procedures
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Apply proximal securing device (ischial strap).
Apply distal securing device (ankle hitch).
Apply mechanical traction.
Position/secure support straps.
Re-evaluate proximal/distal securing devices.
Reassess pulses, motor, sensation distal to the
injury
• Secure torso to the longboard to immobilize
hip.
• Secure splint to the long board to prevent
General Management
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Body substance isolation
Manage life threats
Oxygen (NRB @ 15 lpm)
Splint Injured Area
Application of cold pack
Elevate the extremity.