Lec.4 Musculosceletal

8/18/2019 Lec.4 Musculosceletal

1/18

MUSCULOSKELETAL INJURIES

Ifran Saleh

Consultant Orthopaedic & Spine Sureon

!i"#Orthopaedic & Trau$atolo%

!ept#of Surer% 'ac#of Medicine

Uni"#of Indonesia ( Cipto Manun)usu$o *osp#

Ja)arta


2/18

MUSCULOSKELETAL INJUR+

,ones & Muscles $a% -e in.ured

in / -asic 0a%s 1 'racture !islocation

Sprain Strain


3/18

Musculos)eletal In.ur%

Mechanis$ of In.ur%

!irect Indirect T0istin forces

,endin forces Co$pression forces !istraction forces


4/18

Musculos)eletal In.ur%Sins & S%$pto$s

!efor$it% or anulations

Identif% and treat life threats Sta-ili2e the in.ured e3tre$it% E3pose the in.ur% site Treat an% open 0ounds Allo0 the patient to rest in a position of

co$fort


5/18

Musculos)eletal In.ur%

SplintinSplint is an% de"ice used to i$$o-ili2e a -od% part 1

It $a% -e soft or riid

Ai$ of splintin 1 To pre"ent $otion of -one fra$ent or

dislocated .oints To $ini$i2e da$ae to surroundin tissues

ner"es -loud "essels & in.ured -one To help control -leedin & s0ellin To help pre"ent shoc) To reduce pain & sufferin


6/18

Musculoskeletal Injury

T%pe of splints

Riid splints Traction splints Circu$ ferential splints

I$pro"ised splints Slin & s0athe


7/18

Musculoskeletal Injury4eneral rules of splintin

!o not release $anual sta-ili2ation of an

in.ured e3tre$it% until it is properl% &co$pletel% i$$o-ili2ed

Ne"er intentionall% replace protrudine -ones

or push the$ -ac) -elo0 the s)in

Control -leedin & dress all open 0ounds -efore appl%in a splint If a lon -one is in.ured i$$o-ili2e it until

The-ones a-o"e & -elo0


8/18

If a li$- is se"erel% defor$ed -% the in.ur% or if the li$- has no pulse or c%anctic -elo0

the in.ur% site alin it 0ith entle

$anual traction

5ad a splint -efore appl%in it ,efore & after appl%in a splint assess pulse

$o"e$ent and sensation -elo0 the in.ur% site


9/18

Musculoskeletal InjuryI$proper Splintin 1

Co$press ner"es tissue & -lood "essels

Under the splint ara"ate the in.ur%

and furthe da$ae Mo"e displaced or -ro)en -one Reduces -lood flo0 -elo0 the in.ur% site

!ela% transport of a patient 0ho has a life Threatenin pro-le$


10/18

In.uries to the head Open in.ur% Closed in.ur%

Open head injuryIs acco$panied -% a -rea) in the s)ull caused -%

A fracture or an i$paled o-.ect direct local

!a$ae to -rain tissue

Closed head injury

No -rea) or 0ound

,rain can -e seriousl% in.ured 6S0ellin &

,leedin -rain pressure7


11/18

*ead In.ur%

5atient assess$ent

Altered $ental status fro$ confusion

to un responsi"eness

Irreular -reathin Open 0ounds to the scalp 5enetratin 0ounds to the head Softness or depression of the s)ull ,lood or cere-rospinal fluid lea)in

fro$ the ears nose


12/18

'acial -ruises ,ruisin around the e%es 6raccdon e%es7 ,ruisin -ehind the ears 6,attle sin7 *eadache Nausea "o$itin Une8ual pupil si2e 0ith altered

$ental status Sei2ure acti"it%


13/18

Head Injury

Suspect spine in.ur% in an% patient9ith a head in.ur% i$$ediate

Sta-ili2e the patients head & nec)


14/18

Head Injury4uidelines for e$erenc% care

Ma)e the air0a% a top priorit% Control -leedin & press open 0ounds Appl% a riid cer"ical i$$o-ili2ation de"ice

Monitor "ital sins closel% Cal$ & reassure the patient


15/18

Head InjuryS)ull 'racture

Sins & S%$pto$ps

:isi-le laceration in the scalp !efor$it% of the s)ull or face 5ain or s0ellin at the in.ur% site Clear or pin)ish fluid drippin fro$

Nose ears $outh or head 0ounds Unusual si2e of pupils Raccoon e%es ,attle;s sin


16/18

Head Injury

In.uries to he -rain

Sins & S%$pto$s

Chanes in $ental status6confusion unresponsi"eness7

5aral%sis or flaccidit% usuall% onl% on

one side Un e8ual facial $o"e$ent s8uintin

droopin Une8ual pupil distur-ances

of "ision


17/18


18/18

Head InjuryConclussion

Is a te$porar% loss of the -rain;s a-ilit%

to function

No detecta-le da$ae to the -rain

Could -e $ild $oderate or se"ere

,ased on the to$e inter"al -eforeReturn to responsi"eness

Documents

Lec.4 Musculosceletal