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Trauma

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					              Trauma


   Types of Musculoskeletal
    Trauma
   Causes
Emergency Care

   ABC’s
   Musculoskeletal
    Trauma
     – Assess
     – Circulation
     – Immobilize
First Aid Keys!

                  ABCs First
                  CMS
                  Immobilize
                  RICE
Sprains, Strains
                       Pain!

   Strains
    (tendons,muscle)
   Acute
   Chronic
   Classification
    – 1st degree
    – 2nd degree
    – 3rd degree
What kind
of injury?


Sprain or
strain?
Sprains

   Ligamentous
    Injury
   Sites
   Classification
    – 1st degree
    – 2nd degree
    – 3rd degree
Management Sprains &Strains

   Nursing        Interventions
    Diagnosis       – Grade I=RICE
   Immediate       – Grade II
    Care              • Strain
                      • Sprain
    – Rice
                    – Grade III
Knee Injuries

Types

Terrible trial (medial collateral,
          anterior cruciate, medial
          meniscus)


Assessment

Management
Identify the injury!
The terrible triad!
           Dislocations/Subluxations


   Definitions
                         Management
   Assessment           Reduce
   Nursing              Stabilize
    diagnosis             – Slings
   Examples              – Velpeau
                            bandage
                          – Immobilizer
                          – Splints
Hips also dislocate.
In what positions can a hip
dislocate?
How do you detect hip dislocation in
an infant?
Signs and symptoms
of hip dislocation:
anterior and
posterior
Your patient presents in
the ER with her hand
wrapped in a cloth.


What assessment would
you make?


What actions should you
take?
    Fractures
   Classifications      By Direction
    – Open                 – Transverse
    – Closed,              – Oblique
      complete
                           – Spiral
    – Incomplete
                           – Angulated
    – Impacted
                           – Offset
    – Comminuted
                         By Force
    – Displaced
    – Complicated        By Physician
                         Joint Injury
Significance of Fracture
Description
   Why?
   Examples of Fracture
    – Angulated
    – Communiuted
    – Oblique
    – Stress Fx
    – Compression
Test Your Skill!
Describe these fractures!
How would you
describe these
fractures?
Describe these fractures. Include
location and type.
                   Fractures of the epiphyseal plate. What
                   potential injury may result which has long
                   term implications?




Stress fracture
                  Salter Fractures (epiphyseal
                  plate fractures)
Steps in Bone Healing

   Inflammation
   Cellular Proliferation
   Callus Formation
   Ossification
   Consolidation and Remodeling
Identify the steps in the
bone healing process.
What factors affect
bone healing?
These slides reflect bone
healing in a young
person. Determine what
stage of healing is
reflected in each picture.
Bone Healing Promoted by:

   Influenced by        Fracture
    – Approximation       Management
      of Bone Ends       Examples of
    – Circulation         Fractures
    – Nutrition
    – Type of bone
   Nursing
    diagnosis
Clinical Situation
   JR, 44 yr. old male,
    fell 12 feet; sustained
    open communiuted l.
    tibial fx. and closed
    spiral fx midshaft l.
    femur. Hx. 1 qt Wild      List at least 7
    Turkey daily. Wt. 240     factors that will
                              NEGATIVELY effect
    H&H: 12; 36%; K:3.0;
                              JR’s bone healing.
    albumin: 2.5g/dl;
    amylase: 260 IU/L; T
    102; FBS 150.
Fracture
Assessment/management
   Circulation first
   Deformity
   Ecchymosis
   Muscle spasm
   Pain
   Abnormal
    movement
   Crepitus
A fracture or a dislocation?
Common Fractures and Management

   Colles: fx distal      Clavicle fx: use fig.
    radius                  8 or clavicle strap
   Open fx radius         Pelvic fx: injuries to
                            bladder, iliac artery,
   Supracondylar fx
                            sciatic nerve
    humerus: use
    Dunlop’s traction      Open fx femoral
                            shaft: blood loss
   Shaft of humerus;
    use sling and          Communiuted fx.
    swath                   distal 1/3 tibia
Colles Fracture
Produces a “silverfork”
deformity
What
observations?


What assessment
is most critical?
                             Describe this
                             fracture. What is
                             the anatomical
                             location of the
                             fracture?

                             What type of
                             traction might
                             initially be
                             used?



A potential result of this
fracture is Volksman’s
ischemic contracture due
to compartment
syndrome.
Type of traction to initially treat a
supracondylar fracture of the humerous
Fracture of the
mid-shaft of the
Humerus
What potential
complications
might occur?
Fracture of the mid 1/3 of
the clavicle
      Treatment with figure of 8 or
      clavicle strap. What teaching
      should be done?
                    Pelvic fractures
                    may be treated
                    surgically or
                    with a pelvic
                    fixator.




Pelvis fractures
vary in severity.


What potential
serious injuries
may result form a
pelvic fracture?
What method of treatment has been
selected for this person with a pelvic
fracture?
Describe the anatomy of
the hip joint.
Hip fractures
                               Describe
                               this
                               fracture.
                               What are
                               two major
                               concerns?




Treatment options: traction,
ORIF
Describe the fracture
including location.
Why might this site require
grafting?
How can you determine
is there is a fracture?

				
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posted:3/10/2013
language:Latin
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