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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