Musculoskeletal, Head and Spinal Injuries. Respond
Musculoskeletal, Head and Spinal Injuries Respond
Musculoskeletal, Head and Spinal Injuries • At the end of this module, a student will be able to m...
Musculoskeletal, Head and Spinal Injuries • At the end of this module, a student will be able to manage the patient with head suspected spinal or major limb injuries in accordance with appropriate CPGs.
Knowledge Objectives 1. State the signs and symptoms of fractures 2. Explain the pre‐hospital emergency care management for the patient with a painful, swollen, deformed extremity 3. Relate the mechanism of injury to suspected injuries of the head and spine 4. Outline the indications and risks associated with rapid extrication 5. List the sign and symptoms of a suspected spinal injury
Knowledge Objectives 6. Outline how to stabilise the cervical spine 7. Explain the pre‐hospital emergency care management for assisting with the patient with suspected spinal injuries 8. State how to stabilise the head and remove the helmet 9. List the signs and symptoms of head injuries 10.Explain the pre‐hospital emergency care management for assisting with the patient with head injuries
Attitudinal Objectives At the completion of this section, the student will be able to: Demonstrate a caring attitude towards patients with traumatic injuries who request pre‐hospital emergency services
Skills Objectives 1. Demonstrate the pre‐hospital emergency care management for the patient with a painful, swollen, deformed extremity 2. Demonstrate using a splinting device to an upper limb 3. Demonstrate assisting with use of a splinting device for a lower limb 4. Demonstrate manual stabilisation of the cervical spine
Skills Objectives 5. Demonstrate the application of a cervical collar 6. Demonstrate assisting with the pre‐hospital emergency care management for the patient wit a suspected spinal injury 7. Demonstrate assisting with the pre‐hospital emergency care management for the patient with a head injury 8. Demonstrate helmet removal
Sprain v Strain SPRAIN • Overstretching or tearing of a ligament at a joint
STRAIN • Overstretching of a muscle or tendon
A Fracture is a broken or cracked bone Signs and Symptoms of fractures • • • • •
Swelling Loss of Movement Irregularity Pain Bruising
• • • • •
Deformity Unnatural Movement Crepitus Tenderness Shock
Care management for the patient with a painful, swollen, deformed extremity • Treat for a Fracture before moving the patient – unless necessary to move • Reassure the patient – explain what your doing • Support and Immobilise the affected part – to prevent further movement
Care management for the patient with a painful, swollen, deformed extremity • Avoid direct pressure to the injury site – apply wound dressing to open fractures • Place patient in a comfortable position – if possible slightly raise the affected part • Pass bandages under the natural hollows of the body – secure opposite side to injury • Regularly check CSM’s above and below the injury site
Care management for the patient with a painful, swollen, deformed extremity
Injuries of the Head & Spine
Cervical Spine injury
Closed injury
Open injury
Relate the mechanism of injury to suspected injuries of the head and spine • Any trauma patient with altered level of consciousness • Blunt trauma with associated injuries above the clavicles • Penetrating trauma to head, neck and torso • Falls from height • Shallow water diving accidents • Hangings • Gunshot wounds
Relate the mechanism of injury to suspected injuries of the head & spine • Motor vehicle incidents incorporating one or more of the following: – – – – – – – –
Bulls Eye windscreen Vehicle on its side Vehicle on its roof Vehicle which has overturned Deployment of an airbag Vehicle with a bent steering wheel Known collision speed > 30 mph Intrusion of side impact bars
Outline the indications and risks associated with rapid extrication Indication • Life threatening injury • Airway compromise • Cardiac / Respiratory arrest • Danger of further injury • Fire • Building collapse
Risk • Damage to spinal cord following spinal column injury • Damage to patient limbs and increased potential for further injury
List the sign and symptoms of a suspected spinal injury • Laceration, bruise or injury to the head, neck or spine • Tenderness over any point in neck or spine • Pain in neck or spine or pain radiating to an extremity • Extremity weakness, numbness, paralysis or loss of movement
• Loss of sensation or movement, or tingling/burning sensation in any part of the body below the neck • Loss of bowel or bladder control
Outline how to stabilise the cervical spine
Assisting with the patient with suspected spinal injuries • Return the head & neck in a neutral position unless on movement the patient feels – Increase of pain – Increase in resistance
• Proceed with caution • Full spinal immobilisation is recommended • Observe for airway compromise throughout
State how to stabilise the head and remove the helmet • In most instances, helmets do not have to be removed until the arrival of EMS • Only remove helmet if: – Face mask or visor interferes with adequate ventilation or airway management. – Helmet is too loose making immobilisation inadequate.
List the signs and symptoms of head injuries • • • •
Assisting with the patient with head injuries • Patient with head injury may be combative aggressive or agitated • Proceed with caution • Full spinal immobilisation is recommended • Observe for airway compromise throughout
Question / Discussion
Summary 1. 2. 3. 4. 5. 5. 6. 7. 8.
Signs and Symptoms of fractures Explain the care management for the patient with a painful, swollen, deformed extremity Relate the mechanism of injury to suspected injuries of the head and spine Indications and risks associated with rapid extrication Sign and symptoms of a suspected spinal injury Demonstrate the application of a cervical collar Demonstrate assisting with the management for the patient with a suspected spinal injury Demonstrate assisting with the pre‐hospital emergency care management for the patient with a head injury Demonstrate helmet removal
