Lec.4 Musculosceletal
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Transcript of Lec.4 Musculosceletal
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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
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MUSCULOSKELETAL INJUR+
,ones & Muscles $a% -e in.ured
in / -asic 0a%s 1 'racture !islocation
Sprain Strain
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Musculos)eletal In.ur%
Mechanis$ of In.ur%
!irect Indirect T0istin forces
,endin forces Co$pression forces !istraction forces
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Musculos)eletal In.ur%Sins & S%$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
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Musculos)eletal In.ur%
SplintinSplint is an% de"ice used to i$$o-ili2e a -od% part 1
It $a% -e soft or riid
Ai$ of splintin 1 To pre"ent $otion of -one fra$ent or
dislocated .oints To $ini$i2e da$ae to surroundin tissues
ner"es -loud "essels & in.ured -one To help control -leedin & s0ellin To help pre"ent shoc) To reduce pain & sufferin
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Musculoskeletal Injury
T%pe of splints
Riid splints Traction splints Circu$ ferential splints
I$pro"ised splints Slin & s0athe
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Musculoskeletal Injury4eneral rules of splintin
!o not release $anual sta-ili2ation of an
in.ured e3tre$it% until it is properl% &co$pletel% i$$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$$o-ili2e it until
The-ones a-o"e & -elo0
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If a li$- is se"erel% defor$ed -% the in.ur% or if the li$- has no pulse or c%anctic -elo0
the in.ur% site alin it 0ith entle
$anual traction
5ad a splint -efore appl%in it ,efore & after appl%in a splint assess pulse
$o"e$ent and sensation -elo0 the in.ur% site
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Musculoskeletal InjuryI$proper Splintin 1
Co$press ner"es tissue & -lood "essels
Under the splint ara"ate the in.ur%
and furthe da$ae Mo"e displaced or -ro)en -one Reduces -lood flo0 -elo0 the in.ur% site
!ela% transport of a patient 0ho has a life Threatenin pro-le$
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In.uries to the head Open in.ur% Closed in.ur%
Open head injuryIs acco$panied -% a -rea) in the s)ull caused -%
A fracture or an i$paled o-.ect direct local
!a$ae to -rain tissue
Closed head injury
No -rea) or 0ound
,rain can -e seriousl% in.ured 6S0ellin &
,leedin -rain pressure7
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*ead In.ur%
5atient assess$ent
Altered $ental status fro$ confusion
to un responsi"eness
Irreular -reathin Open 0ounds to the scalp 5enetratin 0ounds to the head Softness or depression of the s)ull ,lood or cere-rospinal fluid lea)in
fro$ the ears nose
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'acial -ruises ,ruisin around the e%es 6raccdon e%es7 ,ruisin -ehind the ears 6,attle sin7 *eadache Nausea "o$itin Une8ual pupil si2e 0ith altered
$ental status Sei2ure acti"it%
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Head Injury
Suspect spine in.ur% in an% patient9ith a head in.ur% i$$ediate
Sta-ili2e the patients head & nec)
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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
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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 $outh or head 0ounds Unusual si2e of pupils Raccoon e%es ,attle;s sin
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Head Injury
In.uries to he -rain
Sins & S%$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
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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