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what is the first thing to do with a patient with a musculo skeletal injury?
check airway and breathing
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what are the 4 types of M/S injuries?
- #
- dislocations
- strains
- sprains
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what is a fracture?
break of the bone by a force greater than the strength of the bone
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what is associated with injuries to the m/s system?
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what are the 5 types of fracture?
- greenstick
- spiral
- comminuted
- transverse
- compound
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what is a greenstick fracture?
- one side of the bone bends
- other side of the bone breaks
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what fracture is common in children?
greenstick
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what is a spiral/ oblique?
- # around the bone or an angle across it
- due to twisting force
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what is a comminuted #?
contains small fragmented ends
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what is a transverse #?
- across the bone
- caused by direct force or blow on the end of the bone
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what is a compound #?
bone broken into multiple pieces
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when does a bone break with direct force?
at point of impact when the force is too great for the soft tissues to absorb and dissipate it
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when does a bone break with indirect force?
force applied to a region of the body is transmitted through the skeleton until it reaches the structurally weakest point causing a bone or bones to #
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what does osteoporosis in elderly make more likely?
# more likely from relatively minor trauma
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what accompanying illnesses may result in fractures from minor injuries?
cancers- breast, lung and prostate
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what is a dislocation?
- bone displaced from the joint occurring when they move beyond there usual range of movements
- muscles involved then spasm causing them to lock
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what is a sprain?
- injury to a ligament
- caused by excessive forces to a joint
- no dislocation or #
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what should you assume when dealing with a sprain, strain or fracture?
- assume there is a #
- can't tell the difference between sprain and # in pre-hospital
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what is a strain?
- muscular injury
- caused by overstretching or tearing muscle fibres beyond their normal limits
- or forcing the muscle to contract to strongly
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how would you manage a m/s injury?
- remove jewellery
- access and record- MCS
- realignment to normal anatomical position if possible
- consider analgesia
- apply slintage
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what should you do before and after immobilisation?
assess and reassess
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what are the 6 P's of ischaemia?
- pain
- pallor
- paralysis
- paraesthesia
- pulselessness
- perishing cold
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what is ischameia?
restriction of blood flow to tissue
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what is the symptom of pain?
out of proportion to the injury not eased by splinting or pain relief
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what is the symptom of pallor?
compromised blood flow
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what are the symptoms of paralysis?
loss of movement
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what are the symptoms of paraesthesia?
changes in sensation
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what are the symptoms of pulselessness?
loss of peripheral pulses which can lead to complete occlusion of circulation
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what are the symptoms of perishing cold?
limb is cold to touch
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what does splinting reduce?
- pain
- further blood loss
- further damage
- provides support
- risk of fat embolism
- pressure on skin
- pressure on adjacent neurovascular structures
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how would you splint a NOF?
- padding between legs
- fig of 8 around ankles
- broad bandage 2 above 2 below knee
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how you you splint a shaft of femur #?
- kendrick traction splint
- not to be used if # ankle, tibia, fibula, knee on the same side as femoral #
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how would you splint a # or #dislocation?
- long leg splint
- vacuum splint
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how would you splint a patella dislocation?
- vacuum splint
- long leg splint
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how would you splint a tibia/fibula #?
- long leg box splint
- long leg vacuum splint
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how would you splint a ankle #?
- short leg box splint
- short leg vacuum splint
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how would you splint a foot#?
- short box splint
- sort vacuum splint
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how would you splint a clavicle, humerus, radius and ulna #?
- self splintage
- triangular sling
- vacuum splint for forearm #
- short box splint
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how much blood can you lose when you break your femur?
500-2000 mls
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what can be the complications of m/s injuries?
- bleeding
- damage to blood vessels, nerves, muscles and arteries.
- loss of tissue
- long term disability
- compartment syndrome
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what is compartment syndrome?
- increased pressure in muscular compartments due to contained haemorrhage
- can lead to ischaemia
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