Chapter 11: Muscle, Bone and Joint Emergencies

Defined:

This emergency occurs when a muscle, bone or joint moves in a direction that it is not supposed to go. This movement can lead to broken bones, sprains, fractures and other injuries.

Causes:

• Falling, tripping
• Motor vehicle accidents
• Running, walking, exercise
• Sports, physical activity
• Sudden impact

Signs and Symptoms:

• Bruising and swelling
• Bone fragment(s) sticking out
• Coldness, numbness
• Discoloration (blue)
• Deformity
• Inability to use the affected part normally
• Pain
• Snapping or popping sound at time of injury

Common Emergency Example(s):

Fracture / Broken Bone:

A fracture is a complete break, a chip or a crack in the bone. An open fracture involves an open wound, and is when a bone end tears through the skin. An open fracture is more dangerous and severe. However, a closed fracture is more common.

Dislocation:

A dislocation is the movement of a bone at a joint from its normal position. When the bone is moved out of place, the joint no longer functions. Usually, dislocations happen at the shoulder, elbow, wrist, jaw and hip.

Sprain / Strain:

A sprain is the tearing of the ligaments at a joint. Sprains mostly occur at the ankle, knee, wrist and fingers. A strain is the stretching and tearing of a muscle. They usually occur in the neck, back, thigh, or the back of the lower leg.

Use RICE method when dealing with a sprain or strain:

Rest:

Do not move or straighten the injury.

Immobilize:

Try to stabilize the person in the position he/she was found. Splint or sling the injured part only and use caution if moving the person.

Cold:

Indirectly cool the part using ice for up to 20 minutes.

Elevate:

Only elevate the part if it does not cause more pain.

First Aid Actions / Treatment:

1. Assess the scene and check for your safety.
2. Get a First Aid kit and wear personal protective equipment.
3. Apply a clean dressing on any open wounds. Don’t move any body part that
   is deformed or bent (fractured).
4. If person is experiencing:
   • Closed Fracture / Dislocation: keep injured area still; apply a light padding underneath injured area and apply a broad sling; tie the affected part with another limb of the body or another body part to keep it sturdy from movement
   • Sprain / Strain: place a cold pack or a plastic bag filled with water and ice on a towel and then on the injured area (up to 20 minutes); use RICE method detailed above
5. Activate EMS (Call 9-1-1) if the open wound is large.