MUNI I S IM U
MED
Limb Injuries
Lukáš Dadák
Learning Objectives
•Student will understand mechanisms of injuries.
• Student will learn the symptoms and first aid for fractures.
•Student will learn the symptoms and first aid for joint injuries.
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Injury
Definition
Sudden incident affecting the organism from outside and damaging it.
• Traumatic event -> leads to trauma
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https://www.nairaland.com/attachments/7847973 14aruesomesportsimuriesthatshockedspectators3 ipega5a5854ffl2cp61ddcp2e43fe33fe804
Statistics
•Trauma = Leading cause of mortality in youth (< 40 years)
•40% of trauma - in traffic accident
• Injuries of limbs - cca 50 % of all trauma.
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Limb
• bones •joints
•muscles, ligaments
• nerves •vessels •skin
https://www.semanticscholar.org/paper/Assessment-of-micro-dose-biplanar-radiography-in-in-Lerisson-Amzallag-
Bellenger/cd7a308d 15204089126cd00d00f3cb37d21 fef5c/figure/11
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Trauma Mechanisms
Force: •direct •indirect
• high power - short time
• low power - long time
• fatigue fracture —► abnormal force on normal (healthy) bone
• pathologic fracture —► low force + abnormal (pathologic) bone - osteoporosis, bone tumors, metastases
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Ideas
•contusion (contusio)
•dislocation, luxation (luxatio) •sprain (distorsio)
•fracture (fractura)
Injured tissue
skin, mm.,tendons, vessels, nerves
join bone
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Fractures - Classification
•closed and open •(incomplete and complete) •(dislocated x non-dislocated)
• Based on mechanism: traumatic x fatigue x patholog
• Based on fracture line:
• transverse, oblique, spiral,
• block fractures (ribs)
• multi-fragment, comminuted, comlex fracture
• compressive fracture
Fractures - Symptoms
https://metrosafetv.ca/first-aid-tiPS-for-fractures/
•hear/feel "crunch"
•visible free end of bone, hole in the skin (open fractures) •pain •limb deformity
•swelling (compare to other limb)
•non-anatomical position
•abnormal movement
•crepitation ("shaking" of bone fragments)
•sensitivity and blood circulation disorders
• signs of blood loss - hemorrhagic shock MUNI I S IM U
ED
Fracture of Clavicle
https://litfl.com/clavicle-fractures/
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Blood loss associated with fractures
•ribs - 150 ml •humerus - 500 ml •forearm bones - 250 ml
•pelvis-2000 (5000!) ml •femur- 1500 ml •tibia-650 ml
• In case of complicated fracture (more fracture lines, fragments) -higher blood loss ! MUNI I S ]
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Fractures - First Aid
• SSSABC
• open fractures - sterile cover of the wound •minimalize movement of the injured limb •don't do repositioning
•don't use splints
•lower limbs —> 155
• upper limbs —► you can transport to the hospital, arm sling.
•Do NOT eat, drink, smoke (surgery may be necessary)!
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Immobilization
No EMS in 60 minutes
• Bandages:
• elastic - immobilization of the joints
• arm sling - for the upper limb
•Splints:
• classic ("Crammer")
• Vacuum
• improvised (rolled blankets, magazines, sticks)
https://ucebnice.horekasluzba.cz/cz/zdravotni-obecna-cas/zachranarske-postupy-a-technika-horske-sluzby/vyprostovani-polohovani-fixace
Splinting Technique
•joint above and below the broken bone should be immobilized • underlay with gauze or clothing on exposed areas end of plate +
bone protrusions (ankle, knee, elbow)
- there is a risk of bruising, nerve damage
•fix the splint with bandages, scarves, improvised parts of clothing
MUNI SIMU
https://www.bezpecnecesty.cz/cz/autoskola/teoreticke-znalosti/zdravotnicka-priprava-prvni-pomoc
Upper Limb
Lower Limb
MED
Lower Limb
https://freehubmaq.com/shorts/bmq-splintinq
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Lower Limb
https://freehubmaq.com/shorts/bmq-splintinq
I SI
ED
Lower Limb
Lower Limb Injuries in the Snow
•ensure safety = mark the "X„ place of the cross ski
•unclip the binding • do not take off your shoes, just loosen the buckles •call mountain service
httPs://www,fsps,muni,cz/sdetmivpohode/kurzv/tv/pohvbow aoaratohrj .
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Pelvic Injuries
Pelvic Injuries
•internal bleeding
• shock
• pain
FA: SSSABC
• EMS (suspect pelvic injury)
• Heat retention
• Don't try to walk
MUNI SIMU
https://cub.co.jp/Flat-Pack-ReflexceM-Hypothermia-Prevention-575945/Sporting-Goods.shtm
Shoulder Dislocation
https://www.fsps.muni.cz/sdetmivpohode/kurzv/tv/pohvbovv aparat.php
https://www.huanaortho.com/shoulder-dislocation-and-instabilitv-labrum-tear
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Luxation
•Mechanism: after short-term emplacement of the joint surface they do not return to their original position
•Injury: articular capsule damage (always), surrounding structures, nerves and bone vessels
•Symptoms: joint deformity, blockage of movement, spring resistance, swelling, disorders of sensitivity and blood circulation in the limb
• First Aid: as fracture
MUNI | SIMU
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Sprains
•Mechanism: after short-term emplacement of the joint surfaces they return to their original positi©^"*^^-0^*^^^*^-^*^™" —► torn ligament, damage to one or more ligaments
•Injury: articular capsule damage, muscles, surrounding structures.
•Signs: frequent blood hematoma formation, pain (often a two-phase course), swelling, movement restriction.
• First Aid: immobilization, fasting = surgery, transport to the hospital, cooling MUNI I SIMU
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Learning Outcomes
•Student is able to describe symptoms of fractures and basics of first aid.
•Student is able to describe the symptoms of joint injuries and basics of first aid.
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Resources
* http://www.fsps.muni.cz/sdetmivpohode/kurzv/tv/pohvbovv aparat
»http://www.cervenvkriz.eu/cz/standardy/zdroie/Standardv prvni p omoci.pdf
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MUNI ISIMU
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Simulation Centre, Faculty of Medicine, Masaryk University 2020