CEN Review: Musculoskeletal & Wound Emergencies – Emergency Nursing Guide to Fractures,
Injuries & Wound Care
Ligament - ANS ✔✔Binds bones at joint
Tendon - ANS ✔✔Connects muscle to bone
1st degree strain/sprain - ANS ✔✔Minor tear, minimal swelling
Compression wrapping
2nd degree strain/sprain - ANS ✔✔Partial tear, joint intact, moderate pain, spasms
Splint
3rd degree strain/sprain - ANS ✔✔Complete tear, separation of muscle/ligament from bone
Splint/cast, surgery, PT
Achilles tendon rupture - ANS ✔✔Sudden, forced plantar flexion or unexpected dorsiflexion
use of Levaquin/cipro & direct steroid injections
Sx: 'popping', walks flat footed, not able to stand on ball of foot, swelling to calf
Tx: splint, crutches, surgery
Costochondritis - ANS ✔✔Inflammation of costal cartilages or sternal articulations
Sx: CP, pleuritic, unilateral/peristernal, reproducible, exacerbated by movement
Tx: r/o cardiac, analgesia, avoid exertion, encourage deep breathing
Subluxation - ANS ✔✔Partial disruption of joint to which there is still some degree of contact
between articular surfaces
, May compress vascular or nerve structures, assess pulses & nerves
Dislocation - ANS ✔✔Complete disruption of joint so surfaces are no longer in contact
May compress vascular or nerve structures, assess pulses & nerves
Median nerve - ANS ✔✔4 sign
Ulnar nerve - ANS ✔✔Pinky pinch
Radial nerve - ANS ✔✔Hitch hikers thumb movement
Femoral nerve - ANS ✔✔Thigh and front of shin
Push leg against hand
Peroneal nerve - ANS ✔✔Back of leg and top of foot
Dorsiflex or extend greater toe
Peroneal, up, top
Tibial nerve - ANS ✔✔Plantar flex, bottom of foot
Tibial, back, bottom
Hip reductions - ANS ✔✔Must take place in <6hr to prevent avascular necrosis
Clavicular/scapular/shoulder fx - ANS ✔✔Thoracic trauma, damage to great vessels, brachial
plexus injury, assess breathing
Injuries & Wound Care
Ligament - ANS ✔✔Binds bones at joint
Tendon - ANS ✔✔Connects muscle to bone
1st degree strain/sprain - ANS ✔✔Minor tear, minimal swelling
Compression wrapping
2nd degree strain/sprain - ANS ✔✔Partial tear, joint intact, moderate pain, spasms
Splint
3rd degree strain/sprain - ANS ✔✔Complete tear, separation of muscle/ligament from bone
Splint/cast, surgery, PT
Achilles tendon rupture - ANS ✔✔Sudden, forced plantar flexion or unexpected dorsiflexion
use of Levaquin/cipro & direct steroid injections
Sx: 'popping', walks flat footed, not able to stand on ball of foot, swelling to calf
Tx: splint, crutches, surgery
Costochondritis - ANS ✔✔Inflammation of costal cartilages or sternal articulations
Sx: CP, pleuritic, unilateral/peristernal, reproducible, exacerbated by movement
Tx: r/o cardiac, analgesia, avoid exertion, encourage deep breathing
Subluxation - ANS ✔✔Partial disruption of joint to which there is still some degree of contact
between articular surfaces
, May compress vascular or nerve structures, assess pulses & nerves
Dislocation - ANS ✔✔Complete disruption of joint so surfaces are no longer in contact
May compress vascular or nerve structures, assess pulses & nerves
Median nerve - ANS ✔✔4 sign
Ulnar nerve - ANS ✔✔Pinky pinch
Radial nerve - ANS ✔✔Hitch hikers thumb movement
Femoral nerve - ANS ✔✔Thigh and front of shin
Push leg against hand
Peroneal nerve - ANS ✔✔Back of leg and top of foot
Dorsiflex or extend greater toe
Peroneal, up, top
Tibial nerve - ANS ✔✔Plantar flex, bottom of foot
Tibial, back, bottom
Hip reductions - ANS ✔✔Must take place in <6hr to prevent avascular necrosis
Clavicular/scapular/shoulder fx - ANS ✔✔Thoracic trauma, damage to great vessels, brachial
plexus injury, assess breathing
