Lab 3: Immediate Care of Musculoskeletal Injuries

Lab 3: Immediate Care of Musculoskeletal Injuries Complete the following activities during your lab class under the guidance of your instructor. Objectives of Lab: • Demonstrate splinting techniques. • Demonstrate ambulatory aid and manual conveyance. • Demonstrate wound care. Lab Activity 1: Immobilization 1. Sling and Swath: Students should perform this technique a total of two times, once for right upper extremity and once for left upper extremity. a. Athlete is standing and flexes elbow to 70o. b. Slide sling underneath injured extremity with apex facing elbow. c. Drape the end of the bandage over the injured shoulder. d. Pull the opposite end of the bandage over opposite shoulder. e. Secure sling behind neck with a knot. f. Fasten apex of bandage with a safety pin or knot. g. Secure sling to body with a swath around the trunk. h. Check distal pulse and capillary refill. i. Check sensation. 2. SAM Splint: Students should perform this technique a total of two times, once for an ankle injury and once for a distal radius/wrist injury. a. Maintain injured body parts in the position found. b. Position splint in appropriate way to treat injury. c. Apply compression wrap distal to proximal. d. Secure by stabilizing above and below the joint/area injured. e. Check distal pulse and capillary refill. f. Check sensation. Lab Activity 2: Ambulatory Aids 1. Crutches a. Fitting i. Inspect crutch tops, bolts, and wing nuts to make sure they are neither worn nor defective. ii. Patient should be standing with feet shoulder width apart and wearing low heeled/flat shoes. iii. Crutch tips are placed 6 inches from the outer margin of the shoe and 2 inches in front of the shoe. iv. Underarm crutch brace is positioned 1 inch below the anterior fold of the axilla. v. The hand brace is positioned at hand level with the patients elbow flexed to 30 degrees. vi. Tighten all fasteners and inspect pads and tips for safety. b. Walking With Crutches: Instruct your partner how to perform the following tripod gait patterns, as demonstrated/instructed in lab. i. Tripod Gait Progression 1. Nonweight Bearing (NWB) 2. Touch-Down Weight Bearing (TDWB) 3. Partial Weight Bearing (PWB) – Progress to 1 crutch 4. Full Weight Bearing (FWB) ii. Stairs: 1. Ascending - Step up with uninjured leg. 2. Descending - Step down with injured leg and crutches. 2. Cane a. Fitting i. Patient should be standing with feet shoulder width apart and wearing low heeled/flat shoes. ii. Measure from greater trochanter of femur to the floor. iii. Adjust cane to the measured length. b. Walking With a Cane i. Cane is placed on the uninjured side. ii. Patient steps forward with injured leg and cane. iii. Uninjured leg follows. 2 3. Manual Conveyance a. One-Person Walking i. From a seated position, flex the noninjured leg. Support the athlete at the waist as the athlete is standing. ii. Place the athlete’s arm around your shoulder and ask athlete to hold on. iii. Grasp around the athlete’s waist with your free hand. iv. Instruct the athlete to lean on you as needed when walking. b. Two-Person Walking i. One person is in charge while the other assists. ii. Stand on opposite sides of the athlete. iii. Place athletes' arms around your shoulders and ask the athlete to hold on. iv. Hold the athlete’s waist and slowly walk to the sidelines. c. Two-Handed Carry Assist i. Stand behind the injured athlete facing your partner. ii. Grasp each other’s forearms nearest the athlete. iii. Instruct the athlete to sit on you and your assistant’s arms and to put their arms around your shoulders. iv. Support the athlete’s back with your free arms. Lab Activity 3: Wound Care 1. Care of an Open Wound a. Practice wound care for an abrasion, laceration, and incision as instructed in class. 2. Care of Blister a. Practice appropriate management of a blister, as instructed. Lab Activity 4: Case Scenario Jordyn is a 16-year-old female soccer player who suffered an injury to her left ankle while playing in the regional soccer tournament for her club team. She was removed from the field and evaluated on the sideline. The athletic trainer determined there was a need for referral to rule out a fracture and decided to fit Jordyn for crutches. 1. Properly fitted crutches will be 1 inch below the axilla when the crutch tip is in what distance from the shoe? _6_ inches from the outer margin of the shoe; _2_ inches in front of the shoe. 3 2. What degree is the bend of the elbow when crutches are properly fitted? 30 DEGREES 3. What anatomical structure is damaged causing crutch palsy? The anatomical structure that is damaged causing crutch palsy is the radial nerve or part of the brachial plexus. They contain various nerves that innervate sense and motor function to the arm and hand. During crutch palsy the nerves are under constant pressure and that affects the function of the arm and hand. 4. When showing Jordyn how to ascend stairs with crutches, the athletic trainer instructs her to first step up with the non broken leg and then follow with the broken leg and crutches. 5. The physician has determined that there is no fracture and instructs the athletic trainer to progress Jordyn off the crutches as tolerable. What is the correct order of progression for return to full weight bearing and when would you progess to the next type of weight bearing? a. No Weight Bearing b. Toe Touch Weight Bearing c. Partial Weight Bearing d. Full Weight Bearing 4