Page 1 Session 11 Bones, Joints and Muscles

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Broken Bones

 A fracture can be described as a chip, crack or break. Children's bones can break due to a direct or indirect force on the bone, they are common injuries amongst children. There are 4 common fractures that may occur in a child. Each one has its own complications.


Important!

Where you see trauma you must suspect broken bones or life threatening injures. i.e a child has been hit by a car

watch the clip below

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Green Stick Fracture

   The most common fracture in a child or Infant is the green stick fracture. Imagine a young tree branch being bent the bark and inner wood would twist,bend but not break in two.

This principle applies to the young bone of a child. In many case it appears swollen, bruised and painful. The child can move it, however there are small hair line fractures along the bone

Open Fractures

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 The open fracture is where the bone snaps and penetrates out through the skin. 

There are a numbers of problems with the open fracture:

  • Extreme Pain
  • Blood loss(Shock)
  • Infection( Bone is exposed)
  • ​Recovery(Long and complicated

Closed Fractures

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 The closed fracture is another common fracture among children, the collar bone is a bone that tends to break. one reason for this it that when a child falls they place their hands in front of them, a shock wave is sent up the arms and the collar bone snaps under the pressure. 

Complicated Fractures

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  The ribs that break may puncture the lungs, this is a complicated fracture. All spinal fractures are complicated due to the possibility of nerve damage. 

Treatment Of Fractures

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  The first thing you need to consider is that this is children and babies we are working with, some young children may not be able to express their pain.

One rule:

DO NOT PICK THE CHILD UP

The reason is that you could inflict more pain and injuries on the child. If the child comes to you with a broken wrist, then Immobilise the arm, place in a sling for comfort and take them to the hospital.

Should the child's wrist have a open fracture with lots of blood and sever pain:

  • Do not pick them up
  • Shout for help, Helper to get first aid kit
  • Gloves on (prevent infection)
  • Apply 2 dressing in each side of the bone (Control blood loss) 
  • Use tape or another dressing to hold in place if not possible get someone else (wearing gloves) to hold them in place
  • Place dressing lightly over the protruding bone (prevent Infection)
  • Get helper to call 999/112
  • Treat for shock


Open Leg Fracture

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 Hold a dressings on each side to control blood loss. Do not move the leg. Prevent movement and ensure emergency services are informed.

​Note!

This subject is a practical subject

and is taught at our Paediatric

first aid workshop.

Dislocations

Dislocation of Joints

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A dislocation of the joint occurs when there is a abnormal separation in the joint between two bones. The dislocation often occurs in a child or infant in a sudden impact of the joint or a fall.

​Further complications and damage to nerves, ligaments,tendons and muscles. One common form of dislocation is a child is the shoulder joints due to swing the child/infant by the arms causing jerking of the joint.


Recognition of Dislocations

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  •  Pain, tenderness,bruising and swelling in the joint area
  • Loss of mobility
  • Deformity
  • Signs of shock
  • Possible wound

Treatment for Dislocations

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The treatment for a dislocation should be similar

to that of a broken bone:

  • Immobilise in the position found
  • Place in sling if child allows
  • Ice or cool pack on swollen area
  • Take child to hospital
  • Phone 999/112 if child is in shock

Sprains & Strains

RICE- Treatment

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Sprains & Strains

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 Sprains and strains are injuries to the muscles and tendons also known as a soft tissue injury. Children tend to have these injuries sports related activities they can be painful, however if treated quickly and effectively the child will recover quickly.  

 

Recognition of Sprain or Strain

  • Pain, tenderness,bruising and swelling in the joint area
  • Lack of mobility

Treatment of Sprain

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 Sprains and strains are treated in the same manner use the following treatment:

  • Rest ( Do not make the child "walk it off")
  • Ice (wrap ice in towel or use instant ice pack for a good 10-20 minutes
  • Compress( Use Crep bandage, compress but not to tight as swelling may return, apply ice for another 10 minutes
  • Elevate (position the leg raised to keep swelling down.

After a few days the area will be stiff and a bit sore. 

Important!

If you in doubt and the child is young 

​take them to hospital to confirm its not a green stick fracture.