Rationale: A fracture is a broken bone. The bone may be completely broken with the pieces separated, or it may just be cracked. Signs that a patient may have a fracture are a deformed body part, pain, swelling at the site of injury, and inability to use the body part.
Rationale: An open fracture is a broken bone in which the skin is broken at the site of injury. With an open fracture, bone may protrude through the wound. Bleeding can be severe with fractures of large bones, and organs nearby may also be injured. An open fracture has a higher risk of infection and complications because of the introduction of bacteria into the body at the site of the fracture.
Rationale: A contusion is a bruise to the muscle. It occurs when blood vessels break and leak blood under the skin, usually after an injury. With a contusion, there will be a black and blue discoloration of the skin. It may also be accompanied by pain at the site of injury.
Rationale: A joint is where two bones come together in the body. When one or more of these bones move out of position, a dislocation has occurred. When a patient has a dislocation, the joint is often deformed. There are signs of pain and swelling, as well as the inability to use the joint. There may also be a fracture at the site of a dislocation, and an x-ray will be necessary to examine the extent of injury.
Rationale: A ligament is a band of tissue that surrounds the joints between the bones. A sprain is an injury in which the ligament can become stretched or torn. Sprains can range from mild to severe. The ankles, knees, wrists, and fingers are the body parts most often sprained.
Rationale: A tendon is a band of tissue that connects muscle to bone. A strain occurs when a muscle or tendon is pulled or stressed. The most common types of strains are to the back muscles. Symptoms of a strain are swelling, bruising, and pain. Pain and weakness may also extend into the surrounding muscle and tissue near the site of injury.
Rationale: A muscle cramp is a tightening of a muscle, usually because of prolonged use. Muscle cramps are sudden and involuntary, and can be in one or more muscles at a time. They are common in the legs, stomach, back, or any muscle that is overused. Cramps can be painful, and may be relieved by stretching or massaging the muscle.
20 minutes on, then 20 minutes off
Rationale: Cold reduces swelling, lessens pain, and minimizes bruising. Ice should be applied to an injury as soon as possible, and should be left in place for 20 minutes, then removed for 20 minutes. This process should be continued for a few hours, then reduced to every few hours for the first 2-3 days after an injury. Ice in a plastic bag, or an improvised cold pack can be applied directly to an injured area. A commercial cold pack should be wrapped in cloth to prevent direct skin contact because it may be cold enough to freeze the skin.
Rationale: Splinting helps prevent further injury, reduces pain, and minimizes bleeding and swelling. A splint should be applied until the patient arrives in the emergency room. Before splinting an injured area, always check for a pulse in the extremity. The pulse should be present before and after splinting. The splint should be applied above and below the injured area, and some type of padding should be placed between the splint and the patient's skin. After the splint is in place, elevate the extremity and apply ice.
Rationale: The RICE acronym is an easy way to remember how to treat all bone, joint, and muscle injuries. When caring for a patient with a musculoskeletal injury, remember the four steps of rest, ice, compression, and elevation. With rest, have the patient get off of the injured area. Apply ice to the injured area as soon as possible in 20 minute increments. The third step is compression, in which a splint or wrap should be applied to site of injury. The last step of RICE is elevation, in which the injured area should be elevated higher than the level of the heart.