BONE,

JOINT,
AND
MUSCLE
INJURIES

The presentation slides contain herein are proprietary to the St. John
Ambulance, Singapore and are for use only in the FIRST AID training courses
conducted by St. John. Reproduction in any form prohibited. NOT FOR SALE
St. JOHN AMBULANCE ASSOCIATION SINGAPORE

FIRST AID TEACHING SLIDES

Compiled by: T. K. KHOO (2010)

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THE SKELETON
The body is
built on a
framework of
bones ( the
skeleton). It
supports the
muscles,
blood vessels
and nerves
and also
protects
important
organs.
SJAA Bone, Joint and Muscle Injuries

BONES, MUSCLES AND JOINTS

The Bones
Bone is a living tissue
containing calcium
and phosphorus that
make it hard, rigid and strong.

The Muscles
Muscles caused various parts of the body to move.
Skeletal muscles are attached to bones by tendons.
Involuntary muscles operate the internal organs.

The Joints
A joint is where bones meet.
The bone ends are joined by
ligaments and protected by
smooth cartilage.
SJAA Bone, Joint and Muscle Injuries

FRACTURES
A FRACTURE is a break or crack in a bone.
Open Fracture

Closed Fracture

Fractures can
also be stable
or unstable
SJAA Bone, Joint and Muscle Injuries

stable

unstable

FRACTURES contd
Recognition
Deformity, swelling and bruising.
Pain. Difficulty with movement.
Shortening, bending or twisting of a limb.
Coarse grating (crepitus) may be heard or
felt.
Signs of shock.
Unnatural movement.
A wound; bone ends
may protrude.
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FRACTURES contd
Treatment (Closed Fracture)
Support the joints above and below the
injured site with your hands.
Place padding around the injury for extra
support.
Call 995 for ambulance.

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FRACTURES contd
Treatment (Closed Fracture)
For firmer support or if ambulance is
delayed, immobilise the injured part to an
unaffected part of the body.
For upper limb immobilise against the
trunk.
For lower limb secure
injured leg to the
uninjured leg.
Treat for shock.
Monitor vital signs.
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FRACTURES contd
Treatment (Open Fracture)
Cover the wound with a sterile dressing and
pad. Secure with a bandage.
Apply pressure around the injury to control
any bleeding.
Immobilise and treat as for a closed fracture.
Tie knots on the uninjured side.

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FRACTURES contd
Treatment
If a bone protrudes,
build up pads around
it and bandage without pressing on it.
Do not allow the casualty to eat
or drink.
Do not move the casualty until the
injured part is secured unless there is
immediate danger.

SJAA Bone, Joint and Muscle Injuries

DISLOCATED JOINT
Recognition
Severe pain.
Inability to move the joint.
Swelling and bruising.
Shortening, bending or
deformity of the area.

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DISLOCATED JOINT contd

Treatment
Ask casualty to keep still.
For shoulder, support
arm with a sling and
immobilise with a broad
bandage around the body for extra support.
For leg, immobilise with broad bandages.
Call 995 for ambulance.
Treat for shock if necessary.
Do not replace the bone into its socket.
Do not allow casualty to eat or drink.
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STRAINS AND SPRAINS

Muscles and tendons may be strained,
ruptured or bruised. A STRAIN occurs when
the muscle is overstretched.
A SPRAIN occurs when a ligament at or near
a joint is torn.

Recognition
Pain and tenderness.
Difficulty in moving.
Swelling and bruising.
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STRAINS AND SPRAINS contd

Treatment

Rest - Rest the injured part.

Ice Apply ice or cold pad
to the area.

Compress Wrap

area with soft padding

and secure it with a
support bandage.

Elevate Elevate the

injured part.

If pain is severe or casualty

is unable to use injured part
send him to hospital.
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FACIAL INJURY
Recognition
There may be
Pain around affected area.
Difficulty speaking,
chewing, swallowing, breathing.
Swelling, bruising, facial distortion and/or
a black eye.
Clear fluid or watery blood
from the ear or nose.
May have neck injury.

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FACIAL INJURY contd

Treatment
Call 995 for ambulance.
Help casualty to sit down and
ask him to spit out blood,
displaced teeth or denture.
Apply a cold compress to the face.
Treat for shock and monitor vital signs.
Do not allow casualty to eat or drink.
Do not bandage around the lower part of the
face or lower jaw in case he vomits or has
breathing difficulties.
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FACIAL INJURY contd

Treatment
If casualty loses consciousness:
Open airway, check breathing and do CPR
if needed.
If he is breathing, put him in recovery
position with injured side down.
Put soft padding under his head.

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LOWER JAW INJURY

Recognition
Pain; difficulty speaking,
swallowing and moving
the jaw.
Loose teeth; dribbling.
Swelling and bruising.

Treatment
Help casualty to sit with head forward. Ask
him to spit out any loose teeth.
Give casualty a pad to hold and support
the jaw.
Call 995 for ambulance.
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COLLAR BONE INJURY

Usually the fracture is caused by an indirect
force transmitted from an impact at the
shoulder or along the arm.

Recognition
Pain and tenderness.
Swelling and deformity at
shoulder.
Casualty may support
arm at elbow and incline
head to injured side.

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COLLAR BONE INJURY contd

Treatment
Help casualty to sit down.
Support the arm on the
injured side with an
elevation sling.
Place padding between arm and body.
Tie a broad bandage over the sling and
body.
Call 995 for ambulance.
Do not let casualty eat or drink.
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HAND AND FINGER INJURIES

Multiple fractures, usually caused by crushing injuries.

Treatment
Loosely cover the wound
with sterile dressing.
Wrap the hand in soft
non-fluffy padding.
Support the arm with an
elevation sling.
Tie a broad bandage over
the sling and body.
Call 995 for ambulance.
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UPPER ARM INJURY

Recognition
Pain and tenderness.
Swelling, bruising, deformity.

Treatment
Place forearm horizontally and
ask to support his elbow.
Support the arm in an arm sling
Tie a broad bandage over
the sling and body.
Call 995 for ambulance.
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FOREARM AND WRIST INJURIES

Recognition
Pain.
Swelling, bruising, deformity.

Treatment
Steady and support the forearm
across the body.
Surround it with padding, e.g. a
towel.
Support the arm in an arm sling.
Tie a broad bandage over the
sling and body.
Call 995 for ambulance.
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ELBOW INJURY
Recognition
Pain, tenderness.
Swelling, bruising, deformity.
Fixed elbow.

Treatment
If elbow can be bent treat
as for upper arm injury.
If elbow cannot bend place
padding around the elbow.
Secure the arm with broad
bandages, avoiding the fractured
site.
Call 995 for ambulance.
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RIB INJURY
Recognition
Swelling, bruising.
Pain at site of injury.
Shallow breathing.
A wound, sound of air
being sucked into chest cavity.
Paradoxical breathing.
Signs of internal bleeding and shock.

Treatment
Support the arm on injured side in a sling.
Call 995 for ambulance.
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RIB INJURY contd.

If there is a penetrating chest wound:
Sit casualty on the floor leaning towards
injured side. Support with cushions.
Cover and seal the wound (see Penetrating
Chest Wound under Respiratory Problems).

Place arm (injured side) in an elevation sling.

Call 995 for ambulance.
Monitor vital signs.
If casualty loses consciousness
Open airway, check breathing.
If breathing, put in recovery
position on his injured side.
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HIP AND THIGH INJURIES

Recognition
Pain, inability to walk.
Signs of shock.
Leg shortening; knee
and foot turning outwards.

Treatment
Help casualty to lie down.
Gently straighten his leg.
Stop of this increases pain.
Call 995 for ambulance.
Support the leg at knee
and ankle until ambulance arrives.
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HIP AND THIGH INJURIES contd.

Treatment
If ambulance is delayed, immobilise by
securing the injured leg to the uninjured.
Bring the sound leg alongside the injured.
Secure with bandages at the ankles and feet,
knees, above and below fractured site.
Do not let the casualty eat or drink.

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LOWER LEG INJURY

Recognition
Pain, inability to stand.
An open wound.
Swelling, bruising, deformity.

Treatment
Help casualty to lie down.
Steady and support his injured leg.
Treat any wound present.
Call 995 for ambulance.
Support the leg with hands above and below
fractured site until ambulance arrives.
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LOWER LEG INJURY contd.

Treatment
If ambulance is delayed, immobilise by securing the
injured leg to the uninjured.
Bring the sound leg alongside the injured.
Secure with bandages at the ankles and feet, knees, above
and below fracture site.
Insert padding between the legs.
Tie knots on the
uninjured side.

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FRACTURED PELVIS
Recognition
Inability to stand.
Pain, tenderness in hip, groin, back
regions, increasing with movement.
Difficulty, pain passing urine.
Signs of shock and internal bleeding.

Treatment
Help casualty to lie down with knees
slightly bent and supported.
Call 995 for ambulance
Immobilise the legs with bandages at the feet/ankles and
knees.
Do Not bandage the legs if this causes more pain.
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KNEE INJURY
Recognition
Pain on moving the knee.
Swelling at the knee.

Treatment
Help casualty to lie down.
Put padding such as pillows
under the knee to support it.
Wrap padding round the knee and bandage
from mid-lower leg to mid-thigh.
Call 995 for ambulance
Do Not forcibly straighten the knee
Do Not allow casualty to eat or drink.
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CRAMP
A sudden painful spasm in one or more
muscles. It can be relieved by stretching
and massaging the affected muscles.

Treatment
Cramp in the Foot
Let casualty stand; rest his
foot on your knee to stretch
the muscles.
Massage the affected part.

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CRAMP contd.
Cramp in the Calf Muscles
Straighten casualtys knee
and support his foot.
Flex his foot towards his shin
and massage his calf.
Cramp in the Front of the Thigh
Let casualty lie down; raise his
leg and bend his knee.
Massage the affected part.
Cramp in the Back of the Thigh
Let casualty lie down; raise his
leg and straighten his knee.
Massage the affected part.
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