Musculoskeletal Injuries

Patient Communication

Communication about musculoskeletal injuries in the prehospital setting includes: explaining procedures to the patient in simple terms, obtaining informed consent when possible (implied consent for unresponsive patients), providing a calm and reassuring presence, and delivering a structured handoff report (SBAR: Situation, Background, Assessment, Recommendation) to the receiving facility.

Common Errors

Critical errors in prehospital application of musculoskeletal injuries:

• Failing to reassess after intervention. Vital signs must be rechecked every 5 minutes for unstable patients
• Incorrect medication dosing. Always use length-based estimation (Broselow tape) for pediatric patients
• Tunnel vision on one finding while missing the complete clinical picture
• Not communicating changes to receiving facility during transport

Related Procedures

Procedures related to musculoskeletal injuries in the EMS setting:

1. AHA ACLS cardiac arrest algorithm: CPR then rhythm check then shock if VF/pVT then epinephrine q3-5min then amiodarone
2. Trauma assessment: scene safety then MOI then primary survey (XABCDE) then rapid transport then secondary survey en route

Overview

Fractures, dislocations, sprains, and strains requiring assessment, splinting, and neurovascular checks. Tested on EMT and Paramedic exams.

In prehospital assessment, temperature reference range: adult 97.8-99.1 F (36.5-37.3 C), pediatric same range, rectal preferred under 2yo. Deviations from these norms guide treatment decisions in the field.