Road traffic accidents have increased as the number of road users increases each day. People affected include motorists, cyclists, and even pedestrians. The extent of injury depends on the force caused by the position of the individual before and during the accident. Injured people are instantaneously taken to a hospital for emergency care. It might be one or a few systems of the body affected simultaneously. The musculoskeletal system is the most commonly susceptible to damage. For this reason, a thorough understanding of its components and deep knowledge of health assessment, medical history recording, physical examination, and diagnostic reasoning are core to the treatment. This essay outlines the basic approach to the management of a road accident victim.
The components of the musculoskeletal system are bones, tendons, ligaments, skeletal muscles, cartilage, and nerves (Watkins, 2010). The human body has 206 bones. They provide support as well as the attachment to organs and soft tissues. They also act as storage for lipids and minerals like calcium. Some of the bones that have red marrow participate in the production of blood cells. Bones like the skull, rib cage, and vertebrae protect delicate organs such as the brain, heart, and spinal cord from direct trauma. Some of them act as levers that change the direction and magnitude of the forces generated by the contraction of muscles to cause motion. Bones have two forms of tissues; the harder outer layer referred to as cortex and the inner softer region referred to as the cancellous bone. Spongy bone is found in less stressful areas or in regions where bones experience stress from many directions. Compact bone is located in parts where bones experience stress from a limited number of directions (Watkins, 2010). One bone is attached to another by ligaments. Skeletal muscles are different from the smooth muscles because they are striated. They contract and pull on tendons that result in motion of bones. Other functions of muscles include generation of body heat, maintaining posture, supporting body position as well as forming an anchor for soft tissues. They act as guards for the openings of the urinary and gastrointestinal tracts. Nerves are the communication conduits between the brain and muscles. Cartilage is found at the tips of bones. The major types of cartilage are elastic, hyaline, and fibrocartilage. Hyaline cartilage is the most common of the three. It makes the movement in the joints smooth and helps in shock absorption (Watkins, 2010). Any of these elements is liable to injury in an accident. If not attended appropriately and timely, some of the damages can cause death.
Health assessment of this patient is meant to determine the extent of injury as well as arrive at proper medical decisions. The first step is to assess whether the patient has sustained severe and life-threatening injuries. Since she can talk, inquiring about the amount of pain can provide an estimate of the damage. The patient can be asked to grade her pain on a scale of zero to 10 where zero refers to no pain and 10 refers to the worst pain that she has ever experienced. If the patient walked in on her own, observation for any signs of respiratory distress is enough for determining the site of airway obstruction and any possible respiratory compromise. However, if she was brought in by well-wishers, the examination of the airway, breathing, and circulation will be done in full (Carragee, 2008). The airway should be checked for obstruction and presence of secretions or fluids and blood by direct observation. Any obstruction should be removed and secretions suctioned. The adequacy of breathing is ascertained by observing the degree of respiratory effort, the number of breaths per minute as well as presence or absence of central cyanosis. If there are no signs of respiratory stress, the circulatory system should be examined next. The peripheral pulse is palpated at the radial artery and described in terms of volume, rate, character, and rhythm. Blood pressure should be measured either manually or using electronic devices. Checking for the capillary refill time might also be helpful. It is necessary for excluding possible internal bleeding from internal injuries that may result in shock and even death. If shock is imminent, the intravascular volume is immediately increased with crystalloids. If the airway, breathing, and circulation are found to be normal, a general examination of the other body parts should be done with the painful areas examined last. The hand and wrist should be examined first by inspection and then by palpation for any signs of fracture. The right thigh is checked in the same manner for any signs of fracture. Once the patient is stabilized, her medical history can be obtained. It should be taken from the witnesses if the patient is unconscious. But if the patient is awake, it is best to take it directly from her (Carragee, 2008). Some of the important information includes her name, residence, and a contact person. The patient is also asked to narrate what happened at the time of the accident. It needs to be established where it happened, what speed she was riding at, and if she hit anything on the ground as she fell (de Waard, Schepers, Ormel, & Brookhuis, 2010). The patient should be asked if she had any unusual sensation like seeing a light flash before the accident. Finding out if she is feeling dizzy will help in determining the possibility of neurological injury. In addition, the history of alcohol or drug use should be obtained as well (Aggarwal, Kaur, & Dhillon, 2012).
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A comprehensive history record of each patient is crucial. For this particular case, the past medical history of the young woman is helpful for proper management. A history of epileptic seizures can explain the cause of the accident (Aggarwal, Kaur, & Dhillon, 2012). A history of allergy to certain medications containing sulfur can be important to avoid an iatrogenic shock due to anaphylaxis.
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