Additional Information
Book Details
Abstract
The latest edition of this popular textbook continues to offer accessible, practical and clinically relevant information on the management of minor injuries. Reflecting the author’s long experience as a practitioner and teacher, the volume covers anatomy, examination and specific injuries in the depth that the specialty requires. Injuries to all parts of the body are included. Richly illustrated throughout - with many original images based on the author’s own designs - the volume is also accompanied by online videos where the author demonstrates the limb examinations which are described in the text.
The new edition has expanded to survey the law and the basic principles for X-ray requesting and interpretation in minor injury areas. The volume also offers more detailed guidance on the specific X-rays which are required for each of the limb joints. This material is intended to satisfy the legal training requirements for new practitioners to request X-rays as non-medical referrers.
Fully updated to include the latest guidelines and current practice on minor injuries of every kind, the third edition now offers a more comprehensive structure for the specialty of minor injuries, based on injuries to the limb and to the midline. Within the different topics under these broad headings, advice is given on the care of children, adults and the elderly.
Minor Injuries: A Clinical Guide, third edition, will be indispensable to every trainee, from nursing and from other professions, and to those who are already qualified and who wish to expand or update their practice. The volume also aims to equip practitioners to work in stand-alone units, seeing every patient who presents, and as such is ideal for those undertaking Advanced Practice training. The book also offers teachers of minor injuries a rationale for their sessions and a framework for designing their courses.
- Describes working methods which are robust, flexible and swift
- Explains the classification of musculoskeletal injuries and use of current investigative techniques
- Explains normal limb movement to contextualize abnormal presentation
- More than 150 illustrations help clarify sometimes complex anatomical and clinical information
- Explains the importance of accurate record keeping, including reference to current law
- Discusses the management of trauma in children and adolescents with special reference to consent and confidentiality, non-accidental injury, communication, analgesia, and sports injuries
- Chapter on wound care, including burns, describes wound assessment, exploration, infection, treatment and complications
- Explains the management of minor head injuries, including clinical examination, the use of imaging techniques, cranial nerve assessment, and discharge advice
- Chapter on facial trauma includes damage to the eye, ENT problems such as foreign bodies, and tooth avulsion
- Accompanying website contains 77 videos showing the techniques described in the book and a fully downloadable image bank to aid personal study
- Contains new information on X-ray interpretation
- Re-organized to reflect the difference in approach between midline injuries and limb injuries
- Explains the differences in the management of children and adults
- Differentiates between the different categories of older people - the active and fit retiree and the frail older person
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| IFC | ES1 | ||
| Minor Injuries | i | ||
| Minor Injuries A Clinical Guide | iii | ||
| Copyright | iv | ||
| Contents | v | ||
| Dedication | vii | ||
| Foreword | ix | ||
| Preface | xi | ||
| Acknowledgements\r | xiii | ||
| 1 - General issues | 1 | ||
| 1 - Minor injuries: an overview | 3 | ||
| WHAT DO YOU DO? | 3 | ||
| A FRAMEWORK FOR MINOR INJURIES | 3 | ||
| Your approach to minor injuries | 3 | ||
| Limb and midline | 4 | ||
| Limb injuries (Box 1.3) | 5 | ||
| Midline injuries | 6 | ||
| Age and stage | 7 | ||
| Consent and confidentiality in childhood | 9 | ||
| Non-accidental injury (Box 1.7) | 10 | ||
| Analgesia (Box 1.8) | 10 | ||
| Children and sports injuries | 10 | ||
| The Child | 11 | ||
| The Sport | 12 | ||
| The elderly | 13 | ||
| 2 - Clinical examination and the written record | 15 | ||
| WHAT DOES CLINICAL MEAN? | 15 | ||
| THE CLINICAL RECORD | 17 | ||
| Technical language | 17 | ||
| Diagrams | 18 | ||
| THE CLINICAL HISTORY | 18 | ||
| The history of an injury | 18 | ||
| When | 19 | ||
| How | 19 | ||
| Where | 19 | ||
| What | 19 | ||
| Who | 19 | ||
| Why | 19 | ||
| The past medical history | 19 | ||
| Tetanus | 20 | ||
| Allergies | 20 | ||
| Medical history and present medications | 20 | ||
| The clinical history for limb and midline injuries | 20 | ||
| Limb | 20 | ||
| Midline | 20 | ||
| The clinical history for children and the elderly | 21 | ||
| Children | 21 | ||
| The elderly | 21 | ||
| RECORDING THE EXAMINATION | 22 | ||
| Layout | 22 | ||
| Case studies in writing a history | 23 | ||
| 3 - X-rays and the non-medical referrer\r | 27 | ||
| X-RAYS | 27 | ||
| THE NON-MEDICAL REFERRER | 28 | ||
| IR(ME)R and the ENP | 28 | ||
| REQUESTING X-RAYS | 30 | ||
| INTERPRETING X-RAYS | 30 | ||
| 2 - Limb injuries | 37 | ||
| 4 - Basics of musculoskeletal injury\r | 39 | ||
| INTRODUCTION | 39 | ||
| TERMINOLOGY | 40 | ||
| THE MUSCULOSKELETAL SYSTEM AND HEALING | 43 | ||
| The Musculoskeletal System | 43 | ||
| Severity of injury (Box 4.1) | 44 | ||
| Tissue healing | 45 | ||
| Scarring | 45 | ||
| The three stages of healing (Box 4.3) | 45 | ||
| TREATMENT OF ACUTE INJURY | 46 | ||
| Holistic care | 46 | ||
| Treatment in the inflammatory stage | 46 | ||
| Protection | 47 | ||
| Rest | 47 | ||
| Ice | 48 | ||
| Compression | 48 | ||
| Elevation | 49 | ||
| Other aspects of treatment | 49 | ||
| Exercise | 49 | ||
| Exercise in the inflammatory phase | 49 | ||
| Exercise in the proliferative phase | 50 | ||
| Exercise in the remodelling phase | 50 | ||
| Heat | 50 | ||
| Ultrasound | 50 | ||
| Walking aids | 51 | ||
| Splints, strapping and slings | 51 | ||
| BONE (BOX 4.4) | 52 | ||
| Types of bone | 52 | ||
| Bone injury: fracture | 53 | ||
| Types of fracture | 54 | ||
| Bone healing (Box 4.9) | 56 | ||
| Treatment of bone injury | 57 | ||
| Emergencies | 57 | ||
| Routine treatment | 58 | ||
| Immobilisation | 59 | ||
| SOFT CONNECTIVE TISSUES | 59 | ||
| Skeletal muscle | 59 | ||
| Healing of muscle | 61 | ||
| Treatment of muscle injuries | 62 | ||
| Tendon | 62 | ||
| Injuries to tendon | 62 | ||
| Rupture of tendons | 62 | ||
| Painful tendons | 62 | ||
| Tendon healing and treatment | 63 | ||
| Cartilage | 63 | ||
| Injuries to cartilage | 64 | ||
| Cartilage healing and treatment | 64 | ||
| Ligament | 64 | ||
| Injuries to ligament | 65 | ||
| Ligament healing and treatment | 65 | ||
| Synovium | 66 | ||
| Injuries to synovium | 66 | ||
| Treatment of synovitis | 66 | ||
| Bursa | 67 | ||
| Injuries to bursa | 67 | ||
| Treatment of bursitis | 67 | ||
| Fascia | 67 | ||
| Injuries to fascia | 67 | ||
| Treatment | 67 | ||
| Joints | 68 | ||
| Injuries to joints | 68 | ||
| Treatment of joint injuries | 68 | ||
| 5 - Basics of musculoskeletal examination\r | 71 | ||
| BASIC PRINCIPLES OF EXAMINATION | 71 | ||
| EXAMINATION AND THE ACUTELY INJURED PATIENT | 71 | ||
| THE ORDER OF EXAMINATION (BOX 5.1) | 72 | ||
| FRACTURE (BOX 5.2) | 73 | ||
| Fracture first | 73 | ||
| Signs and symptoms | 73 | ||
| Assessment | 74 | ||
| Aspects of examination | 74 | ||
| The need to X-ray | 74 | ||
| MUSCULOSKELETAL EXAMINATION | 75 | ||
| Preliminary observation | 75 | ||
| History | 75 | ||
| Physical examination | 76 | ||
| Look | 76 | ||
| Feel | 77 | ||
| Move | 78 | ||
| Active movement | 78 | ||
| The uses of passive and resisted movements | 79 | ||
| Passive Movement | 79 | ||
| Accessory Movement and Stress Testing. Accessory movement and stress testing refer to passive tests at the joint of movements wh... | 80 | ||
| Resisted Movement | 81 | ||
| Complicating Factors in Examination (BOX 5.3) | 81 | ||
| The capsular pattern | 81 | ||
| Referred pain | 82 | ||
| 6 - The shoulder | 85 | ||
| ANATOMY | 85 | ||
| The scapula | 85 | ||
| The acromioclavicular joint | 86 | ||
| The clavicle | 86 | ||
| The sternoclavicular joint | 87 | ||
| The humerus | 87 | ||
| The glenohumeral joint | 87 | ||
| EXAMINATION (BOX 6.1) | 87 | ||
| Look | 88 | ||
| Feel | 89 | ||
| Palpation of the muscles of the rotator cuff | 89 | ||
| Move | 89 | ||
| Movement and the arc of pain | 92 | ||
| X-RAYS | 95 | ||
| The anteroposterior (AP) view (Fig. 6.10) | 96 | ||
| INJURIES | 98 | ||
| Sternoclavicular dislocation | 98 | ||
| Fracture of the clavicle | 98 | ||
| Acromioclavicular dislocation | 99 | ||
| Anterior shoulder dislocation | 99 | ||
| Posterior shoulder dislocation | 100 | ||
| Fracture of the proximal humerus | 100 | ||
| Rupture of the rotator cuff | 100 | ||
| Supraspinatus tendinitis | 101 | ||
| Acute calcific tendinitis | 101 | ||
| Subacromial bursitis | 101 | ||
| Winging of the scapula | 101 | ||
| Referred pain to the shoulder | 101 | ||
| 7 - The elbow\r | 103 | ||
| INTRODUCTION | 103 | ||
| ANATOMY | 103 | ||
| The humerus | 103 | ||
| The radius | 104 | ||
| The ulna | 104 | ||
| The ulnar collateral ligament | 104 | ||
| The radial collateral ligament | 105 | ||
| EXAMINATION | 105 | ||
| Look | 105 | ||
| Feel | 105 | ||
| Move | 106 | ||
| X-RAYS | 106 | ||
| INJURIES | 108 | ||
| Supracondylar fracture of the humerus | 108 | ||
| Radial head fracture | 108 | ||
| Olecranon fracture | 109 | ||
| Pulled elbow | 109 | ||
| Olecranon bursitis | 109 | ||
| Epicondylitis | 110 | ||
| 8 - The forearm, wrist and hand | 111 | ||
| ANATOMY | 111 | ||
| Terminology | 111 | ||
| The bones of the forearm | 113 | ||
| The wrist joint (radiocarpal) | 114 | ||
| The carpal bones | 114 | ||
| The carpal tunnel | 117 | ||
| The bones of the hand | 117 | ||
| Ligaments | 117 | ||
| The muscles of the forearm, wrist and hand | 117 | ||
| EXAMINATION | 119 | ||
| Examination of the hand | 120 | ||
| Look | 126 | ||
| Feel | 126 | ||
| Move | 127 | ||
| X-RAYS | 135 | ||
| Wrist X-rays | 137 | ||
| Scaphoid X-rays | 140 | ||
| X-rays of the hand | 141 | ||
| INJURIES | 141 | ||
| Hand splinting | 142 | ||
| Fractures | 142 | ||
| The fall on the outstretched hand | 142 | ||
| Hand fractures | 144 | ||
| Finger fractures | 145 | ||
| Soft tissue injuries | 145 | ||
| Skier’s (gamekeeper’s) thumb | 145 | ||
| Distal phalanx injuries in children | 146 | ||
| Tendon tears | 146 | ||
| Overuse | 147 | ||
| Infections | 148 | ||
| 9 - The pelvis and hip | 151 | ||
| ANATOMY | 152 | ||
| Ilium | 153 | ||
| The pubis | 153 | ||
| The ischium | 153 | ||
| The femur | 153 | ||
| Ligaments | 154 | ||
| EXAMINATION | 154 | ||
| Look | 154 | ||
| Feel | 154 | ||
| Move | 155 | ||
| X-RAYS | 155 | ||
| INJURIES | 156 | ||
| Childhood presentations (Boxes 9.3–9.5) | 157 | ||
| Hip problems in adulthood | 161 | ||
| The adductor longus | 162 | ||
| The iliopsoas | 162 | ||
| Piriformis syndrome | 163 | ||
| Quadriceps tears | 163 | ||
| Hamstring tears | 163 | ||
| Bursitis at the hip | 164 | ||
| The elderly patient | 164 | ||
| 10 - The knee | 165 | ||
| ANATOMY | 165 | ||
| Femur | 165 | ||
| Tibia and fibula | 166 | ||
| Patella | 167 | ||
| Meniscus | 167 | ||
| Collateral ligaments | 167 | ||
| Cruciate ligaments | 167 | ||
| Bursae | 167 | ||
| EXAMINATION | 167 | ||
| Look | 167 | ||
| Feel | 168 | ||
| Move (Figs 10.4–10.12) | 168 | ||
| X-RAYS (FIGS 10.13–10.15) | 174 | ||
| INJURIES | 175 | ||
| Fractures | 175 | ||
| Injuries to the extensor mechanism | 176 | ||
| Osteochondritis dissecans | 176 | ||
| Patella dislocation | 176 | ||
| Osgood–Schlatter disease (Box 10.3) | 176 | ||
| Ligament tears | 176 | ||
| Meniscus | 177 | ||
| Bursitis | 177 | ||
| 11 - The lower leg | 179 | ||
| ANATOMY (FIG. 11.1) | 179 | ||
| Tibia | 179 | ||
| Fibula | 179 | ||
| Ligaments of the lower leg | 181 | ||
| Bones of the foot (see Fig. 11.1) | 181 | ||
| The joints of the ankle and foot (see Fig. 11.1) | 181 | ||
| Collateral ligaments of the ankle (see Fig. 11.1) | 182 | ||
| EXAMINATION | 182 | ||
| Look | 182 | ||
| Feel | 182 | ||
| Move | 183 | ||
| X-RAYS | 183 | ||
| The tibia and fibula | 188 | ||
| The ankle (see Fig. 11.9) | 190 | ||
| The heel | 190 | ||
| The foot (Fig. 11.11) | 191 | ||
| The toes | 191 | ||
| INJURIES | 192 | ||
| Lower leg fractures | 192 | ||
| Tibia | 192 | ||
| Fibula | 192 | ||
| Ankle injuries | 192 | ||
| The foot | 193 | ||
| Lower leg pain | 193 | ||
| ‘Shin splints’ | 193 | ||
| Calf pain and injury | 194 | ||
| The Achilles tendon | 194 | ||
| 3 - Midline injuries | 197 | ||
| 12 - Minor head injuries | 199 | ||
| ANATOMY | 200 | ||
| MINOR HEAD INJURIES AND IMAGING | 202 | ||
| EXAMINATION | 203 | ||
| The history | 203 | ||
| The physical examination | 205 | ||
| The Glasgow Coma Scale (GCS) | 205 | ||
| Cranial nerve assessment (Box 12.1) | 207 | ||
| Cranial nerve I: olfactory | 207 | ||
| Cranial nerve II: optic nerve | 208 | ||
| Pupil Reaction | 208 | ||
| Visual Fields | 209 | ||
| Cranial nerves III, IV and VI: oculomotor, trochlear and abducent nerves | 209 | ||
| Cranial nerves V and VII: trigeminal and facial nerves | 210 | ||
| Cranial nerve VIII: vestibulocochlear nerve | 210 | ||
| Cranial nerves IX, X and XII: glossopharyngeal, vagus and hypoglossal nerves | 211 | ||
| Cranial nerve XI: spinal accessory nerve | 211 | ||
| Deep tendon reflexes | 211 | ||
| 13 - The face, the eye and ENT | 215 | ||
| INTRODUCTION | 215 | ||
| THE FACE | 215 | ||
| Anatomy | 216 | ||
| Bone | 216 | ||
| The muscles of the jaw | 218 | ||
| Examination | 218 | ||
| Injuries | 219 | ||
| Fracture | 219 | ||
| Blowout fracture | 219 | ||
| The zygoma and the rim of the orbit | 220 | ||
| The maxilla | 220 | ||
| The nose | 220 | ||
| Mandible | 221 | ||
| Dislocation | 221 | ||
| THE EYE | 221 | ||
| Introduction | 221 | ||
| Anatomy | 221 | ||
| Examination | 224 | ||
| History | 224 | ||
| Physical examination | 224 | ||
| Eye procedures | 226 | ||
| Visual acuity (Fig. 13.4) | 226 | ||
| Putting in eye drops or ointment | 227 | ||
| Eversion of the eyelid | 227 | ||
| Irrigation of the eye | 227 | ||
| Eye patches | 228 | ||
| Eye medications | 228 | ||
| Eye injuries | 228 | ||
| Chemical burn | 228 | ||
| Corneal abrasion | 228 | ||
| Blunt trauma | 228 | ||
| Corneal foreign body | 229 | ||
| Intraocular foreign body and penetrating injury | 229 | ||
| EAR, NOSE AND THROAT (ENT) | 229 | ||
| Nosebleed | 229 | ||
| Foreign bodies | 231 | ||
| Teeth that have been avulsed | 231 | ||
| 14 - The spine | 233 | ||
| NERVE ROOT PAIN AND FOCAL NEUROLOGY | 233 | ||
| THE NECK | 234 | ||
| Introduction | 234 | ||
| Anatomy | 236 | ||
| Examination | 241 | ||
| Look | 241 | ||
| Feel | 241 | ||
| Move | 242 | ||
| Nerve tests in the arms | 242 | ||
| Neck pain and injury | 242 | ||
| The Canadian C-spine rules | 242 | ||
| Neck injury: the rear-end shunt | 244 | ||
| Treatment | 244 | ||
| Nerve root pain (cervical radiculopathy) | 245 | ||
| Torticollis or wry neck | 245 | ||
| Neck injuries in children | 245 | ||
| THE LOWER BACK | 246 | ||
| Introduction | 246 | ||
| Anatomy of the lumbar spine | 246 | ||
| The patient with back pain | 248 | ||
| Common patterns of back pain | 249 | ||
| Examination | 249 | ||
| History | 249 | ||
| Feel | 250 | ||
| Move | 250 | ||
| Treatment | 251 | ||
| A summary | 252 | ||
| 15 - The chest | 253 | ||
| Children and rib injuries | 253 | ||
| Elderly patients and rib injuries | 253 | ||
| ANATOMY | 254 | ||
| Spine | 254 | ||
| Sternum | 254 | ||
| Ribs | 254 | ||
| INJURIES | 255 | ||
| EXAMINATION | 256 | ||
| History | 256 | ||
| Physical examination | 256 | ||
| TREATMENT | 257 | ||
| 4 - Wounds and burns | 259 | ||
| 16 - Wounds and burns\r | 261 | ||
| Initial problems | 261 | ||
| Bleeding | 261 | ||
| Pain | 262 | ||
| The time factor | 262 | ||
| Faint | 262 | ||
| Blood-borne infection | 262 | ||
| TYPES OF WOUNDS | 263 | ||
| WHEN IS A WOUND MINOR? | 264 | ||
| Factors which complicate wounds | 264 | ||
| ASSESSMENT AND EXPLORATION OF WOUNDS | 265 | ||
| The injured tissue | 265 | ||
| Exploration | 265 | ||
| Other tests for complications | 266 | ||
| Observation | 266 | ||
| Test of function | 266 | ||
| Radiography | 267 | ||
| WOUND CLEANING | 267 | ||
| Reasons for wound cleaning | 267 | ||
| Infection | 267 | ||
| Cosmetic | 267 | ||
| Exploration | 267 | ||
| Cleaning agents | 268 | ||
| Water | 268 | ||
| Saline | 268 | ||
| Povidone iodine | 268 | ||
| Chlorhexidine | 268 | ||
| Methods of wound cleaning | 268 | ||
| Lacerations and cuts | 268 | ||
| Abrasions | 268 | ||
| Debridement | 269 | ||
| WOUND INFECTION | 269 | ||
| What is a wound infection? | 269 | ||
| When is a wound infected? | 269 | ||
| Treatment of an infected wound | 270 | ||
| Abscess | 270 | ||
| Cellulitis and spreading infection | 271 | ||
| Tetanus | 271 | ||
| WOUND TREATMENT | 272 | ||
| Wound healing and the scar | 272 | ||
| The aims of wound treatment | 273 | ||
| Wound closure | 273 | ||
| Approaches to closure | 273 | ||
| Primary Closure (Primary Intention) | 273 | ||
| Secondary Closure (Healing by Secondary Intention) | 273 | ||
| Delayed Primary Closure (Tertiary Closure) | 273 | ||
| Closure with Steri-Strips | 273 | ||
| Application of Steri-Strips | 274 | ||
| Closure with an interrupted suture | 274 | ||
| Local Anaesthetic | 274 | ||
| Suture Materials | 277 | ||
| Suture Instruments | 278 | ||
| Suture Technique | 278 | ||
| Closure with skin staples | 279 | ||
| Closure with skin glue | 279 | ||
| Dressings | 280 | ||
| Closed wounds | 280 | ||
| Open wounds | 280 | ||
| Types of dressing | 280 | ||
| Securing a dressing | 281 | ||
| SPECIAL TYPES OF WOUND | 281 | ||
| Scalp wounds | 281 | ||
| Face wounds | 281 | ||
| Cosmetic implications of face wounds | 281 | ||
| Neck and trunk wounds | 282 | ||
| Hand wounds | 282 | ||
| Subungual haematoma | 282 | ||
| Nail bed lacerations | 282 | ||
| Amputations | 283 | ||
| Bites | 284 | ||
| Insect bites | 284 | ||
| Penetrating wounds to hands and feet | 285 | ||
| Pretibial lacerations | 285 | ||
| High-pressure injection wounds | 285 | ||
| MINOR BURNS | 285 | ||
| Assessment | 286 | ||
| Chemical burns | 286 | ||
| Smoke | 286 | ||
| Electric shock | 286 | ||
| Non-accidental injury in children | 287 | ||
| Types of minor burn | 287 | ||
| Definition of a minor burn | 288 | ||
| Size of the burn | 288 | ||
| Depth of the burn | 288 | ||
| Site of the burn | 288 | ||
| Treatment of minor burns | 289 | ||
| References | 291 | ||
| Bibliography | 293 | ||
| Index | 295 | ||
| A | 295 | ||
| B | 296 | ||
| C | 296 | ||
| D | 297 | ||
| E | 297 | ||
| F | 298 | ||
| G | 298 | ||
| H | 298 | ||
| I | 299 | ||
| J | 299 | ||
| K | 299 | ||
| L | 300 | ||
| M | 300 | ||
| N | 301 | ||
| O | 301 | ||
| P | 301 | ||
| Q | 301 | ||
| R | 302 | ||
| S | 302 | ||
| T | 303 | ||
| U | 303 | ||
| V | 303 | ||
| W | 304 | ||
| X | 304 | ||
| Z | 304 |