How to Master a Musculoskeletal Assessment using ‘The 5 P’s’

Today we’re talkin’ muscles and skeleton🦿.If you haven’t dealt much with the musculoskeletal system no need to fret. Below I am sharing the most important categories to touch on in order to ensure a successful and AMAZING musculoskeletal assessment.

𝐓𝐡𝐞 𝟓 𝐏’𝐬 𝐨𝐟 𝐌𝐮𝐬𝐜𝐮𝐥𝐨𝐬𝐤𝐞𝐥𝐞𝐭𝐚𝐥 𝐈𝐧𝐣𝐮𝐫𝐲:
•𝐏𝐚𝐢𝐧➝ use an appropriate pain scale to assess the child’s pain. If they have pain assess the location, severity and quality. When assessing for pain you actually have to touch on and around the injury site. Don’t be afraid to palpate the area. It is essential in determining how far that pain travels and if there could be other points of injury. Sometimes the child will say they have pain in one area but when you palpate the pain is actually coming from another area. It’s important to identify the exact location, especially if x-rays will be ordered. 

•𝐏𝐚𝐫𝐞𝐬𝐭𝐡𝐞𝐬𝐢𝐚➝ Assess the child for loss of sensation when touching the injured area. You can do this by using the edge of a tongue blade. Loss of sensation or tingling indicates there is neurovascular involvement and this finding should be reported to the physician immediately. 

•𝐏𝐚𝐫𝐚𝐥𝐲𝐬𝐢𝐬➝ Assess for movement in the affected area. Can the child move the injured area, at least a little. Granted, when a child has pain the last thing they want to do is move the injured area. However, it is important to assess for any CMS (Circulation, Motor & Sensory) abnormalities. Can the child move area distal to the injury? E.g., wiggle toes if it’s an ankle injury.

•𝐏𝐚𝐥𝐥𝐨𝐫➝ assess the color of the skin. Is there any paleness or discoloration on the side of injury? In addition, feeling the skin is important to determine if the skin is warm or cool. Coolness and/or paleness is an abnormal finding and would indicate neurovascular compromise.

•𝐏𝐮𝐥𝐬𝐞➝ assess the injured site for pulses. You will be checking all pulses distal to the affected area. You will also be checking for capillary refill. If a pulse is thready or absent, and there is a delay in capillary refill, blood supply to the area is compromised. This finding must be reported immediately as it is an emergency.

The information above is not intended as medical advice but as educational content.