ABOUT BROKEN BONES. Essential Question: How Do Bones Heal? Learning Targets: Lesson Overview

Transcription

1 ABOUT BROKEN BONES Essential Question: How Do Bones Heal? Learning Targets: Students will: Explain the role of bones in the functioning of the human body. Summarize the stages of how bones heal. Use a variety of media to develop and deepen understanding of a topic or idea. Practice a standard technique, revising work when needed. Justify thinking using evidence to solve x-ray mysteries. Lesson Overview This lesson introduces the fields of EMT, x-ray technician, and radiologist, as well as the big picture of the hidden functions of bones. After learning how bones heal and key new vocabulary through a quick charades activity, the young professionals will face a splinting design challenge before practicing a standardized splinting technique. Finally, they will use critical thinking to puzzle out a short series of x-ray mysteries. 1

2 Lesson Agenda Opening (5 min) Emergency Scenario: Broken Radius and Ulna Work Time Closure (10 min) How Bones Heal (10 min) Vocabulary Preview (5 min) Splinting Design Challenge (15 min) Splinting Practicum (20 min) X-Ray Mysteries (10-15 min) Career Venn Diagram Materials Splinting practicum (1 set per group) Splint (magazine/notebook) Wrapping bandage Two triangle bandages Padding (can be t-shirts, cut up towels, etc.) Supportive materials (SAM splint) Young Allied Health Professional student packet <How Does a Bone Heal> video to project <Getting an X-ray> and <How Dangerous Are X-rays> videos to project <X-ray Images> to project FACILITATION NOTES The Narrative Arc. The more each <Emergency Scenario> can be presented as if telling a story, the more engaged the audience will be. Work to avoid a stale reading and lean towards bringing the information to life as in a conversation or a reveal of the next chapter. Think of creative ways to make the story your own. Background Knowledge. Familiarize yourself with information on x-rays: Time Management. This lesson may take two class periods. 2

3 Extensions. The following activities have been built in as extensions to the main lesson. If you extend the lesson to two class periods, you can choose to complete one or more of these stations. o Rotation Stations. To implement the Rotation Stations Protocol, set up the station materials and display the student directions and the sentence starters around the room. Decide how you will group students. If you do not feel comfortable implementing this protocol for classroom management reasons, pace all students through each activity as a whole group. These stations were adapted from the haspi.com health science curriculum. IN ADVANCE Preview the videos on splinting: and cover how to properly splint an extremity arm fracture. Please review these BEFORE assisting students. One video models using stabilizers other than SAM splints ( Not all students have had an x-ray; this video provides a visual so that they can understand the process you go through when you see an x-ray technician. Show to 1:30- Are x-rays dangerous? helps to answer commonly asked questions about x-rays. Preview How Does a Bone Heal: This video is a computer graphic that illustrates the healing process. The video can give students ideas about how to take notes on the steps of bone healing on the <How Bones Heal Graphic Organizer>. Vocabulary Content forearm, blood clot, callus, x-ray, radiology, fractures, splint, joint, extremity Tier II synthesize, remodeling, compare & contrast, immobilize, stabilize, secure 3

4 Opening (5 min) Emergency Scenario: Broken Radius and Ulna 1. Invite the young professionals to turn to a colleague and share any personal stories they have about broken bones. 2. Ask: What might you do to help someone with a broken bone? 3. Invite volunteers to answer the question. Listen for: Splinting, calling 911, going for help. 4. Share the <Emergency Scenario: Broken Ulna and Radius> in a conversational, engaging manner. Say: The skateboard patient s arm was splinted in the field by the first responder. First, let s learn about how bones heal and how to do first aid in the field if someone breaks a forearm. The personal connections help students activate prior knowledge and connect to the day s material. Even if using a different hook, we recommend including this time to connect the known to the new. Work Time How Bones Heal (10 min) How Bones Heal When a bone breaks, what happens? Are all breaks the same? How do bones heal? These are questions that are important for both the patient and for the health care team helping them heal. Unlike machines, our bodies can repair themselves. The next video will help us learn how bones heal. Focus on the function of each stage if some of the vocabulary is new. As you watch the video, be sure to record the functions of each in the <How Bones Heal Graphic Organizer>. 1. Project: 2. Stop the video at each stage so students can fill out their graphic organizers: o Day 1: Blood Clot (0:35) o Day 7: Soft Callus (1:15) o Day 28: Hard Callus (1:37) o Month 3: Remodeling (1:39) 4

5 3. Ask: Now that you know how bones heal, why would we splint broken bones? Cast them? Splinting Vocabulary Preview (5 min) 1. Say: Let s take a moment to learn some new words. 2. Project the new vocabulary words. 3. Invite volunteers to act the words out. Have other YPs guess them like charades. splint immobilize joint extremity stabilization secure (i.e. hold still) Take a moment to bring alive the key vocabulary for this lesson to ensure equity of access for all students. Now we are going to learn about a process that first responders use in the field. Has anyone here ever had a splint? The splint is a temporary way to immobilize an extremity an arm, leg, wrist, finger, etc. Why do you think we would want to immobilize a broken limb on the way to a hospital? While an EMT or paramedic often work in professionally stocked ambulances, many first responders have to improvise until help arrives. At other times, more advanced medical equipment may be far away, or in cases of wilderness settings or natural disasters, a wellstocked ambulance is not always available. In this case, first responders must improvise using specific principles to help guide their work. Imagine you came upon someone with a broken arm and help was far away what would you do? What are important things to think about? Listen for: Reduce pain, immobilize the break so the patient can be moved, reduce swelling, keep the bone from breaking through the skin, support the injury. Splinting Design Challenge (15 min) Ask: If you were far from help and came across a hiker with a fractured forearm, how would you respond? (Invite a few students to share their responses.) In the next activity, we will explore how to splint this type of injury. 5

6 1. Pair the students for the <Splinting Design Challenge>. 2. Ask the pairs to take three minutes to 1) look through the <Splinting Design Challenge> and 2) discuss a plan. 3. Have one person in each pair raise their hand. This arm becomes the broken arm, and they are now the patient. o The non-injured partner has 7-8 minutes to create a splint that meets the design constraints below (write on the board or project): Protect the injury. Immobilize the joint above and below the break. Make sure the patient has pulse, sensation, and movement in the fingers (this shows you have not cut off circulation, which would damage the nerves and flesh). Support the injury. 4. After the allotted time, ask the patients to line up in the front of the room, and the first responders to take a seat. 5. Take a moment to critique each (or selected) splint/s. o o For selected splint, ask: Which constraints were met? Which ones were not? After each critique, consider asking the first responder what challenges they faced and what they would do differently next time. In this design challenge, the YPs are given a set of design constraints. These will guide them as they design a solution. After the feedback, YPs will think about what they would change in their next iteration. Emphasize experimentation over perfection during this challenge what did they learn during this quick problemsolving process? Splinting Practicum (20 min) Luckily, allied health professionals are trained to deal with emergencies. They spend time practicing standard ways of treating emergencies in the field. We are now going to learn how professionals apply a splint and then practice a more standard approach. 1. Project selected video: or Say: We are going to practice splinting based on a simplified checklist an EMT uses in their practicum test this is in your Young Allied Health Professional packet. Before you start splinting, I want to model the key steps that first responders do in the splinting process. After each one, I would like someone to share why this is critical, or very important, to the splinting process. 1. Model each step as you state it aloud. Then ask why the step is important. 6

7 2. Select a volunteer patient. 3. Say or show safety precautions (I am putting on gloves or act it out, etc.). o Ask: Why do this? 4. Keep the extremity still and stabilized with a SAM splint or magazine (to reduce pain and further damage to site). 5. Immobilize the joint above and below the injury (to reduce pain and further damage to the site). 6. Place something under the hand (for comfort and circulation). 7. Wrap the forearm using an ace bandage (to stabilize injury). 8. Access motor, sensory, and circulation before and after splinting (to ensure blood flow is not cut off from fingers and that the wrap is not too tight). 9. Use a triangle bandage to create a sling (to support and protect injury in transport and reduce pain). It may be temping to tell students the reason for each step. Instead, encourage them to think with a problem-solving approach. Use wait time if needed to encourage participation. Paired Splinting Activity 1. Provide time for partners to splint each other. o Begin with partners trading roles. 2. Circle and provide support. o o Students should provide support and padding to the wound! Provide formative assessment so students meet criteria. 3. Sign off on each young First Responder s sheet. Say: It is important to note that practicing splinting once does not make you a real Allied Health Professional. From First Responders to EMTs to Paramedics, our health care professionals go through rigorous training and practice before they work in the field. Reading X-rays (10-15 min) What happens once a patient with a suspected broken bone arrives at the hospital? Often, they go to have the bone x-rayed. X-ray or radiology technicians learn how take different kinds of X- rays. These images are then read by radiologists, or doctors who use medical images to diagnose diseases and injuries. For our patient, it is important to know the bones that are 7

8 fractured and the type of fracture, or the break, in order to treat it correctly and effectively. Today, we will experience this as a radiologist s mystery, where you will problem solve to match the x-ray image to the cause/definition. Say: We are going to take a moment to learn about x-rays and the allied health career of X-ray Technician. What are x-rays? Are they dangerous? Project video: Say: Now let s learn how x-rays are used and the role of the X-ray Technician. Since not everyone has had an x-ray, this video will help share the process. Show to 1:30: 1. Review the common types of fractures with students, asking them to follow along on their <Types of Fractures> student sheet. Share some observations on what makes each fracture unique. 2. Model the problem solving: reading an x-ray of a transverse fracture. 3. Project x-ray of the transverse fracture. o o Ask: What do you notice about this break? What evidence suggests it is a transverse fracture? Listen for: There is a clean, horizontal break in the bone. This short activity provides the YPs an opportunity to apply contextualized critical thinking skills. Push students to supply the reasoning behind their answers, justifying their ideas by using evidence when possible. 4. Project each x-ray image. o Answer Key: Oblique, Avulsion, Impacted, Comminuted, Greenstick 5. Ask: What kind of fracture is illustrated? What is your evidence? o Students should use the images on the <Types of Fractures> sheet as a basis for comparison. The power of this activity is as a reasoning/mystery activity. Push students to move from making guesses to finding evidence or clues to support their thinking. 8

9 Closure (10 min) Venn Diagram: X-ray Tech & Radiologist What is the difference between a x-ray technician and a radiologist? Both have important roles in helping patients on the road to recovery. 1. Highlight the <Career Venn Diagram>. 2. Ask: Who here knows how to use a Venn diagram? 3. Explain that they will compare and contrast the two careers. 4. Model inputting information that is shared by each career and information that is specific to one or the other. o Use the Lenses on the Future language when possible. 5. Ask students to work individually or in assigned pairs to complete the Venn diagram. 6. Debrief with the class, ensuring key points are called out. 7. Invite students to reflect on the <What Are Bones? Quick Write> questions privately and record their answers. This activity has students comparing and contrasting two careers. While both work with medical imaging, one is a technical career that provides a familysustaining wage and requires less investment in terms of years of education. Highlighting technical careers as well as the more recognized doctors and nurses demonstrates the diverse professional opportunities in the growing sector of Health Science. Ensure that during the activity one career is not presented as more important or better than the other. 9

10 Extensions Rotation Stations: What Are bones? Many allied health workers take courses in anatomy and physiology to better understand the body. Medical professionals who work with the skeletal system also have to know a lot about the composition of bones and how they heal. As a body system, it has a crucial role in supporting our tissues and allowing us to move. For this activity, the young professionals will move around in small groups to different stations as they work together to respond to prompts or completing tasks. 1. Explain to the young professionals that the activity will get them moving around the room to different stations in order to explore bones. Moving around and talking with your group about the task at each station keeps your brains alert and helps you remember what you are learning. 2. Draw the young professionals attention to the different stations by explaining what they can expect to learn about at each station. a. Station #1: Long Bone Strength- You will build a model bone from paper and test the strength it has based on its shape. b. Station #2: Skeletal System Histology- Histology just means you are studying the microscopic parts of tissues. You will examine the insides of bones closely, sketch what you see, and answer a few questions. c. Station #3: Bone Length and Height- You will take measurements of yourself and your colleagues to see the relationship between the length of certain bones in the body and height. 3. Review the student directions. a. Tell the young professionals they will have 10 minutes at each station, and they may collaborate together in a whisper. b. Emphasize that the young professionals are expected to interact with their group members to process the material at each station. 10

11 c. Remind young professionals that the <Sentence Starters> can help them communicate with each other about their work. 4. Assign each group to a station and instruct them to move there and begin. 5. Circulate, listen and support the young professionals as needed. 6. Use a timer to keep the young professionals on track with how many minutes they spend at each station. Check in to see if groups need more time and make adjustments as needed. 7. Before changing stations, provide feedback about ways the young professionals are interacting effectively. a. I notice b. I like the way that 8. Continue until the young professionals have rotated through all the stations. 11

12 Name: Date: ABOUT BROKEN BONES: How Do Bones Heal? Today s Learning Objectives: I can: Explain the role of bones in the functioning of the human body. Summarize the stages of how bones heal. Use a variety of media to develop and deepen understanding of a topic or idea. Practice a standard technique, revising work when needed. Justify thinking using evidence to solve x-ray mysteries This lesson introduces the fields of EMT, x-ray technician, and radiologist, as well as the big picture of the hidden functions of bones. After learning how bones heal and key new vocabulary through a quick charades activity, I will face a splinting design challenge before practicing a standardized splinting technique. Finally, I will use critical thinking to puzzle out a short series of x-ray mysteries. Today s Activities: How Bones Heal; Vocabulary Preview Splinting Design Challenge Splinting Practicum X-ray Mysteries Career Venn Diagram and Quick Write Exit Ticket 12

13 Emergency Scenario: Broken Radius and Ulna As the emergency room x-ray technician, the person who administers and reads x-rays, you are very familiar with your patient s diagnosis: a broken radius and ulna in the forearm. Broken forearms are often caused by an impact injury, such as from a fall (when a child uses their outstretched arm to break a fall) or a direct blow. They are the most common fractures in children, especially if they re active. You have already taken the X-ray of the adolescent male s broken forearm. While he is sedated for suturing his facial laceration, the doctor works to set his broken bones. His fracture is a closed fracture, one of the least complicated to set. This type of fracture means that the bones are broken but no bone has broken through the skin, an open fracture. And, luckily, the bones did not fragment into smaller pieces as we see in a comminuted fracture. In this case, the bones are set in alignment and then splinted so they will be immobilized, or unable to move. The patient is later supplied with a sling to further minimize movement. He will receive physical therapy to help reduce the stiffness he will feel in his shoulder and to help restore muscle strength. The treatment plan states that his arm will be X-rayed again in 5-7 days, and the splint may be replaced with a cast. 13

14 How Bones Heal Graphic Organizer Stages List the four stages of the regenerative process in order. Functions Describe the function of each stage. (In other words, what is the body doing at each stage?) Word Bank Soft Callus Blood Clot Hard Callus Remodeling 14

15 Types of Fractures The type and severity of a fracture is dependent on the strength and direction of the forces that cause a bone to break. The following image summarizes the common types of fractures. X-Ray Image Type of Fracture Evidence 15

16 X-Ray Image Type of Fracture Evidence 16

17 Splinting Design Challenge! Scenario: You are a first responder who has come across an injured hiker with a fractured forearm. You are far from help, so you must splint the forearm in order to prevent further injury. Follow the directions below. Directions: You will have 7-8 minutes to create a splint that meets all of the design constraints below. Take some time to discuss a plan with your partner now. Design Constraints: 1. The injury must be protected. 2. The joint above and below the break must be immobilized. 3. Make sure the hiker has pulse, sensation, and movement in the fingers (this shows you have not cut off circulation, which would damage the nerves and flesh). The injury must be supported. 17

18 EMT Splinting Practicum Checklist Directions: With your group, use this chart to check each step of splinting a broken limb. Score each section; scores below 10 will try again. Long Bone Immobilization Points Possible Points Earned Say or show safety precautions (I am putting on gloves or act it out, etc.). Keep the extremity still and stabilized with a SAM splint or magazine (to reduce pain and further damage to site). Immobilize the joint above and below the injury (reduce pain and further damage to the site) Place something under the hand (for comfort and circulation). 1 Wrap the forearm using an ace bandage (stabilizes injury). 1 Access motor, sensory, and circulation before and after splinting (to ensure blood flow is not cut off to fingers and that the wrap isn t too tight). Use triangle bandage to create a sling (to support and protect injury in transport and reduce pain). 1 1 TOTAL 7 18

19 19

20 What are Bones? Quick Write Summarize what you learned about bones in today s activities. Which activity was the most challenging? What are some reasons it was challenging? What did you do to persist through those challenges? 20

21 Rotation Stations Directions: 1. At the signal, move to your assigned station. 2. Work with your group to respond to complete the task. 3. Complete the task on a graphic organizer or data table. 4. At the signal, move to the next station and repeat. Sentence Starters: What does everyone think about? I m wondering if we want to I agree/disagree with the idea because. So we re saying It sounds like we agree that What will we all write down? What are some additional ideas about? Do we all agree that? Is there anything here we have a question about? 21

22 Rotation Stations: Station #1 Long Bone Strength Long bones are hard, dense bones that provide strength, structure, and movement. The femur (thigh bone) is a long bone. A long bone has a shaft and two ends. There are also bones in the fingers that are classified as "long bones," even though they are short in length. This name is due to the shape of the bones, not the actual size. Long bones contain yellow bone marrow and red bone marrow, which produce blood cells. The construction materials and shape of bone give it its strength and the ability to deal with great amounts of force. Collagen fibers, formed from a type of protein, allow bone to endure stretching forces. Harder mineral salts allow bone to endure compression forces. Bone construction is similar to that of reinforced concrete in that steel rebar allows concrete to resist stretching forces, while the cement resists compression. The circular shape of osteons, or round structures in the bone, are able to deal with greater amounts of force. Unfortunately, bone construction does not tend to resist twisting forces. In fact, twisting is the primary cause of bone fractures. In this activity, you will examine the ability of the concentric circular shape of bone to withstand direct forces. 22

23 Rotation Stations: Station #2 Skeletal System Histology Histology is a fancy name for the study of the microscopic structures of tissues bones, in this case. At this station, you will be analyzing a chicken bone to examine the internal structures of bones. Instructions 1. Observe the outsides of the bones with and without the magnifier. 2. In your notebook, draw the exterior view of the bone. 3. Ask your teacher to break open the bones for your group. 4. Observe the insides of the bone with and without a magnifier. 5. In your notebook, draw the interior view of the bone. 6. Answer the following questions in your notebooks: Are bones solid or hollow? What might be the advantages of this type of structure? 7. Summarize this statement: What is inside bones? Bone marrow is another important component of the bone matrix. Bone marrow is a gelatinous organic tissue (tissues are a group of identical cells) found within the cavities of spongy bone in some of our bones, such as the hip and thigh. Bone marrow contains stem cells which give rise to the different blood cells. There are two kinds of bone marrow: red marrow and yellow marrow. Red marrow produces red blood cells, platelets, and white blood cells and is found in the ends of long and flat bones (i.e. femur, ribs, vertebrae, and pelvic bones). Yellow marrow stores fat and is found in the middle of long bones (i.e. most of the bones of our limbs). 23

24 Rotation Stations: Station #3 Bone Length and Height Inferring the height of an individual based on the length of long bones is common in forensic pathology, or crime scene investigation. When skeletal remains are found, the sex, race, and height can be crucial clues to identify the patient. In fact, a single long bone can be used to calculate approximate height. Gender and race also contribute to these numbers to give a close approximation of height. In this activity, you will calculate your height using the length of your long bones. 24

25 Facilitator Documents: X-ray Images to Project 25

26 26

27 27

28 Venn Diagram to Project 28