Musculoskeletal Trauma

A sprain is any injury to the joint in which ligaments are stretched and torn. Strain is an injury to a muscle that occurs when the muscle is stretched beyond its normal range of motion, causing the muscle to tear. A dislocation is the separation of a bone end from a joint, leaving the bone end out of alignment with the joint. It is when a joint, such as a knee, hip, or shoulder, is not in the proper position.

Signs and symptoms of sprain and strain Pain – tenderness Swelling Deformity Discoloration of the skin Inability to use the affected part

First aid of sprains, strains and dislocations: The goal: to prevent further injury to the ligament.  Rest injured area.  Apply cold to hemorrhage, edema, pain, and disability: with a plastic bag or damp cloth filled with ice.  To prevent cold injury, limit each application of cold to 20 minutes and place a barrier (thin towel). Assume that any injury includes a bone fracture.  If an injured extremity is blue or pale, send to the emergency department immediately.

 Cover open wounds with a dressing if available  Cover open wounds with a dressing if available.  Do not move or straighten an injured extremity.  Stabilize the extremity in the position found.  Compression - bandage for support.  Elevate injured area  The victim should not bear weight.  Seek medical help

FRACTURES A fracture is any break in the continuity of a bone. Fractures can cause total disability or in some cases death by breaking vital organs and/or arteries. They can most often be treated so there is a complete recovery. The potential for recovery depends greatly upon the first aid the individual receives before he is moved.

Kinds of Fractures: 1.A Single Fracture is when the bone breaks in one place. 2.A Compound Fracture is when the bone has broken into two pieces. 3.A Comminuted Fracture is when the bone is broken in more than two places or crushed. 4.Closed Fracture. A closed fracture is a broken bone that does not break the overlying skin. The tissue beneath the skin may be damaged. 5.Open Fracture. An open fracture is a broken bone that breaks (pierces) the overlying skin.

Types of Fractures According to the Shape 1. A Greenstick Fracture is when the bone only cracks, and does not fully break. Because these do not break the skin. 2. Spiral . Oblige 4. Horizontal 5. Vertical 6. impacted

Signs and Symptoms of Fractures Deformity Tenderness Swelling Pain: sharp pain when an attempt to move the part. Inability to move the injured part Protruding bone. Bleeding or discolored skin at the injury site.

Immobilizing Fractures: Prevent the sharp edges of the bone from moving and cutting tissue, muscle, blood vessels, and nerves. Reduce pain and helps prevent or control shock. Keep bone fragments from causing an open wound in a closed fracture, which can become contaminated and subject to infection.

Splints, Padding, Bandages, Slings, and Swathes Splints: Splints may be improvised from such items as boards, sticks, tree limbs Padding: Padding may be improvised from such items as a jacket or blanket Bandages: Bandages may be improvised from belts, slings, & kerchiefs Slings: A sling is a bandage suspended from the neck to support an upper extremity.

Swathes: Swathes are any bands (pieces of cloth or load bearing equipment that are used to further immobilize a splinted fracture. Triangular bandages are often used and are called swathe bandages. The purpose of the swathe is to immobilize;

Locate the Site of the Suspected Fracture (1) Ask the victim: Does he have any pain? Where is it tender? (2) Look for an unnatural position of the extremity. (3) Look for a bone sticking out (protruding).

Prepare the victim for splinting the suspected fracture (1) Reassure the victim; tell him that you will be providing first aid for him and that medical help is on the way. (2) Loosen any tight or binding clothing. (3) Remove all jewelry from the injured part and place it in the casualty’s pocket. (4) Shoes should not be removed from the casualty unless there is actual bleeding from the foot.

Apply the Splint in Place 1) Splint the fracture in the position found. DO NOT attempt to reposition or straighten the injury. If it is an open fracture, stop the bleeding and protect the wound. Cover all wounds with dressings before applying a splint. (2) Place one splint on each side of the fracture. Make sure that the splints reach, if possible, beyond the joints above and below the fracture. (3) Tie the splints. Secure each splint in place above and below the fracture site

Check the Splint for Tightness (1) Be sure that bandages are tight enough to securely hold splinting materials in place, but not so tight that circulation is impaired. (2) Recheck the circulation after application of the splint. Check the skin color and temperature.

Eye, nose and ear Injuries

Eye injuries Eye injuries can happen to anyone, and are quite common. Below are several types of injuries and suggested treatments. Foreign body in the eye (Particle of dust or dirt) Symptoms  Pain  Burning  Redness  Tearing

First aid management  Do not rub the eye, as it may cause scratching and other injury to your cornea.  Gently lift the upper eyelid down over the lower one, allowing the eye to flush the particle of dirt out. Hold the eyelid like this for a minute or so or until the victim feel the object has been removed. This may be repeated as necessary.  If not removed turn back the led over a swab stick, and remove the visible foreign body with a clean tissue.

 Ask the victim to blink his eye several times to help remove the object.  If not improved, flush the eye using a little bit of cool clean water.  Try not to remove it with fingers as you may do damage to the eye.  If object remains in the eye, keep it closed and go see your doctor.

embedded object in the eye Cover both eyes with a clean sterile pad and go to the ED Do not apply direct pressure Do not try to remove the object or touch the eye.

A hit or blow to the eye  Quickly apply a cold compress to the area around the eye, not the eye itself, for about 15 minutes. This will reduce pain and swelling.  A black eye or blurred vision indicate eye damage and should be assessed by a doctor.

Cuts to the eye or eyelid Bandage the eye area gently with gauze and medical tape and get the person to the doctor as soon as possible. Do not attempt to remove any objects on the eye, or touch the eye. Do not apply pressure to the injured area, and do not rub the affected area.

Chemical burns to the eye  Immediately flush off your eyes with plenty of water for about 15-20 minutes.  The victim may want to move his eye around while doing this to help assure the removal of all chemicals.  Clean your hands with soap and water to remove any chemical from the hands.  Remove off the contact lenses.  Seek medical help immediately, if needed.  Make sure the head is tilted so the chemicals and water do not flow into the unaffected eye.  These burns should be looked at by a doctor as soon as possible to make sure no damage was done to the eye.

Foreign body in the nose Don’t search at the foreign with cotton swab or another tool. Ask the victim not to breathe in forcefully to prevent inhaling the foreign body. Encourage the victim to breathe from his mouth. Ask the victim to blow gently and effectively into a tissue paper. If not removed, apply gentle pressure into the nose trill of free side (no foreign body), and ask him to blow gently. If the object is visible, gently remove it with tweezers. If not removed send the victim to ED.

Bleeding nose  Ask the victim to sit in upright position to decrease the flow of blood in the nasal veins.  Apply pressure on the nose by asking the victim to pinch the nose with the thumb and the forefingers.  Ask the victim to lean forward (not to the back) and continue applying pressure for 10 minutes.  Apply ice bag wrapped in a towel on the bridge of the nose  If the bleeding continues, send the victim to ED.

Foreign body in the ear Don’t search at the foreign with cotton swab or another tool. If the object is visible, gently remove it with tweezers. If the object is not visible, ask the victim to tilt his head into the affected side and ask him to shake his ear gently toward the earth gravity. If not removed send the victim to ED.