Chapter 15 Extremity Injuries

Extremity Injuries Injuries to the extremities are common because people are involved in active lifestyles that include sports and wilderness activities.

Extremity Injury Assessment Look for Examine the extremities using Compare Use Consider the

Types of Extremity Injuries (1 of 2) Contusions Strains Sprains

Types of Extremity Injuries (2 of 2) Tendonitis Dislocations Fractures

Care for Extremity Injuries

RICE Procedures (1 of 7) Acronym Recommended The first

RICE Procedures (2 of 7) R = .

RICE Procedures (3 of 7) I

RICE Procedures (4 of 7) C

RICE Procedures (5 of 7) E

RICE Procedures (6 of 7) R = I = .

RICE Procedures (7 of 7) C = E =

Shoulder Dislocation Occurs Result of Second in

Recognizing a Shoulder Dislocation (1 of 2) Victim holds Arm cannot Extreme Shoulder appears

Recognizing a Shoulder Dislocation (2 of 2) Injury results in. History of Numbness or paralysis

Care for a Shoulder Dislocation Do not Place a Apply Apply. Seek

Clavicle Fracture Common Usually result of Most occur in the

Recognizing a Clavicle Fracture (1 of 2) Fell on Direct Severe Holding injured arm

Recognizing a Clavicle Fracture (2 of 2) No movement

Care for a Clavicle Fracture Treat for Apply and swathe. Apply ice pack: ___ minutes, __to __times during 24 hours Seek _______medical care.

Contusions Caused by Often called

Recognizing Contusions Pain at Feeling of Black-and-blue discolorations

Care for Contusions Apply an ice pack: Place arm in sling and swathe.

Tendonitis _________of the shoulder Result of

Recognizing Tendinitis Constant or Limited _____of shoulder “_______” sound _________over the area

Care for Tendonitis Use an ice massage for __ minutes before and after exercise. Use a Use pain medication. Seek medical advice.

Humeral Fracture Shaft of the humerus can be

Recognizing a Humerus Fracture Direct blow Twist or fall Severe Deformity Tender if touched Inability Holds

Care for a Humerus Fracture ______and treat for shock. Apply an ice pack for ___minutes. Stabilize the arm. Seek immediate medical care.

Elbow Injuries Should be considered serious Treat with extreme care.

Recognizing Elbow Fractures and Dislocations Immediate Severe Possible Restricted, painful motion Numbness

Care for Elbow Fractures and Dislocations Do not Treat for Splint the Apply Seek

Tennis Elbow Results from Inflammation of the

Recognizing Tennis Elbow Pain increases Gradual grip Injured Very tender on

Care for Tennis Elbow Apply heat Apply ice pack Seek

Golfer’s Elbow Equivalent to Pain is on

Recognizing Golfer’s Elbow Pain increases Gradual Injured elbow

Care for Golfer’s Elbow Apply Apply an ice pack for __ minutes after activity. Seek medical advice.

Radial and Ulnar Fractures The radius and ulna are the two large bones in the forearm. When one bone is broken, the other acts as a splint, and there may be little or no deformity. When both are broken, the arm usually appears deformed.

Recognizing Radius and Ulna Fractures Pain in Deformity Severe pain Inability to

Care for Radial and Ulnar Fractures Assess and treat for shock if indicated. Apply an ice pack for __ minutes. Apply Seek medical care.

Wrist Fracture Wrist usually

Recognizing a Wrist Fracture

Care for a Wrist Fracture

Hand Injuries—Crushed Hand May be fractured by:

Recognizing a Crushed Hand

Care for a Crushed Hand

Finger Injuries The __bones that make up each finger are the most commonly broken bones. The finger has three joints:

Finger Fracture Finger bones can move when they are broken.

Recognizing Finger Fractures

Testing Finger Fractures If possible, Tap the Pain

Care for Finger Fractures Do not try Gently apply an ice pack. Splint the finger. Seek medical care.

Finger Dislocation Common Same causes of fractured fingers

Recognizing Finger Dislocation

Care for Finger Dislocation Do not try to realign. Apply an ice pack for 20 minutes. Splint the finger. Seek medical care.

Sprained Finger Upper joints of the fingers have a ligament on each side of the joint.

Recognizing a Sprained Finger “ Pain and swelling Unable to make a fist Weakness Weakness or pain

Care for a Sprained Finger Apply an ice pack for ___ minutes. Reevaluate. Seek medical care if pain and weakness exist. “______” tape the fingers.

Nail Avulsion Injury in which a nail is partly or completely torn loose

Recognizing a Nail Avulsion Nail may be

Care for a Nail Avulsion Secure Apply antibiotic ointment. Secure a. Do not trim away loose nail. Consult a physician.

Splinters Sharp splinters, usually wooden, can be impaled into the skin or under a fingernail or toenail.

Recognizing Splinters Small puncture wound Sliver may be seen.

Care for Splinters Use tweezers to remove it. If splinter is impaled under a nail and breaks off flesh:

Blood Under a Nail Blood

Recognizing Blood Under a Nail

Care for Blood Under a Nail .

Ring Strangulation Within ___ or ___ hours

Recognizing Ring Strangulation A ring has become tight on a finger.

Care for Ring Strangulation (1 of 2) Spray onto finger. Massage finger from tip to hand. Smoothly wind.

Care for Ring Strangulation (2 of 2) Lubricate finger well, and then Cut the _________part of the ring. Inflate an ordinary balloon.

Hip Joint Injuries Hip joint is a Requires great force to dislocate

Recognizing Hip Dislocation Severe pain at injury Swelling at injury Hip is flexed and knee is bent and rotated inward toward opposite hip. Visible injury

Care for Hip Dislocation Assess and treat for shock. Stabilize injury. Check for ankle pulse. Seek medical care.

Hip Fracture

Recognizing a Hip Fracture Severe pain in groin area Inability to lift injured leg Leg may appear shortened and be rotated with the toes pointing abnormally.

Care for a Hip Fracture Treat for shock. Stabilize injured leg. Monitor ankle pulse. Seek immediate medical care.

Femur Fractures Femur injuries can occur in any part of the femur. Femur fractures often include open wounds. External bleeding may be severe.

Recognizing a Femur Fracture Severe pain at injury Deformity Swelling Severe pop or snap

Care for a Femur Fracture Assess and treat for shock. Cover wound with sterile dressing. Stabilize injured leg. Monitor ankle pulse. Seek immediate medical care.

Muscle Contusion The muscle group on the front of the thigh is the quadriceps group. Often gets bruised

Recognizing a Muscle Contusion Swelling Pain and tenderness Tightness or firmness of site Visible bruise

Care for a Muscle Contusion Follow the RICE procedures. Stretch the muscle.

Muscle Strain Occurs when a muscle is overstretched A first aider will be unable to determine its degree.

Recognizing a Muscle Strain Pop or pulling sensation while running or jumping Tenderness Stiffness and pain Swelling Visible bruise appears days later.

Care for a Muscle Strain Follow the RICE procedures. Apply an ice pack. 20 minutes, three to four times a day for 48 hours Stretch the muscle.

Knee Injuries .

Recognizing a Knee Fracture May look like a dislocation Deformity Tenderness Swelling

Care for a Knee Fracture No deformity: Feel for pulse in the ankle. If pulse is felt, splint the leg with the knee straight. Significant deformity: If pulse is felt, splint the knee in the position found. Seek medical care immediately if pulse is absent.

Knee Dislocation A knee dislocation is a serious injury. Deformity will be grotesque.

Recognizing a Knee Dislocation Excruciating pain Deformity Pulse may be absent in the ankle.

Care for a Knee Dislocation Stabilize the knee in the position found. Seek medical care immediately.

Patella Dislocation Must be treated immediately Most commonly occurs in teenagers and young adults who are engaged in athletic activities.

Recognizing a Patella Dislocation A blow or twisting causes kneecap to move outside of the knee joint. Swelling Inability to bend or straighten knee Pain Deformity

Care for a Patella Dislocation Follow the RICE procedures. Do not try to relocate. Splint knee in position found. Seek medical care.

Knee Sprain Ligament injury Can range from mild to complete tearing

Recognizing a Knee Sprain Severe pain Pop or snap at the time of injury Locking sensation Inability to walk without limping Inability to bend or straighten the knee Swelling Bruising

Care for a Knee Sprain Follow the RICE procedures. Seek medical care.

Knee Contusion Caused by: A direct blow Falling on the knee

Recognizing a Knee Contusion Pain Swelling Tenderness Black-and-blue discoloration

Care for a Knee Contusion Follow the RICE procedures.

Lower Leg Injuries Tibia and Fibula Fractures Can occur at any place between the knee joint and the ankle joint Deformity may occur when one bone is broken. When only one bone is broken, little deformity may be present.

Recognizing Tibia and Fibula Fractures Severe pain Swelling Deformity Tenderness

Care for Tibia and Fibula Fractures Stabilize the leg. Apply an ice pack. Seek medical care.

Recognizing Tibia and Fibula Contusion Victim received a direct hit directly on shin. Tender when touched Sharp pain Black-and-blue mark Difficulty moving ankle up and down Numbness or coldness in toes or foot

Care for a Tibia and Fibula Contusion Expose the injury. Apply the RICE procedures. Use an ice pack. 20 minutes, three to four times daily for 48 hours If numbness or tingling exists, seek medical care.

Muscle Cramp Temporary condition Usually occurs in the calf and sometimes in the thigh or hamstring

Recognizing a Muscle Cramp During or after intense exercise sessions Painful muscle contraction or spasm that disables the victim

Care for Muscle Cramps Gently stretch. Apply pressure. Apply ice to the muscle. Pinch the upper lip hard. Drink lightly salted, cool water. Drink a commercial sports drink.

Shin Splints Pain in the front of the lower leg or shin

Recognizing Shin Splints Ache subsides after activity stops. Ache is a result of an increase in the workout routine. Chronic problem that gets worse

Care for Shin Splints Apply an ice pack before activity. Apply pressure. Apply an ice pack for 20 minutes after activity. Curtail activity until the shin is pain free. Take anti-inflammatory pain medications.

Ankle and Foot Injuries Frequently injured by twisting Stretches or tears ligaments Most ankle injuries are sprains that involve the outside ligaments.

Recognizing Foot and Ankle Injuries (1 of 2) Two-part test to determine whether an X-ray is needed: Press along the bones. Pain and tenderness may indicate a broken bone. Have the victim try to stand on it. Ability to take four or more steps is most likely a sprain. Inability to walk on it may indicate a break.

Recognizing Foot and Ankle Injuries (2 of 2) If injured ankle cannot tolerate hopping on opposite foot, suspect a fracture. Swelling One sided indicates a sprain. Both sided indicates a fracture.

Care for Foot and Ankle Injuries Take shoes off. Use RICE procedures.

Aftercare of an Ankle Injury (1 of 2) Use the RICE treatment for 24 to 48 hours. Use a contrast bath if swelling persists. Begin range-of-motion exercises once initial swelling has decreased. Begin gentle exercises.

Aftercare of an Ankle Injury (2 of 2) Within 7 to 14 days, if pain and swelling have stopped, begin to stretch and strengthen the calf and ankle. Brace or tape healed ankle. Nonsteroidal anti-inflammatory drugs (NSAIDs)

Toe Injuries Include: Torn-off nails Hematoma formation under the nails Dislocations Fractures

Recognizing Toe Injuries Pain and swelling Deformity

Care for Toe Injuries Treat the same as a finger injury.