1. Sprains, Strains & Dislocations
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2. (Remember the ‘T’ in Strain is for Tendon)
Definitions
Sprain
Ligaments holding a joint are stretched and torn e.g. ankle sprain
Strain
Fibres of a muscle or tendon are stretched and torn e.g. groin strain
(Remember the ‘T’ in Strain is for Tendon)
Dislocation
Bones are displaced at a joint e.g. dislocated shoulder
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3. Coffs Harbour Divisional Training
Sprains
A sprain occurs when the ligaments holding a joint together are stretched and torn.
This happens when a joint is forced to move beyond its normal range
The more severe the injury, the more ligaments will be torn
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5. Signs & symptoms of Sprains
Pain from a sprain may be intense
Casualty’s ability to move the joint is restricted
There is swelling around the joint
Bruising
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Sprain
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Strains
A strain occurs when the fibres of a muscle or tendon are stretched and torn
This usually happens as a result of lifting something too heavy; working a muscle too hard or making a sudden, uncoordinated movement
Common examples are the groin and hamstring strains of footballers
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Hamstring strain
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13. Signs & Symptoms of Strains
Casualty will feel sharp pain in the region of the injury
Sharp pain on any attempt to stretch the muscle
A loss of power in the affected limb
The muscle is tender
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14. Coffs Harbour Divisional Training
Rice management
REST the casualty and the injured part.
ICEPACKS (cold compress) wrapped in a wet cloth may be applied to the injury for 15 minutes, every 2 hours for 24 hour, then for 15 minutes every 4 hours for 24 hours.
COMPRESSION apply elastic bandage, firmly to extend well beyond the injury.
ELEVATE the injured part.
If there is a lot of pain, manage the injury as a fracture and seek medical aid.
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15. Coffs Harbour Divisional Training
Soft tissue injury
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Soft tissue injury
A soft tissue injury is an acute connective tissue injury that may involve muscle, ligament, tendon, joint/capsular structures and/or cartilaginous structures.
These injuries can be categorised into three grades or degrees of severity of injury.
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First degree (mild)
The result of a mild over-stretch of ligament or capsular structures.
There is minimal swelling and bruising but mild pain is felt at the end of a movement or on stretch or contraction of muscle.
There is no joint instability, minimal muscle spasm and no overall loss of function.
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18. Second degree (moderate)
The result of moderate over-stretch of ligament or capsular structures, or direct blow to muscle, causing tearing of some fibres.
There is some swelling and bruising, with possible muscle spasm and moderate pain felt on movement , causing interference with function.
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19. Second degree (moderate)
There may be some joint instability with ligament/capsular injuries.
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Third degree (severe)
The result of a severe over-stretch of ligament, or excessive stretch or direct blow to muscle, causing a complete tear of the injured structure.
There is significant swelling and bruising with severe pain even at rest which significantly interferes with function.
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Third degree (severe)
Ligament injuries result in gross instability, with muscle injuries causing severe muscle spasm and 'splinting'.
Function is severely impaired.
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22. Coffs Harbour Divisional Training
Soft tissue injury
When the body sustains an injury, it undergoes an organised and consistent process in its attempt to heal the area.
In a sprain or strain the local network of blood vessels is damaged, and oxygenated blood can no longer reach the tissues, causing some cells to die.
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Soft tissue injury
There are three phases in the healing process:
the inflammatory phase
the proliferative phase
the maturation or remodelling phase
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Soft tissue injury
There is a certain degree of overlap between these phases.
The essential period of concern for the RICE guidelines is the inflammatory phase
Although the events occurring in the early part of the proliferative phase are also of interest.
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Soft tissue injury
The inflammatory phase may last anything up to six days
Of course the time frame will be related to the severity of the injury.
The cardinal signs of inflammation are Calor (heat), Rubor (redness), Dolor (pain) and Tumor (swelling).
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If a severe injury is suspected, the casualty should seek prompt medical advice
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27. Signs of severe injury include:
severe pain which does not subside
immediate and profuse swelling
deformity
extreme loss of function
guarding, or unusual or false motion
noises (grating / cracking) at injury site
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Dislocation
Dislocation occurs when one or more bones are displayed at a joint –most often at the shoulder, elbow, kneecap and fingers
This occurs when a strong force acts directly or indirectly on the joint and wrenches the bone into an abnormal position
This will always result in tearing of the ligaments and if the force is strong enough may cause a fracture and damage nearby nerves and blood vessels
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36. Signs & Symptoms of dislocations
Pain at or near the site of injury
Difficult or impossible to move the joint
Loss of power
Deformity or abnormal mobility
Tenderness
Swelling
Discoloration and bruising
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37. Management of Dislocation
Follow DRABCD
DO NOT attempt to reduce the dislocation
If the injury is to limb
Check circulation and if absent move limb gently to try to restore it. Call 000
Rest and support the limb and apply icepacks directly over joint
If a shoulder - support the arm in position of least discomfort (St John or full arm sling) and apply ice pack
If a wrist - support in a sling (full arm) and apply ice pack
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38. Coffs Harbour Divisional Training
Scenario 4.1
You are setting up a First Aid Post at a local fun run. As you are putting up the tent a colleague puts their foot in a hole and twists their ankle. They fall to the ground and complain of pain to their right ankle. The casualty is not able to weight‐bare, so you need to lift the casualty to a chair so they are off the wet ground. Demonstrate how you would lift and move the casualty and manage their injury?
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4.1 ASSESSMENT CHECKLIST
Check for danger What are the possible dangers?
Put on gloves
Check for response (engages to casualty in conversation to establish conscious level)
Check airway (open mouth)
Check for breathing (casualty is talking)
Secondary survey
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Casualty information
You are a member of St John Ambulance on duty at a local fun run. You are helping to put up a tent for the first aid post when you put your foot into a hole and twist your ankle. You instantly feel pain to your right ankle. You are unable to weight bare and need to be lifted to a chair as the ground is wet and you risk becoming cold if you sit on it for too long. You can wiggle your toes and do not have any loss of sensation in your foot. You do not have any medical conditions or allergies.
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4.1 ASSESSMENT CHECKLIST
Treat the ankle for a sprain using RICE
Provide medical advice
Remove gloves and dispose of appropriately
Complete a Casualty Report (OB12)
Complete Workplace Injury Form applicable to your State / Territory
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42. Coffs Harbour Divisional Training
Questions
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