first aid in fractures
TRANSCRIPT
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M.Hakan DURAL M.D.
BONE, JOINT, AND
MUSCLE INJURIES
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Some signs of serious muscle, bone or joint injuries: Significant deformity
Bruising and swelling
Inability to use the affected part normally
Bone fragments sticking out of the wound
Person feels bone grating after injury
Heard a snap or pop sound at the time of injury
The injured area is cold or numb
Cause of the injury suggests that the injury may be
severe
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Fractures
any break in a bone
Dislocation
when one end of a bone making up a joint is pulled or
pushed out of place
Sprain
when a ligament is torn (ankle, knee, finger…)
Strain
stretching of a muscle or tendon or mild tearing of muscle
(neck, lower back…)
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There are two categories of fractures:
Closed (Simple) fracture
○ The skin is intact and no wound exists anywhere near
the fracture site.
Open (Compound) fracture
○ The skin over the fracture has been damaged or broken.
○ The wound may result from bone protruding through the
skin.
○ The bone may not always be visible in the wound.
Fractures
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Fractures What to Look for:
General signs and Symptoms:○Tenderness to touch. ○Swelling.○Deformities may occur when bones are broken, causing an abnormal shape.○Open wounds break the skin.○A grating sensation caused by broken bones rubbing together can be felt and sometimes even heard.Do not move the injured limb in an attempt to detect it.○Loss of use.
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Fractures
Additional signs and symptoms include:
The history of the injury can lead to suspect
a fracture whenever a serious accident has
happened.
○ The victim may have heard or felt the bone
snap.
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Simple:
This is a clean break orcrack in the bone
Simple Fracture
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Comminute:
This is a type of fracturethat produces multiple bonefragments
Comminuted Fracture
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Green stick:
A split in a young, immaturebone. Most common in children
Green-Stick Fracture15
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Open:
In a open fracture, part ofthe bone breaks through theskin causing bleeding
The exposed bone isVulnerable to contamination
Wound
Open Fracture
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Closed:
The surrounding skin isunbroken.
Closed Fracture
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Open Fractures
Call for medical help. 112 If necessary, control bleeding by applying
continuous pressure above the fracture site. Cover wound with dry sterile dressing. Stabilize the injured area in position found.
Splint if necessary. Monitor and treat for shock if present. Nothing to eat or drink
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Dislocations
Partial or full displacement of bones at a joint
Tears ligaments Associated fracture External wrenching force Violent muscle contraction Do not attempt to replace joint
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Dislocations
Support injured part Secure injured part 112 Circulation
(10 minutes) N.B. Traction in extreme locations
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Soft Tissue Injuries - Sprains
Sprains are injuries due to: Stretching or tearing
ligaments or other tissues at a joint.
Caused by a sudden twist or stretch of a joint beyond it’s normal motion
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Soft Tissue Injuries - Sprains
The Symptoms of a Sprain are: Pain on movement Swelling Tenderness Discoloration
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Soft Tissue Injuries - StrainsThe Symptoms of a strain are; Intense pain Moderate swelling Painful movement Difficult movement Sometimes, discolouration
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Soft Tissue Injuries - Strains A strain is an injury to a muscle or
tendon caused by over-exertion. In severe cases muscles or tendons are
torn and the muscle fibres are stretched.
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Assessment of Injuries History: (Ask the casualty what happened)
Violent blow or fallSnapping soundSharp pain
Compare:One side of the body against another
Visualise:Try and imagine what happened
X-ray:Injury may not be obvious
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Assessment of injuries
Recognition; Difficulty moving limbs Pain made worse by movement Distortion Coarse grating at bone ends Shock (Femur, Ribcage, Pelvis) Shortening, bending or twisting
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IF IN DOUBT - TREAT AS A FRACTURE !
IF IN DOUBT - TREAT AS A FRACTURE !
Soft Tissue injuries Treatment (RICER)
Rest the injured part. Apply Ice or cold compress.
(15-20mins) Compress the injury. Elevate the injured part. Rehabilitate / Recuperation
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The most common indicator of the severity of the injury is the intensity of the pain. Also the area may be swollen, red and bruised. Follow the below mentioned general guidelines (RICE): Rest: Do not move or straighten the injury
Immobilize: Try to stabilize the person in the position he/she was found. Splint or sling the injured part only and caution to move the person; it should not be more painful.
Cold: Indirectly cool the part using ice for a maximum of 20 minutes. Remove it for 20 minutes and then cool the part again.
Elevate: Only elevate the part if it does not cause more pain.
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