People fall and in injure themselves all the time. More often than not, they dust themselves down, laugh it off and carry on. But what if they have seriously hurt themselves, and more importantly, how can we tell?
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If a casualty has an injury to their bones, muscles or joints, your aim as a first aider is to prevent further injury. Because of the signs and symptoms, it may be difficult for the first aider to recognise the difference between a fracture, dislocation, strain or sprain.
No first aider is expected to make a diagnosis, but instead recognise a serious injury to the bone, muscle or joint and arrange appropriate medical treatment.
Broken bones are usually caused by considerable direct or indirect force (but might require less force in an elderly casualty or those with Osteoporosis – brittle bone disease).
They can range from relatively minor breaks, such as fingers or toes, to major breaks that are potentially life-threatening. An example of a nastier breaks is the pelvis, where complications to surrounding organs and the blood supply leads to internal bleeding.
Different Types of Injury to the Bone:
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Breaks are usually closed, where the bone remains within the body. However, sometimes these can open where the bone has broken the skin.
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In younger children, it is common to see ‘green stick’ breaks where the bone has bent and fractured, but not snapped completely. This is because the younger we are, the lower density our bones. As a result, they are more flexible.
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A dislocation is where a joint is fully or partially pulled out of position. Common sites of dislocation include the knee, hip, shoulders or fingers.
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Strains and sprains are injuries to muscles, tendons and ligaments. They are usually caused by overstretching or forceful twisting of a joint.
Possible Signs and Symptoms:
- Pain and tenderness
- Irregularity
- Swelling and bruising
- A grating sensation or noise from the bone ends rubbing together (crepitus)
- Loss of power or use of a limb
- A shortening of the limb
- Shock
Treatment:
- Tell the casualty to keep as still as possible
- If possible, elevate and support the injury
- Immobilise to avoid further movement. Immobilise only if it will not cause further pain or damage. Immobilisation may just be padding or supporting the injury.
- If appropriate, apply an ice pack or cold compress. This will help control swelling. Wrap the ice pack in a towel or similar to avoid contact with the skin. Keep the ice pack in place for 10 minutes at a time.
- Keep the casualty warm
- Nothing to eat or drink
- Treat for shock if needed
- Call for an ambulance unless minor
- Never attempt to reposition or relocate a dislocation – it is likely to cause severe pain and even further injury
- Additionally (for an open fracture) cover any open wounds with a clean and preferably sterile dressing
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