Fractures, Sprains, Strains, Dislocations and Bleeding

Fractures, Sprains, Strains & Dislocations

Fractures, sprains, strains and dislocations may be hard for the lay person to tell apart. For this reason, first aid treatment of any of these conditions is handled as though the injury was a fracture.

Signs and symptoms of the above conditions may include a "grating" sensation of bones rubbing together, pain, tenderness, swelling, bruising and an inability to move the injured part.

First Aid for any of these conditions consists of:

• Control bleeding, if present.
• Care for shock.
• Splint affected area to prevent further movement, but do so only if possible without causing further pain to victim.
• Cold packs may help reduce pain and swelling.

Victims with traumatic injuries, such as those caused by automobile accidents, falls etc. should not be moved except by trained rescue workers. Head, neck and back injuries are serious and require special care for movement and transport of victims with these conditions. In exceptional circumstances, such as when a victim is at risk of further injury unless moved, the victim's head and neck should be stabilized and the body moved with minimal flexing of the head, neck or spinal cord.

Bleeding

Major bleeding may be a life-threatening condition requiring immediate attention. Bleeding may be external or internal. Bleeding may be from an ARTERY, a major blood vessel which carries oxygen-rich blood from the heart throughout the body. It may be from a VEIN, which carries blood back to the heart to be oxygenated or bleeding may be from a CAPILLARY, the smallest of our body's blood vessels.

ARTERIAL bleeding is characterized by spurts with each beat of the heart, is bright red in color (although blood darkens when it meets the air) and is usually severe and hard to control. ARTERIAL bleeding requires immediate attention!

VENUS bleeding is characterized by a steady flow and the blood is dark, almost maroon in shade. Venus bleeding is easier to control than Arterial bleeding.

CAPILLARY bleeding is usually slow, oozing in nature and this type of bleeding usually has a higher risk of infection than other types of bleeding.

FIRST AID FOR BLEEDING IS INTENDED TO:

• STOP THE BLEEDING
• PREVENT INFECTION
• PREVENT SHOCK

How to control bleeding

• Apply DIRECT PRESSURE on the wound. use a dressing, if available. if a dressing is not available, use a rag, towel, piece of clothing or your hand alone.

IMPORTANT: 
ONCE PRESSURE IS APPLIED, KEEP IT IN PLACE. IF DRESSINGS BECOME SOAKED WITH BLOOD, APPLY NEW DRESSINGS OVER THE OLD DRESSINGS. THE LESS A BLEEDING WOUND IS DISTURBED, THE EASIER IT WILL BE TO STOP THE BLEEDING!

• If bleeding continues, and you do not suspect a fracture, ELEVATE the wound above the level of the heart and continue to apply direct pressure.
• If the bleeding still cannot be controlled, the next step is to apply PRESSURE AT A PRESSURE POINT. For wounds of the arms or hands, pressure points are located on the inside of the wrist ( radial artery-where a pulse is checked) or on the inside of the upper arm (brachial artery). For wounds of the legs, the pressure point is at the crease in the groin (femoral artery). Steps 1 and 2 should be continued with use of the pressure points.
• The final step to control bleeding is to apply a PRESSURE BANDAGE over the wound. Note the distinction between a dressing and a bandage. A dressing may be a gauze square applied directly to a wound, while a bandage, such as roll gauze, is used to hold a dressing in place. Pressure should be used in applying the bandage. After the bandage is in place, it is important to check the pulse to make sure circulation is not interrupted. When faced with the need to control major bleeding, it is not important that the dressings you will use are sterile! use whatever you have at hand and work fast!

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A SLOW PULSE RATE, OR BLUISH FINGERTIPS OR TOES, 
SIGNAL A BANDAGE MAY BE IMPEDING CIRCULATION.

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Signs and symptoms of INTERNAL BLEEDING are:

• bruised,swollen, tender or rigid abdomen
• bruises on chest or signs of fractured ribs
• blood in vomit
• wounds that have penetrated the chest or abdomen
• bleeding from the rectum or vagina
• abnormal pulse and difficulty breathing
• cool, moist skin

First aid in the field for internal bleeding is limited. If the injury appears to be a simple bruise, apply cold packs to slow bleeding, relieve pain and reduce swelling. If you suspect more severe internal bleeding, carefully monitor the patient and be prepared to administer CPR if required (and you are trained to do so). You should also reassure the victim, control external bleeding, care for shock (covered in next section), loosen tight-fitting clothing and place victim on side so fluids can drain from the mouth.