There are 206 bones in the human body and over 600 muscles. Bones and muscles work together to provide strength, support, protection and movement to the human body. When stressed or damaged, the body’s ability to move is affected. Sometimes severe injury to a bone can be life threatening.
A fracture is a broken or cracked bone. Fractures generally cause pain. Sometimes the pain is not detected until the bone is stressed by use. Swelling, tenderness, discoloration, and inability to move the affected body part are common. Sometimes deformity of the affected body part is noted. The location and severity of the fracture determine the signs and symptoms.
If medical help is close by do not immobilise with splints and bandages. Instead support the effected area by placing padding either side to prevent movement.
Note: Never try to put the broken bone back in place. If it is an open fracture, immobilise the protruding bone using a ring pad and bandage, covering the wound with a light bandage that does not cause pressure over the fracture.
When immobilising a fracture it is important to:
Note: Severe blood loss can occur particularly with fractured femur, so be aware to assess and manage shock.
Support as you find it, or in a position of comfort for the casualty. Seek medical assistance. If medical assistance is likely to be more than one hour away you may need to immobilise the fractured limb where possible. Place a splint or padding such as towels or clothing under the fracture and use broad bandages (where possible) to prevent movement at joints above and below the fracture. Apply an arm sling (for lower arm) or a collar and cuff sling (for upper arm) for support.
A blow to the head, neck, back or spine can cause swelling, bleeding and complicated injuries that might involve damage to the nerves. All head, neck, back and spinal injuries are potentially life threatening and might involve changes to level of consciousness, speech, hearing and coordination of movement.
Velocity accidents, that is, accidents that involve speed and sudden halting, can cause head and spinal injuries. Examples are motor vehicle, bike, bicycle and pedestrian accidents, falls and diving accidents.
Note: The spinal cord may become further damaged if the casualty moves. Do not move the casualty who has a suspected spinal injury unless their life may be in danger, for example from fire, or in order to provide basic life support, for example CPR, or to place the casualty into the recovery position if unconscious and breathing.
If the casualty is unconscious and breathing, maintaining an open airway is vital to life and therefore the casualty needs to be placed into the recovery position. For the casualty with suspected spinal injuries, great care must be taken when rolling the casualty so as to maintain alignment of the spine. This can be done using by 4-5 bystanders to assist in rolling the casualty ‘like a log’. The head, neck, spine and legs should be turned slowly and all at the same time to prevent any further trauma to the spinal cord.
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A crush injury occurs when a heavy weight has been applied to part of the body. For example, a heavy piece of machinery has trapped the casualty’s legs and crushed them.
Caution — If the crushing force is not removed immediately, or very soon after the injury occurs, do not attempt to remove the object unless advised by medical personnel.
Chest injuries often occur in falls, crush injuries and car accidents. All severe chest injuries can be potentially life threatening as the ribs and chest protect some of our most vital organs.
It is important with any chest injury that you closely monitor the casualty for signs of life.
Sprains, strains, bruising and dislocations are all examples of soft tissue injuries. If in doubt, treat them like a fracture. Excessive pain can indicate fracture.
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Sprain: A sprain occurs when ligaments around a joint have been stretched or torn.
Strain: A strain occurs when a muscle or tendon has been overstretched.
Bruising: A bruise occurs when the blood vessels below the skin are damaged. Bruising often results from a blow, knock or fall.
Dislocation: A dislocation is a joint injury that occurs when the bones around a joint have been displaced into an unnatural position. Associated soft tissue injury can occur.
Here is a summary of soft tissue injuries
|Condition||Signs and symptoms||Management|
Pain, tenderness; swelling
RICE (see below)
Pain, stiffness; swelling
RICE (see below)
Pain, tenderness; swelling, discolouration of the skin
RICE (see below)
Pain, inability to move part; joint deformed; swelling
DRABCD. If in doubt, manage as a fracture. DO NOT attempt to move bones back into place. Support in position found. Get medical help.
Strains, sprains and bruises can be generally managed using the four step R.I.C.E. technique: Rest , Ice, Compression, Elevate
R – Rest the casualty and the injured part. As movement will increase the blood flow, swelling and pain to the area the aim is to keep the part rested and supported.
I – Ice (wrapped in a wet cloth) or cold compress is applied to the injured area. Apply for approximately 20 minutes, and then reapply every two hours for approximately 20 minutes for the first 24 hours, then approximately 20 minutes every four hours for the next 24 hours.
C – Compression is applied to the injured part through the application of a compression bandage. A crepe roller bandage is often used and should support the joint or affected area.
E – Elevate the injured part, if possible.
Caution — Using ice. Never apply ice directly to the skin as this can cause ice burns and discomfort.