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BONE, JOINT & MUSCLE
INJURIES
INTRODUCTION
 Skeleton is a framework of bones.
 Functions
 Supports the tissues of the body.
 Protects the vital organs.
 Acts as levers that change magnitude and
direction of forces generated by muscles.
TYPES OF INJURY
 Fracture
 Dislocation
 Muscle strain
 Torn ligaments
FRACTURES
 A break, split or crack in a bone
 2 main categories of fractures
 Open fracture
 Closed fracture
 Causes
 Direct force
 Indirect force
TYPES OF FRACTURES
DISLOCATIONS
 Displacement of bones at a joint
ASSESSMENT OF BONE, JOINT &
MUSCLE INJURIES
 Note as many features as possible without
moving the injured part unnecessarily.
 Try to visualise how the injury was caused.
 Compare the shape, position and appearance
of the injured part with the uninjured side.
 If in doubt about the severity of an injury, treat
it as a fracture.
ASSESSMENT OF BONE, JOINT &
MUSCLE INJURIES
 Recognition of Fracture
 Pain at or near the site of injury
 Tenderness at or near site of fracture
 Swelling & redness at or near site of injury
 Loss of function
 Deformity
 Casualty feels or hear the break occur
 Coarse grating sound is heard or felt
 DO NOT try to produce this deliberately!
ASSESSMENT OF BONE, JOINT &
MUSCLE INJURIES
 Recognition of Dislocation
 Pain at or near the site of injury
 Difficult or impossible normal movement
 Loss of power
 Swelling
 Deformity or abnormal mobility
 Tenderness
 Discolouration and bruising
CLOSED FRACTURES &
DISLOCATIONS
 Recognition
 Pain, increased by movement
 Shortening or unnatural shape to the limb
 Tenderness, swelling & bruising at the site
 There would have been a violent blow
or fall and there might have been a
snapping sound on impact.
CLOSED FRACTURES &
DISLOCATIONS
 Treatment
 Carefully stabilise and support the injured part with your
hands, holding above and below the injury.
 If necessary, gently straighten a bent limb so you can
immobilise it. Always pull straight and steadily in the natural
line of the bone. Stop if pain is too great.
 Use towels and bandages to immobilise the injured limb.
 Immobilise lower limb fractures against the sound leg, with
padding between them.
CLOSED FRACTURES &
DISLOCATIONS
 Treatment
 Immobilise upper limb fractures against the trunk in a sling.
 Call for an ambulance and treat for shock. Raise the injured
limb if possible, without causing pain or further injury.
 Every 10 minutes, check circulation beyond the bandages
and loosen them if necessary.
 DO NOT move casualty until the injury is supported and
immobilised (unless it is dangerous to stay at the scene)
 DO NOT let casualty eat or drink anything.
OPEN FRACTURES
 Recognition
 Pain, increased by movement
 Shortening or unnatural shape to the limb
 Wound, with broken end of bone visible
 There would have been a violent blow
or fall and there might have been a
snapping sound on impact.
OPEN FRACTURES
 Treatment
 Working from the uninjured side, cover the wound with a
sterile dressing.
 Apply pressure around the bone to control bleeding.
 Place cotton wool or padding over and around the dressing.
 If bone protrudes from the wound, treat as an embedded
object.
 Build up non-fluffy padding around the bone untill it is higher
than the bone.
OPEN FRACTURES
 Treatment
 Bandage dressing and padding securely to control bleeding
but without restricting circulation.
 Immobilise the injured part, as for a closed fracture.
 Call for an ambulance and treat for shock.
 Every 10 minutes, check circulation beyond the bandages
and loosen them if necessary.
 DO NOT move the casualty until the injury is supported and
immobilised (unless it is dangerous to stay at the scene).
OPEN FRACTURES
 Treatment
 DO NOT move the casualty until the injury is
supported and immobilised (unless it is
dangerous to stay at the scene).
 DO NOT let the casualty eat or drink anything.
 DO NOT press directly on a protruding bone end.
INJURIES TO THE FACE AND JAW
 Recognition
 Distortion of the eye sockets, nose, upper teeth
and palate.
 Swelling and bruising.
 Bleeding may occur from the nose or mouth or
tissue.
 Also signs of head and neck injury.
INJURIES TO THE FACE AND JAW
 Treatment
 Open & clear casualty’s airway.
 Place the casualty in recovery position.
 Remains in the recovery position, if you have to carry the
casualty on stretcher.
 If jawbone is injured, place soft padding under the head to
keep weight off the jaw.
 DO NOT apply a jaw bandage.
INJURIES TO THE UPPER LIMB
FRACTURED COLLAR BONE
 Recognition
 Pain & tenderness at the
site of the injury.
 Pain, increased by
movement.
 Casualty may support
the arm at the elbow and
incline the head to the
injured side.
INJURIES TO THE UPPER LIMB
FRACTURED COLLAR BONE
 Treatment
 Place the injured arm across the chest and ask
the casualty to support at the elbow.
 Apply an elevation sling.
 Place soft padding between the injured arm and
the body.
 Support with a broad bandage.
INJURIES TO THE UPPER LIMB
DISLOCATED SHOULDER
 Recognition
 Pain, increased by
movement.
 Reluctance to move.
 Casualty often supports
the arm and inclines the
head to the injured side.
 A flat, angular look to the
shoulder.
INJURIES TO THE UPPER LIMB
DISLOCATED SHOULDER
 Treatment
 Place the injured arm across the chest gently at
an angle that causes the least pain.
 Support the injured arm with an arm sling.
 Send casualty to the hospital, keeping the
casualty in a seated position.
 DO NOT replace the bone in position.
INJURIES TO THE UPPER LIMB
FRACTURED UPPER ARM
 Recognition
 Pain, increased by
movement.
 Tenderness over the
fracture site.
 Rapid swelling.
 Bruising.
INJURIES TO THE UPPER LIMB
FRACTURED UPPER ARM
 Treatment
 Ask the casualty to sit down.
 Gently place the injured arm across casualty’s
chest in the position that is most comfortable.
 Ask the casualty to support the injured arm, if
possible.
 Place the affected arm in an arm sling.
INJURIES TO THE UPPER LIMB
FRACTURED UPPER ARM
 Treatment
 Place soft padding between the arm and the
chest.
 Secure the limb to the chest by tying a broad
bandage around the chest and over the sling.
 Send the casualty to hospital, keeping the
casualty in a seated position.
INJURIES AROUND THE ELBOW
 Recognition
 Pain, increased by movement.
 Tenderness over the fracture site.
 Possible swelling and bruising.
 Fixed elbow if the head of the radius is fractured.
INJURIES AROUND THE ELBOW
 Treatment for an elbow that can bend
 Treat as for a fracture of the upper arm.
 Check the affected wrist pulse every 10 minutes.
 Treatment for an elbow that cannot bend
 Lay casualty down.
 Place padding, such as cushions or towels around
the elbow for comfort and support.
INJURIES TO THE FOREARM &
WRIST
 Recognition
 Pain, increased by
movement.
 Tenderness over the
fracture site.
 Possible swelling &
bruising.
INJURIES TO THE FOREARM &
WRIST
 Treatment
 Ask the casualty to sit down.
 Gently stabilise and support the injured forearm
across casualty’s chest.
 If necessary, carefully expose and treat any
wound.
 Place a triangular bandage between the chest
and the injured arm, as for an arm sling.
 Gently surround the forearm in soft padding.
INJURIES TO THE FOREARM &
WRIST
 Treatment
 Tie the arm and its padding in an arm sling to
support it.
 If necessary, secure the limb to the chest using a broad
bandage. Tie it over the sling, positioning it close to the
elbow.
 Send the casualty to hospital and keeping casualty in a
seated position.
 Can also use splint to support the injured forearm.
INJURIES TO THE HAND &
FINGERS
 Treatment
 Remove any rings before the hand begins to
swell.
 Keep the hand raised to reduce swelling.
 Protect the injured hand by wrapping it in folds of
soft padding.
 Gently support the affected arm in an elevation
sling.
INJURIES TO THE HAND &
FINGERS
 Treatment
 If necessary, secure the arm to the chest by tying
a broad bandage around the chest and over the
sling.
 Send casualty to hospital, keeping casualty in a
seated position.
 Use the sound finger as a splint.
FRACTURES OF THE RIBCAGE
Recognition
 Sharp pain at the site of fracture.
 Pain on taking a deep breath.
 Shallow breathing.
 Paradoxical breathing
 Chest moves in during inhalation, out during exhalation
 An open wound over the fracture through which you might
hear air being “sucked” into the chest cavity.
 Features of internal bleeding and shock.
FRACTURES OF THE RIBCAGE
 Treatment for a fractured rib
 Support the limb on the injured side in an arm
sling.
 Send casualty to hospital.
FRACTURES OF THE RIBCAGE
 Treatment for open/multiple fractures
 Immediately cover and seal any wounds to the
chest wall.
 Place casualty in the most comfortable position.
 Half-sitting, head, shoulders and body turned towards
the injured side.
 Support the limb on the injured side in an
elevation sling.
FRACTURES OF THE RIBCAGE
 Treatment for open/multiple fractures
 Call for an ambulance.
 If casualty becomes unconscious, place casualty
in recovery position, uninjured side uppermost.
SPINAL INJURY
 Causes
 Falling from a height.
 Falling awkwardly while doing gymnastics.
 Diving into a shallow pool and hitting the bottom.
 Being thrown from a horse or from a motorbike.
 Being in a collapsed rugby scrum.
 A heavy object falling across the back.
 Injury to the head or face.
SPINAL INJURY
 Recognition
 When only the bones of the spinal column are
damaged, there may be:
 Pain in the neck or the back at the level of injury
 A step, irregularity, or twist in the normal curve of
the spine.
 Tenderness on gently feeling the spine.
SPINAL INJURY
 Recognition
 When the spinal cord is also damaged, there may
be:
 Loss of control over limbs; movement may be weak or
absent.
 Loss of normal sensation.
 Abnormal sensations such as burning or tingling.
 Breathing difficulties.
SPINAL INJURY
CHECKING FOR SPINAL CORD INJURY
 Examine the casualty carefully in the position
found
 Ask helper to maintain support at casualty’s head.
 Ask casualty to move limbs to test for loss of power.
 Touch casualty without casualty knowing to test for loss of
sensation.
SPINAL INJURY
 Treatment for a conscious casualty
 DO NOT move the casualty from the position found,
unless he or she is in danger or becomes
unconscious.
 Reassure the casualty and tell casualty not to move.
 Stabilise and support casualty’s head in neutral
position by placing your hands over casualty’s ears.
Maintain this support throughout.
SPINAL INJURY
 Treatment for a conscious casualty
 If you suspect neck injury, get a helper to place
rolled-up blankets or articles of clothing on both
sides of the casualty’s neck and shoulders.
 Call for an ambulance.
 You may apply a collar if the neck is injured.
SPINAL INJURY
 Treatment for an unconscious casualty
 Check ABC & perform CPR if necessary.
 Maintain airway.
 Call for an ambulance.
 Keep casualty’s head, trunk and toes in a straight line at all
times.
 Check for pulse and breathing regularly.
FRACTURED PELVIS
 Recognition
 Inability to walk or even stand.
 Pain & tenderness in the region of the hip, groin or back.
Increased when the casualty moves.
 Blood at the urinary orifice especially in a male casualty.
 The casualty may not be able to pass urine or may find this
painful.
 Signs of shock & internal bleeding.
FRACTURED PELVIS
 Treatment
 Help casualty to lie on his or her back.
 Straighten casualty’s leg or if it is more comfortable, help
casualty to bend his or her knees slightly and support them.
 Immobilise his legs by bandaging them together, placing
padding between the bony points.
 Call for an ambulance.
 DO NOT bandage the legs together if this causes
intolerable pain.
INJURIES TO THE LOWER LIMB
HIP & THIGH FRACTURE
 Recognition
 Pain at the site of the injury.
 Inability to walk.
 Signs of shock.
 Shortening of the thigh.
 A turning outwards of the knee and foot.
INJURIES TO THE LOWER LIMB
HIP & THIGH FRACTURE
 Treatment
 Lay the casualty down gently.
 Ask helper to stabilise and support the injured limb.
 Gently straighten the lower leg and apply traction at the
angle, if appropriate.
 Call for an ambulance.
 Treat shock but do not raise casualty’s legs.
INJURIES TO THE LOWER LIMB
HIP & THIGH FRACTURE
 Treatment
 If ambulance is delayed, immobilise the limb by securing or
splinting it to the uninjured limb.
 Gently bring the casualty’s sound limb alongside the injured
one.
 Maintaining traction throughout at the ankle.
 Insert padding between the thighs, knees and ankles.
 Tie the bandages around casualty’s ankles and knees &
above and below the fracture.
 Release traction only when all bandaging knots are tied.
INJURIES TO THE LOWER LIMB
HIP & THIGH FRACTURE
 Treatment for transporting a casualty
over distance
 Place a leg splint, from the armpit to the foot,
against side.
 Pad between the legs and between the splint and
body.
 Secure the splint and the body with bandages.
INJURIES TO THE LOWER LIMB
KNEE JOINT
 Recognition
 A recent twist or blow to the knee.
 Pain, spreading from the injury to become deep-seated in
the joint.
 If the bent knee has “locked”, acute pain on attempting to
straighten the leg.
 Rapid swelling at the knee joint.
INJURIES TO THE LOWER LIMB
KNEE JOINT
 Treatment
 Help casualty to lie down.
 Place soft padding under the injured knee to
support it in the most comfortable position.
 Hold padding in place with bandage.
 Send casualty to hospital.
INJURIES TO THE LOWER LIMB
KNEE JOINT
 Treatment
 DO NOT attempt to straighten the knee forcibly.
 DO NOT give anything by mouth.
 DO NOT allow the casualty to walk.
INJURIES TO THE LOWER LIMB
LOWER LEG
 Recognition
 Localised pain.
 A recent blow or wrench of the foot.
 Inability to walk.
 Open wound may occur.
INJURIES TO THE LOWER LIMB
LOWER LEG
 Treatment
 Stabilise and support the injured leg.
 Gently expose and treat any wound if necessary.
 Straighten the leg using traction.
 Support the leg with your hands until the
ambulance arrives.
INJURIES TO THE LOWER LIMB
LOWER LEG
 Treatment
 If ambulance is delayed:
 Bring the sound limb to the injured leg.
 Insert padding between the knees and ankles and
between the calves.
 Tie the bandages firmly around ankles and knees,
then above and below the fracture.
TREATMENT FOR SOFT TISSUE
INJURIES
 REST
 I CE
 COMPRESS
 ELEVATE

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Sec1.fa7 bone, joint & muscle injuries

  • 1. BONE, JOINT & MUSCLE INJURIES
  • 2. INTRODUCTION  Skeleton is a framework of bones.  Functions  Supports the tissues of the body.  Protects the vital organs.  Acts as levers that change magnitude and direction of forces generated by muscles.
  • 3. TYPES OF INJURY  Fracture  Dislocation  Muscle strain  Torn ligaments
  • 4. FRACTURES  A break, split or crack in a bone  2 main categories of fractures  Open fracture  Closed fracture  Causes  Direct force  Indirect force
  • 7. ASSESSMENT OF BONE, JOINT & MUSCLE INJURIES  Note as many features as possible without moving the injured part unnecessarily.  Try to visualise how the injury was caused.  Compare the shape, position and appearance of the injured part with the uninjured side.  If in doubt about the severity of an injury, treat it as a fracture.
  • 8. ASSESSMENT OF BONE, JOINT & MUSCLE INJURIES  Recognition of Fracture  Pain at or near the site of injury  Tenderness at or near site of fracture  Swelling & redness at or near site of injury  Loss of function  Deformity  Casualty feels or hear the break occur  Coarse grating sound is heard or felt  DO NOT try to produce this deliberately!
  • 9. ASSESSMENT OF BONE, JOINT & MUSCLE INJURIES  Recognition of Dislocation  Pain at or near the site of injury  Difficult or impossible normal movement  Loss of power  Swelling  Deformity or abnormal mobility  Tenderness  Discolouration and bruising
  • 10. CLOSED FRACTURES & DISLOCATIONS  Recognition  Pain, increased by movement  Shortening or unnatural shape to the limb  Tenderness, swelling & bruising at the site  There would have been a violent blow or fall and there might have been a snapping sound on impact.
  • 11. CLOSED FRACTURES & DISLOCATIONS  Treatment  Carefully stabilise and support the injured part with your hands, holding above and below the injury.  If necessary, gently straighten a bent limb so you can immobilise it. Always pull straight and steadily in the natural line of the bone. Stop if pain is too great.  Use towels and bandages to immobilise the injured limb.  Immobilise lower limb fractures against the sound leg, with padding between them.
  • 12. CLOSED FRACTURES & DISLOCATIONS  Treatment  Immobilise upper limb fractures against the trunk in a sling.  Call for an ambulance and treat for shock. Raise the injured limb if possible, without causing pain or further injury.  Every 10 minutes, check circulation beyond the bandages and loosen them if necessary.  DO NOT move casualty until the injury is supported and immobilised (unless it is dangerous to stay at the scene)  DO NOT let casualty eat or drink anything.
  • 13. OPEN FRACTURES  Recognition  Pain, increased by movement  Shortening or unnatural shape to the limb  Wound, with broken end of bone visible  There would have been a violent blow or fall and there might have been a snapping sound on impact.
  • 14. OPEN FRACTURES  Treatment  Working from the uninjured side, cover the wound with a sterile dressing.  Apply pressure around the bone to control bleeding.  Place cotton wool or padding over and around the dressing.  If bone protrudes from the wound, treat as an embedded object.  Build up non-fluffy padding around the bone untill it is higher than the bone.
  • 15. OPEN FRACTURES  Treatment  Bandage dressing and padding securely to control bleeding but without restricting circulation.  Immobilise the injured part, as for a closed fracture.  Call for an ambulance and treat for shock.  Every 10 minutes, check circulation beyond the bandages and loosen them if necessary.  DO NOT move the casualty until the injury is supported and immobilised (unless it is dangerous to stay at the scene).
  • 16. OPEN FRACTURES  Treatment  DO NOT move the casualty until the injury is supported and immobilised (unless it is dangerous to stay at the scene).  DO NOT let the casualty eat or drink anything.  DO NOT press directly on a protruding bone end.
  • 17. INJURIES TO THE FACE AND JAW  Recognition  Distortion of the eye sockets, nose, upper teeth and palate.  Swelling and bruising.  Bleeding may occur from the nose or mouth or tissue.  Also signs of head and neck injury.
  • 18. INJURIES TO THE FACE AND JAW  Treatment  Open & clear casualty’s airway.  Place the casualty in recovery position.  Remains in the recovery position, if you have to carry the casualty on stretcher.  If jawbone is injured, place soft padding under the head to keep weight off the jaw.  DO NOT apply a jaw bandage.
  • 19. INJURIES TO THE UPPER LIMB FRACTURED COLLAR BONE  Recognition  Pain & tenderness at the site of the injury.  Pain, increased by movement.  Casualty may support the arm at the elbow and incline the head to the injured side.
  • 20. INJURIES TO THE UPPER LIMB FRACTURED COLLAR BONE  Treatment  Place the injured arm across the chest and ask the casualty to support at the elbow.  Apply an elevation sling.  Place soft padding between the injured arm and the body.  Support with a broad bandage.
  • 21. INJURIES TO THE UPPER LIMB DISLOCATED SHOULDER  Recognition  Pain, increased by movement.  Reluctance to move.  Casualty often supports the arm and inclines the head to the injured side.  A flat, angular look to the shoulder.
  • 22. INJURIES TO THE UPPER LIMB DISLOCATED SHOULDER  Treatment  Place the injured arm across the chest gently at an angle that causes the least pain.  Support the injured arm with an arm sling.  Send casualty to the hospital, keeping the casualty in a seated position.  DO NOT replace the bone in position.
  • 23. INJURIES TO THE UPPER LIMB FRACTURED UPPER ARM  Recognition  Pain, increased by movement.  Tenderness over the fracture site.  Rapid swelling.  Bruising.
  • 24. INJURIES TO THE UPPER LIMB FRACTURED UPPER ARM  Treatment  Ask the casualty to sit down.  Gently place the injured arm across casualty’s chest in the position that is most comfortable.  Ask the casualty to support the injured arm, if possible.  Place the affected arm in an arm sling.
  • 25. INJURIES TO THE UPPER LIMB FRACTURED UPPER ARM  Treatment  Place soft padding between the arm and the chest.  Secure the limb to the chest by tying a broad bandage around the chest and over the sling.  Send the casualty to hospital, keeping the casualty in a seated position.
  • 26. INJURIES AROUND THE ELBOW  Recognition  Pain, increased by movement.  Tenderness over the fracture site.  Possible swelling and bruising.  Fixed elbow if the head of the radius is fractured.
  • 27. INJURIES AROUND THE ELBOW  Treatment for an elbow that can bend  Treat as for a fracture of the upper arm.  Check the affected wrist pulse every 10 minutes.  Treatment for an elbow that cannot bend  Lay casualty down.  Place padding, such as cushions or towels around the elbow for comfort and support.
  • 28. INJURIES TO THE FOREARM & WRIST  Recognition  Pain, increased by movement.  Tenderness over the fracture site.  Possible swelling & bruising.
  • 29. INJURIES TO THE FOREARM & WRIST  Treatment  Ask the casualty to sit down.  Gently stabilise and support the injured forearm across casualty’s chest.  If necessary, carefully expose and treat any wound.  Place a triangular bandage between the chest and the injured arm, as for an arm sling.  Gently surround the forearm in soft padding.
  • 30. INJURIES TO THE FOREARM & WRIST  Treatment  Tie the arm and its padding in an arm sling to support it.  If necessary, secure the limb to the chest using a broad bandage. Tie it over the sling, positioning it close to the elbow.  Send the casualty to hospital and keeping casualty in a seated position.  Can also use splint to support the injured forearm.
  • 31. INJURIES TO THE HAND & FINGERS  Treatment  Remove any rings before the hand begins to swell.  Keep the hand raised to reduce swelling.  Protect the injured hand by wrapping it in folds of soft padding.  Gently support the affected arm in an elevation sling.
  • 32. INJURIES TO THE HAND & FINGERS  Treatment  If necessary, secure the arm to the chest by tying a broad bandage around the chest and over the sling.  Send casualty to hospital, keeping casualty in a seated position.  Use the sound finger as a splint.
  • 33. FRACTURES OF THE RIBCAGE Recognition  Sharp pain at the site of fracture.  Pain on taking a deep breath.  Shallow breathing.  Paradoxical breathing  Chest moves in during inhalation, out during exhalation  An open wound over the fracture through which you might hear air being “sucked” into the chest cavity.  Features of internal bleeding and shock.
  • 34. FRACTURES OF THE RIBCAGE  Treatment for a fractured rib  Support the limb on the injured side in an arm sling.  Send casualty to hospital.
  • 35. FRACTURES OF THE RIBCAGE  Treatment for open/multiple fractures  Immediately cover and seal any wounds to the chest wall.  Place casualty in the most comfortable position.  Half-sitting, head, shoulders and body turned towards the injured side.  Support the limb on the injured side in an elevation sling.
  • 36. FRACTURES OF THE RIBCAGE  Treatment for open/multiple fractures  Call for an ambulance.  If casualty becomes unconscious, place casualty in recovery position, uninjured side uppermost.
  • 37. SPINAL INJURY  Causes  Falling from a height.  Falling awkwardly while doing gymnastics.  Diving into a shallow pool and hitting the bottom.  Being thrown from a horse or from a motorbike.  Being in a collapsed rugby scrum.  A heavy object falling across the back.  Injury to the head or face.
  • 38. SPINAL INJURY  Recognition  When only the bones of the spinal column are damaged, there may be:  Pain in the neck or the back at the level of injury  A step, irregularity, or twist in the normal curve of the spine.  Tenderness on gently feeling the spine.
  • 39. SPINAL INJURY  Recognition  When the spinal cord is also damaged, there may be:  Loss of control over limbs; movement may be weak or absent.  Loss of normal sensation.  Abnormal sensations such as burning or tingling.  Breathing difficulties.
  • 40. SPINAL INJURY CHECKING FOR SPINAL CORD INJURY  Examine the casualty carefully in the position found  Ask helper to maintain support at casualty’s head.  Ask casualty to move limbs to test for loss of power.  Touch casualty without casualty knowing to test for loss of sensation.
  • 41. SPINAL INJURY  Treatment for a conscious casualty  DO NOT move the casualty from the position found, unless he or she is in danger or becomes unconscious.  Reassure the casualty and tell casualty not to move.  Stabilise and support casualty’s head in neutral position by placing your hands over casualty’s ears. Maintain this support throughout.
  • 42. SPINAL INJURY  Treatment for a conscious casualty  If you suspect neck injury, get a helper to place rolled-up blankets or articles of clothing on both sides of the casualty’s neck and shoulders.  Call for an ambulance.  You may apply a collar if the neck is injured.
  • 43. SPINAL INJURY  Treatment for an unconscious casualty  Check ABC & perform CPR if necessary.  Maintain airway.  Call for an ambulance.  Keep casualty’s head, trunk and toes in a straight line at all times.  Check for pulse and breathing regularly.
  • 44. FRACTURED PELVIS  Recognition  Inability to walk or even stand.  Pain & tenderness in the region of the hip, groin or back. Increased when the casualty moves.  Blood at the urinary orifice especially in a male casualty.  The casualty may not be able to pass urine or may find this painful.  Signs of shock & internal bleeding.
  • 45. FRACTURED PELVIS  Treatment  Help casualty to lie on his or her back.  Straighten casualty’s leg or if it is more comfortable, help casualty to bend his or her knees slightly and support them.  Immobilise his legs by bandaging them together, placing padding between the bony points.  Call for an ambulance.  DO NOT bandage the legs together if this causes intolerable pain.
  • 46. INJURIES TO THE LOWER LIMB HIP & THIGH FRACTURE  Recognition  Pain at the site of the injury.  Inability to walk.  Signs of shock.  Shortening of the thigh.  A turning outwards of the knee and foot.
  • 47. INJURIES TO THE LOWER LIMB HIP & THIGH FRACTURE  Treatment  Lay the casualty down gently.  Ask helper to stabilise and support the injured limb.  Gently straighten the lower leg and apply traction at the angle, if appropriate.  Call for an ambulance.  Treat shock but do not raise casualty’s legs.
  • 48. INJURIES TO THE LOWER LIMB HIP & THIGH FRACTURE  Treatment  If ambulance is delayed, immobilise the limb by securing or splinting it to the uninjured limb.  Gently bring the casualty’s sound limb alongside the injured one.  Maintaining traction throughout at the ankle.  Insert padding between the thighs, knees and ankles.  Tie the bandages around casualty’s ankles and knees & above and below the fracture.  Release traction only when all bandaging knots are tied.
  • 49. INJURIES TO THE LOWER LIMB HIP & THIGH FRACTURE  Treatment for transporting a casualty over distance  Place a leg splint, from the armpit to the foot, against side.  Pad between the legs and between the splint and body.  Secure the splint and the body with bandages.
  • 50. INJURIES TO THE LOWER LIMB KNEE JOINT  Recognition  A recent twist or blow to the knee.  Pain, spreading from the injury to become deep-seated in the joint.  If the bent knee has “locked”, acute pain on attempting to straighten the leg.  Rapid swelling at the knee joint.
  • 51. INJURIES TO THE LOWER LIMB KNEE JOINT  Treatment  Help casualty to lie down.  Place soft padding under the injured knee to support it in the most comfortable position.  Hold padding in place with bandage.  Send casualty to hospital.
  • 52. INJURIES TO THE LOWER LIMB KNEE JOINT  Treatment  DO NOT attempt to straighten the knee forcibly.  DO NOT give anything by mouth.  DO NOT allow the casualty to walk.
  • 53. INJURIES TO THE LOWER LIMB LOWER LEG  Recognition  Localised pain.  A recent blow or wrench of the foot.  Inability to walk.  Open wound may occur.
  • 54. INJURIES TO THE LOWER LIMB LOWER LEG  Treatment  Stabilise and support the injured leg.  Gently expose and treat any wound if necessary.  Straighten the leg using traction.  Support the leg with your hands until the ambulance arrives.
  • 55. INJURIES TO THE LOWER LIMB LOWER LEG  Treatment  If ambulance is delayed:  Bring the sound limb to the injured leg.  Insert padding between the knees and ankles and between the calves.  Tie the bandages firmly around ankles and knees, then above and below the fracture.
  • 56. TREATMENT FOR SOFT TISSUE INJURIES  REST  I CE  COMPRESS  ELEVATE