Fractures, Dislocations, Soft Tissue Injury

Hint

A soft tissue injury is the damage to muscles, ligaments and tendons anywhere in the body. Common soft tissue injuries usually occur from a sprain, strain, a one off blow resulting in a contusion or overuse of a particular part of the body. Soft tissue injuries can result in pain, swelling, bruising and loss of function. It can be difficult to distinguish between a soft tissue injury and a fracture. If unsure, treat the injury as a fracture and seek medical assistance.

Hint

Follow the DRSABCD emergency action plan.

Call 000 for an ambulance urgently.

Check for warmth or pulse to the hand on the injured side; if no circulation gently adjust the position of the limb until circulation returns. This should only be done with great care and if the arm is showing signs of insufficient circulation i.e. skin is pale or blue in colour and cool to touch.

Treat any wounds.

Use an ‘elevation arm sling’.

Position the affected arm with the casualty’s hand placed on the opposite shoulder.

Using the longest side of the sling, drape it on top of the arm.

Gently tuck the sling under the arm up to elbow forming a pocket for the injured arm.

Gather the rest of the sling at the elbow and twist anti-clockwise.

Pull the sling around the back of the casualty firmly and tie off on the uninjured side.

Pad under the knot.

Continue to check the limb for circulation.

If required, you can place a broad fold bandage around the casualty to secure the arm to the casualty’s chest. This is to prevent movement of the arm. If the casualty has found a comfortable position with the fractured collarbone try and splint it in this position.

DO NOT let the casualty eat or drink anything until seen by a doctor, in case surgery is required.

Reassure the casualty.

Monitor the casualty for signs of shock.

Hint

Control bleeding and treat wounds.

Allow any fluid coming from the ear to drain freely. If in recovery position put injured side down with a pad placed over the affected ear.

Reassure the casualty and monitor pulse, respirations and level of consciousness closely for any deterioration.

The casualty should never be left alone and if consciousness returns, the casualty should be given reassurance and kept lying down at rest while awaiting the arrival of the ambulance.

Hint

Call 000 for an ambulance urgently.

If the casualty is conscious, lay them flat on their back with their knees slightly bent, elevate the lower legs slightly and support if possible (remember all unconscious casualties should be placed on their side).

Remove everything from the casualty’s pockets and give to relatives or friend.

Immobilise the legs by placing a broad fold bandage around the thighs and a narrow fold bandage around the ankles.

Support both hips with folded blankets on either side.

Discourage the casualty from urinating.

Treat the casualty gently, as they could have further fractures of the legs or internal injuries.

DO NOT let the casualty eat or drink anything until seen by a doctor, in case surgery is required.

Reassure the casualty.

Monitor the casualty for signs of shock.

Hint

Minor Wounds

These guidelines can help you care for minor cuts and scrapes.

Wash your hands. This helps avoid infection.

Stop the bleeding. Minor cuts and scrapes usually stop bleeding on their own. If needed, apply gentle pressure with a clean bandage or cloth and elevate the wound until bleeding stops.

Clean the wound. Rinse the wound with water. Keeping the wound under running tap water will reduce the risk of infection. Wash around the wound with soap. But don’t get soap in the wound. And don’t use hydrogen peroxide or iodine, which can be irritating. Remove any dirt or debris with tweezers cleaned with alcohol. See a doctor if you can’t remove all debris.

Apply an antibiotic cream. Apply a thin layer of antibiotic cream to keep the surface moist and help prevent scarring. Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the ointment.

Cover the wound. Apply a sterile dressing. Change the dressing daily or when soiled. When the dressing is changed, clean the site and reapply antibacterial cream. Covering the wound keeps it clean. If the wound is a minor scrape or scratch, leave it uncovered.

Get a tetanus shot. If you have not had a tetanus shot in the past five years and the wound is deep or dirty.

Watch for signs of infection. See a doctor if you see signs of infection on the skin or near the wound, such as redness, increasing pain, drainage, warmth or swelling.

Hint

 Check for warmth or pulse to the hand on the injured side; if no circulation gently adjust the position of the limb until circulation returns. This should only be done with great care and if the arm is showing signs of insufficient circulation i.e. skin is pale or blue in colour and cool to touch.

 Continue to check the limb for circulation.

 If required, you can place a broad fold bandage around the casualty to secure the arm to the casualty’s chest. This is to prevent movement of the arm. If the casualty has found a comfortable position with the fractured collarbone try and splint it in this position.

Hint

Change in level of consciousness; drowsy, vague, becomes unconscious.

Anxious, irritable, irrational, uncooperative.

Memory impairment.

Blood or clear fluid coming from the ears, eyes, nose or mouth (suspect a base of skull fracture).

Changes in the size and shape of pupils, blurred vision.

Head wound or deformity to the skull (complicated skull fracture).

Difficulty in breathing.

Headaches and/or dizziness.

History of trauma.

Nausea or vomiting.

Seizures.

Slurred speech.

Swelling around one or both eyes.

Follow the DRSABCD emergency action plan.

Call 000 for an ambulance urgently.

Always suspect a spinal injury – apply a cervical collar to immobilise the neck only if trained to do so.

If drowsy or unconscious and breathing normally; place in recovery position while supporting the neck.

Control bleeding and treat wounds.

Allow any fluid coming from the ear to drain freely. If in recovery position put injured side down with a pad placed over the affected ear.

Reassure the casualty and monitor pulse, respirations and level of consciousness closely for any deterioration.

While regaining consciousness the casualty may vomit, have blurred vision, be irrational and uncooperative, be dizzy and have memory loss and be unable to recall events surrounding the accident.

The casualty should never be left alone and if consciousness returns, the casualty should be given reassurance and kept lying down at rest while awaiting the arrival of the ambulance.

If a casualty has a suspected skull fracture, DO NOT place any pressure on the area, as this can put direct pressure onto the brain and cause brain damage.

Hint

Deformity of the joint.

Loss of power and movement at the joint.

Sudden severe pain and tenderness in the affected joint.

May have some temporary paralysis of the injured limb.