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بسم الله الرحمن الرحيم. First aid of traumatology. By Khaled Issa , Wael Azam Orthopedic Department Tanta University. First – Aid for Fractures. Simple (closed) fracture : there is no skin wound leading to the fractre. Compound (open) fracture :
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First aid of traumatology By Khaled Issa, Wael Azam Orthopedic Department Tanta University
Simple (closed) fracture: there is no skin wound leading to the fractre. • Compound (open) fracture: there is a wound leading to the fracture.The bone may protrude through the skin.
How do you suspect a fracture ? History of trauma followed by • pain, • inability to use the injured part, • deformity, • swelling , • local bruising, • localized tenderness, • crepitus or abnormal mobility (unnecessary painful maneuver)
First-aid for closed fracture: • Immobilize the injured part (splint the fracture): to reduce pain, prevent shock and prevent further soft tissue injury,dec. fat embolism. • Effective splints can be made from rolled-up newspapers,magazines, blankets, cardboard or a stick.
Place the splint around the injured limb and hold it in place with a necktie, strip of cloth or belt. • The general rule is to splint a joint above and below the fracture.
You can tie an injured leg to the uninjured one, putting padding between the legs. • You can tap an injured arm to the chest (if the elbow is bent), or to the side (if the elbow is straight) placing padding between the body and the arm.
For a broken arm make a sling out of a triangular piece of cloth.
Do not try to set a broken bone yourself . The exceptions to this rule are when there is severe deformity or ischaemia distal to the fracture. • Apply ice (wrapped in cloth) to the injured area to help reduce swelling and inflammation (not in open fracture).
Do not give anything to eat or drink in case an operation is necessary. • Give analgesic anti-inflammatory drugs. • Watch out for signs of shock.
First-aid for open fractures: • Have the victim lie flat. • Remove clothing covering the wound. • Apply direct pressure to the wound to stop bleeding • Cover the wounded area with a clean cloth or dressing.
Continue to apply pressure as long as the wound bleeds. Add new dressings over existing ones. • Immobilize the injured area (splint the fracture): as mentioned above. • Do not try to push a protruding bone back under the skin.
Do not give anything to eat or drink. • Give analgesic to reduce pain and swelling. • Please , do not Make stitches
Watch out for signs of shock. if present: - elevate the victims feet. - cover the victim with a blanket to keep him or her warm.
Give - antishock measures, - antitetanic serum, - antigas gangrene serum, - and antibiotics.
Dislocations are common injuries in contact sports, such as football and hockey, and in sports that may involve falls, such as downhill skiing and volleyball.
Dislocations may occur in major joints such as your shoulder, hip, knee, elbow or ankle or in smaller joints such as your finger, thumb or toe.
A dislocated joint is: - Misshapen - Very painful - Swollen - Discolored
If you believe you have a dislocated joint: • Don't delay medical care. (emergency). • Don't move the joint. • splint the affected joint into its fixed position. don't try to move a dislocated joint or force it back into place. This can damage the joint and its surrounding muscles, ligaments, nerves or blood vessels.
Put ice on the injured joint. This can help reduce swelling by controlling internal bleeding and the buildup of fluids in and around the injured joint.
A sprain results from overstretching or tearing a ligament (fibrous tissue that connects bones), a tendon (tissue that attaches a muscle to a bone) or a muscle. A strain occurs when a muscle or tendon is overstretched or overexerted.
Common causes for sprains and strains are falls, twisting a limb, sports injuries and over-exertion. Both sprains and strains result in pain and swelling. The amount of pain and swelling depends on the extent of damage
First-aid for sprain and strain(known as RICE) • Rest the injured part of the body. • Ice: apply ice packs or cold compresses for up to 10 or 15 minutes at a time every few hours for the first 2 days to prevent swelling. • Compression: wearing an elastic compression bandage for at least 2 days will reduce swelling. • Elevation: keep the injured part elevated above the level of the heart to reduce swelling.
Give analgesic such as acetamenophen or ibuprofen. • Do not apply heat in any form for at least 24 hours. (heat increases swelling and pain).
Note: • Inadequate or delayed treatment of severe sprain may cause long-term joint instability or chronic pain.
At the scene of the accident • The first duty of a doctor arriving at the scene of a major accident is to introduce calm and order and to avoid injury to himself and others. • Rapidly assess the situation and decide on priorities.
Bystanders can be taught how to maintain an airway with a jaw thrust or chin lift, maintain in-line immobilization of the neck and compress external bleeding points.
Treatment of polytraumatized patients begins at once. A = establish an airway but protect the cervical spine. B = breathing. C = circulation (arrest haemorrhage and combat shock. I.V. line, Blood grouping. examination, analgesia, splint fractures, dressing of open wounds.
To move a severely injured patient onto a stretcher at least four people are required to transfer the patient as one straight piece. The airway, breathing and circulation should be checked again before the ambulance departs, and during the journey.
Ambulances should be equipped with splints, dressings, airways, oxygen and transfusion apparatus.
At hospital A rapid primary survey with simultaneous resuscitation. A detailed secondary survey. Constant re-evaluation. Initiation of definitive care.
The primary survey • A = Airway maintenance with control • of the cervical spine. • B = Breathing and oxygenation. • C = Circulation and control of • bleeding. • D = Disability. • E = Exposure and avoidance of • hypothermia.
Secondary survey Once the patient has been resuscitated, he or she is examined thoroughly from head to toe. Anteroposterior x-rays of the chest and pelvis and a lateral x-ray of the spine are obtained. Other investigations may be needed depending on the findings of the secondary survey.
Definitive treatment This is decided by the findings during the primary and secondary surveys. Other specialist assistant may be required. The patient may need transfer (but only after the condition is stable).
