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Extremity injuries

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are common because people are involved in active lifestyles that include sports and wilderness activities.

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Extremity injury assessment

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-Look for signs and symptoms of fractures and dislocations. -Examine the extremities, using the mnemonic D-O-T-S. -Compare one extremity with the other to determine size and shape differences. -Use the "rule of thirds" for extremity injuries. -Consider the cause of injury (COI) when evaluating the possibility of a fracture and its location. -Use the mnemonic CSM as a reminder to check for Circulation, Sensation, and Movement of fingers or toes

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types of injuries to the extremities

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-contusions -strains -sprains -tendinitis -dislocations -fractures

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care for extremity injuries

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-use the RICE procedures -apply a splint to stabilize fractures and dislocations

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Care for contusions

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-Apply an ice pack to the area for 20 minutes, three to four times during the first 24 hours. -Place the arm in a sling and swathe.

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Care for muscle strain

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-Follow the RICE procedures. -Stretch the muscle but do not force stretching.

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Care for a sprain

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-follow RICE procedures -seek medical care

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Care for tendinitis

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-Apply heat before an activity; the victim might wear a brace on the sore elbow. -Apply ice for 20 minutes after completion of the activity. -Seek medical advice for appropriate rehabilitation program. -Use pain medication such as ibuprofen.

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Care for dislocation

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-Do not try to force, twist, or pull the shoulder back in place. -Place a pillow between the upper arm and the chest. -Apply an arm sling and swathe. -Check distal pulse/capillary refill -Apply an ice pack for 20 minutes. -Seek immediate medical care.

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Care for fracture

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-Treat for shock. -Apply an arm sling and swathe. -Check distal pulse/capillary refill -Apply ice to the area for 20 minutes, three to four times during the next 24 hours. -Seek immediate medical care.

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three bones come together at the shoulder

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the scapula, clavicle, and humerus -the shoulder is the most freely moveable joint in the body

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shoulder dislocation

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-occurs when the bones of the shoulder comes apart. -Shoulder dislocation is second in frequency only to finger dislocations.

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Recognizing shoulder dislocation

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-Victim holds the upper arm away from the body, supported by the uninjured arm -Dislocated arm cannot be brought across the chest wall to touch the opposite shoulder -Extreme pain in the shoulder area -In a dislocation, the shoulder looks squared off, rather than rounded. -Victim may describe a history of previous dislocations. -Numbness or paralysis in the arm from pressure, pinching blood vessels or nerves

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Clavicle fracture

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-are common and usually are the result of falling with the arm and hand outstretched. -80% of clavicle fractures occur in the middle third of the bone.

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Recognizing clavicle fracture

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Usually the fracture is easy to detect because the clavicle lies immediately under the skin. The victim: -Fell on an outstretched arm -Received a direct blow to the clavicle or shoulder AND if the victim has: -Severe pain over the injured area -Not moved the arm because of pain -Swelling -Visible deformity -Tenderness -"Dropped" or drooped shoulder -Bruising

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Contusions

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direct blows cause contusions around the shoulder

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Recognizing contusions

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-Swelling -Pain at the injury site -Feeling of firmness when pressure is exerted on the shoulder -Tenderness -Discoloration under the skin

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Tendonitis

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-general cause of tendinitis in the shoulder is continuous overuse or unusual use -examples: throwing sports such as baseball and swimming

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Recognizing tendinitis

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-Constant pain or pain with motion of the shoulder -Limited motion of the shoulder -"Crackling" sound when the joint is moved (crepitus=squeaking) -Tenderness over the area

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Humerus fracture

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the shaft of the humerus can be felt throughout its entire length along the inner side of the upper arm

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recognizing a humerus fracture

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The victim received: -direct blow to the area -twist or fall on the outstretched arm And any one or combination of these occurred -severe pain -swelling -Visible deformity -Tender if touched -May be unable to move the arm -Will hold the arm against the chest for comfort

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Elbow injuries

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-All elbow fractures and dislocations should be considered serious and treated with extreme care. -Inappropriate care can result in injury to the nearby nerves and blood vessels.

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Recognizing elbow fractures and dislocations

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-Immediate swelling -Severe pain -Possible visible deformity; compare it with the uninjured elbow. -Restricted, painful motion -Numbness or coldness of the hand and fingers below the elbow

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Tennis Elbow

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-Results from sharp, quick twists of the wrist (not just from playing tennis) -An inflammation of the tendons on the outer side of the elbow (Can be very painful whenever the wrist and elbow are used)

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Recognizing tennis elbow

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-Pain increases while using the arm -Causes gradual grip weakness -Injured elbow fatigues quicker than normal -Very tender on outer protrusion of elbow

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Golfer's elbow

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-The equivalent of the more common tennis elbow but with pain on the inside of the elbow -It is tendinitis affecting the tendons attached to the bony protrusion, on the inside of the elbow.

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Radius and ulna fractures

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-The radius and ulna are the two large bones in the forearm. -When only one bone is broken, the other acts as a splint and there may be little or no deformity. -When both bones are broken, the arm usually appears deformed. -the victim has pain in the forearm or wrist from: a direct blow or falling on an outstretched hand AND has: -a visible deformity -severe pain radiating up and down from the injury site -an inability to move the wrist or it is painful while moving the wrist OR: the wrist is painful on the thumb side and pain continues into next day

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Wrist fracture

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The wrist is usually broken when the victim falls with the arm and hand outstretched.

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recognizing a wrist fracture

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-Injury to the wrist associated with a snapping or popping sensation within the wrist -Pain in the wrist that is aggravated by movement -Tenderness -Swelling -Unable or unwilling to move the wrist -Lump-like deformity on the back of the wrist

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hand injuries-crushed hand

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-The hand may be fractured by a direct blow or by a crushing injury. Recognizing a crushed hand: -Pain -Swelling -Loss of motion -Open wounds -Broken bones

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Care for a crushed hand

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-Control the bleeding. -Apply an ice pack for 20 minutes. -Seek medical care.

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Finger injuries

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-The three bones that make up each finger are the most commonly broken bones in the body. -The three joints can also be injured. -A so-called finger sprain may be a complicated fracture or dislocation.

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Finger fracture

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can move even when broken

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recognizing a finger fracture

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-A visible deformity -Immediate pain and hurts with or without movement -Numbness -Swelling -Pinpointed tenderness

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Testing for finger fracture

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If possible, straighten the fingers and place them on a hard surface. Tap the tip of the injured finger toward the hand. -Pain lower down in the finger or into the hand can indicate a fracture.

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care for finger fractures

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-Do not try to realign the finger. -Gently apply an ice pack. Splint the finger by one of two methods: -Buddy taping the fractured finger to another for support -Keeping the hand and fingers in the position of function with extra padding in the palm

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Finger dislocation

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-Finger dislocations are common. -Same causes of fractured fingers can also cause a dislocated finger.

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recognizing finger dislocation

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-A visible deformity -Immediate pain -Swelling -Shortening of the finger -May be unable to bend the finger in the injured area

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sprained finger

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The upper joints of the fingers have a ligament on each side of the joint.

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recognizing a sprained finger

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The finger or thumb has been: -"Jammed" or compressed -Stepped on -Forced or twisted sideways AND the victim: -Has pain and swelling -Is unable to make a fist -Has weakness while curling the finger or gripping

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nail avulsion

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When a nail is partly or completely torn loose Recognizing a nail avulsion: Nail may be completely detached or partially held in place by the skin

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care for nail avulsion

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-Secure the damaged nail in place with an adhesive bandage. -If part of all of the nail has been completely torn away, apply antibiotic ointment. -Do not trim away the loose nail. -Consult a physician for further advice.

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Blood under nail

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Blood collects under a nail when underlying tissues are bruised. Recognizing blood under a nail: Excruciating pain exists because of the blood pressure against the nail Pain does not disappear until the collection of blood is drained

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Care for blood under nail

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-Apply an ice pack with the hand elevated. -Relive the pressure using a knife or a red-hot metal paperclip or needle. -Apply a dressing.

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Ring strangulation

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-Can be a serious problem if it cuts of the blood supply long enough -Recognizing ring strangulation: -The ring has become tight on the finger after an injury or swelling.

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Care for ring strangulation

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-Lubricate the finger with soap and water or some other slippery substance. -Immerse the finger in cold water or apply an ice pack to reduce swelling. -Liberally spray window cleaner onto the finger, then try to slide the ring off. -Massage the finger from the tip toward the hand to move the swelling -Lubricate the finger again and try removing the ring -Cut the narrowest part of the ring with a ring saw, jeweler's saw, or fine hacksaw blade, taking care to protect the exposed parts of the finger.

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Hip joint injuries

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-hip dislocation -hip fracture

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hip dislocation

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-A hip can be dislocated by a fall, a blow to the thigh, or direct force to the foot or knee. -Often a hip is dislocated when the knee strikes the dashboard during a motor vehicle crash. -It is difficult to differentiate a hip dislocation from a hip fracture.

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Recognizing hip dislocation

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-Severe pain at the injury site -Swelling at the injury site -Hip is flexed and the knee bent and rotated inward toward the opposite hip -Injury usually quite visible

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Hip fracture

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-Fracture of the upper end of the femur, not the pelvis -Elderly people, especially women, are susceptible to this type of injury because of brittle bones.

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recognizing a hip fracture

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-Severe pain in the groin area -Inability to lift the injured leg -Leg may appear shortened and be rotated with the toes pointing abnormally outward.

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thigh injuries

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-femur fracture -muscle contusion -muscle strain

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femur fractures

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-Because the femur is the largest bone in the body, considerable force is required to break it. -Femur fractures often include open wounds and external bleeding may be severe.

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recognizing a femur fracture

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-Severe pain at the injury site -Deformity may occur -Swelling comes from severe damage to blood vessels -Victim may report having heard or felt a severe pop or snap at the time of injury.

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muscle contusion

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-The muscle group on the front of the thigh is the quadriceps group and often gets bruised. -Depending upon the force of impact and muscles involved, the contusion may be of varying degrees of severity.

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recognizing muscle contusion

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Victim received a direct hit producing: -Swelling -Pain and tenderness -Tightness or firmness of site when pressed -Visible bruise that may appear hours later

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muscle strain

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-When a muscle is overstretched, it can result in a tear, called a strain. -Different degrees of strains occur, but first aiders will be unable to determine their degree.

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recognizing muscle strain

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While running or jumping, the victim: -Feels a pop or pulling sensation And later has: -Tenderness -Stiffness and pain during movement -Swelling -A visible bruise appearing days later

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knee injuries

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-Among the most serious joint injuries -Their severity is difficult to determine, thus medical care is necessary if the injury is from being hit or twisted and not from overuse.

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knee fracture

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-Generally occurs as a result of a fall or a direct blow -May occur at the end of the femur, at the end of the tibia, or in the knee cap

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recognizing a knee fracture

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-Determining if a fracture exists is difficult. -Some fractured knees may look like a dislocation. Other signs include: -Deformity -Tenderness -Swelling

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knee dislocation

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A knee dislocation is a serious injury. Recognizing a knee dislocation: -Excruciating pain -Deformity -Pulse may be absent in the ankle -Do not confuse a knee dislocation with a patella dislocation

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patella dislocation

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-A dislocated patella can be a very painful injury and must be treated immediately. -Some people have repeated kneecap dislocations. -A dislocated patella most commonly occurs in teenagers and young adults who are engaged in athletic activities. -more common in women, knee cap is going to go laterally

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recognizing a patella dislocation

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-Possible swelling -An inability to bend or straighten the knee -Pain -Deformity

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Knee sprain

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-Ligament injuries occur most often in sports. -The knee is very prone to ligament injury, ranging from mild sprains to complete tearing.

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Recognizing a knee sprain

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At the time of injury the victim has: -Severe pain -The feeling of a pop or snap -A locking sensation -The victim may not be able to walk without limping, or bend the knee -Later, there may be swelling in the knee and bruising.

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Knee Contusion

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Contusions of the knee are caused by a direct blow or by falling on the knee. Recognizing a knee contusion: -Pain -Swelling -Tenderness -Bruise marks -Care for a knee contusion: -Follow the RICE procedures.

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lower leg injuries

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-Tibia and fibula fractures -Tibia and fibula contusion -Muscle cramps -Shin splints -Ankle and foot injuries -Toe injuries

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tibia and fibula fractures

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-Tibia and fibula injuries can occur at any place between the knee joint and the ankle joint. -Injuries to the blood vessels, caused by extreme deformity, are common with injuries of the tibia and fibula, and the pain is usually severe.

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recognizing tibia and fibula fractures

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-Severe pain -Swelling -Visible deformity -Tenderness when touched

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recognizing tibia and fibula contusion

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Victim received a hit directly on the shin. -Tender when touched -Sharp pain Later has: -Discoloration -Difficulty moving ankle up and down -Numbness or coldness in toes or foot

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Muscle cramp

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-Muscle spasm or cramping usually occurs in the calf and sometimes in the thigh or hamstring. -It is a temporary condition of little consequence.

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recognizing a muscle cramp

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-Happens during or after intense exercise sessions -Painful, muscle contraction or spasm which disables the victim

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care for muscle cramps

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-Have the victim gently stretch the affected muscle. -Relax the muscle by applying pressure to it. -Apply ice to the cramped muscle. -Pinch the upper lip hard to reduce calf-muscle cramping. -Have the victim drink lightly salted, cool water.

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shin splints

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-Describes pain in the front of the lower leg -Caused by repetitive stress in the leg such as running or walking

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recognizing shin splints

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The shin aches during activity, but: -Ache subsides significantly after activity stops -Ache is a result of an increase in the workout routine -Usually a chronic problem that gets worse

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care for shin splints

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-Apply an ice pack before an activity. -Apply pressure with a 3-inch elastic bandage over the sorest point. -Apply an ice pack for 20 minutes after the activity. -Curtail activity until the shin is pain free. -Pain medications that are anti-inflammatory drugs may be taken.

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Ankle and foot injuries

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-The ankle and foot frequently are injured, mainly by twisting. -In some cases, the damage requires surgical correction. -Most ankle injuries are sprains; about 85% of sprains involve the outside ligaments.

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recognizing foot and ankle injuries

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-Press along the bones to check for pain and tenderness. -Ask the victim, "Have you tried standing on it?" -If the victim hops on the good foot and the injured ankle cannot tolerate the jarring, suspect a fracture. (not too worried about this) -Ankle sprains tend to swell on only one side of the foot; swelling on both sides usually accompanies fractures. (not always true at all)

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care for foot and ankle injuries

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-Controversy exists about whether to remove a shoe from an injured foot. -Shoe may act as a splint and retard swelling; however, taking the shoe off allows for better examination and care. -Use RICE procedures to reduce swelling.

first aid chapter 15 – Flashcards

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