First Aid

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Bone and Joint Injuries

Fractures

A fracture is any break or crack in a bone.

• A fracture may be closed or open.
  • Closed fracture - a fracture where the skin is not broken.
  • Open fracture - a fracture where the skin is broken and bone ends may protrude.
• The cause/mechanism of injury for upper limb fractures may be:
  • direct force, eg. a hard blow or kick.
  • indirect force, eg the bone breaks at some distance from the point of impact.
  • twisting, eg abnormal turning (rotation) of shoulder or wrist joint.

A joint is formed where two or more bones come together. Joints allow for body movement. The bones of a joint are held in place by supporting tissue called ligaments.

• The major joints of the upper limb are at the:
  • shoulder
  • elbow
  • wrist

Joint injuries happen when the bones and surrounding tissues are forced to move beyond their normal range.

• Two common joint injuries are sprains and dislocations:
  • sprain - a complete or partial tearing or stretching of the ligaments around a joint.
  • dislocation - a displacement of one or more bone ends at a joint so that their surfaces are no longer in proper contact.

General signs and symptoms

• Some or all of the following signs and symptoms occur in most bone and joint injuries:
  • You may see:
    • swelling and discoloration
    • deformity and irregularity
    • protruding bone ends
    • inability to use the limb
    • guarding and tensing of muscles around the injured area
    • grating noise that can be heard as the bone ends rub together
    • signs of shock, increasing with the severity of the injury
  • The casualty may complain of:
    • pain made worse by movement
    • tenderness on touching

To prevent further damage and reduce pain

• treat the injury at the incident site if possible
• control bleeding from open wounds if present
• call for medical help - 911
• apply a cold compress, a wrapped, cold pack or ice bag on any closed fracture or injury to reduce pain and control swelling (15 minutes on - 15 minutes off)
• apply gentle pressure/compression with a bandage to reduce swelling
• elevate the injured part if possible
• do not give anything to eat or drink
  • Note: all fractures, dislocations and sprains should be immobilized before the casualty is moved, unless the casualty is in immediate danger and always immobilize in the position found.

RICE

"RICE" is a mnemonic for treatment for soft-tissue injury, the most common injury in Western Martial Arts.

• R - rest
• I - ice
• C - compression/bandaging
• E - elevation (above the heart to reduce pressure)

Muscle strains

• A strain is an injury that occurs when a muscle is stretched beyond its' normal limits. The cause/mechanism of injury for a strain may be:
  • sudden pulling or twisting of a muscle
  • poor body mechanics during lifting
  • failure to condition muscles before physical activity
  • repetitive, long-term overuse
• A strain can be recognized by some or all of the following:
  • You may see;
    • swelling of muscle
    • discolouration
  • the casualty may complain of;
    • sudden sharp pain
    • severe cramps
    • stiffness
• NOTE: Signs and symptoms may not appear until later.

To give first aid, you should

• place the casualty in the position of greatest comfort
• apply cold (15 minutes on - 15 minutes off) to help relax muscle spasm, reduce pain and prevent further tissue swelling
• refer to medical help.

Chest Injuries

The chest cavity is formed by the breastbone (sternum), ribs and spine. These bones protect the lungs, heart and major blood vessels. The chest cavity is separated from the abdominal cavity by the diaphragm.

• There are two general types of chest injuries:
  • closed - the skin remains unbroken (usually caused by a blunt force)
  • open - the skin is broken (when the chest is punctured)
• NOTE: Chest injuries can be life-threatening because of the possibility of severe breathing problems, damage to the heart and lungs and internal bleeding.

Penetrating chest wound

• A penetrating or 'sucking' chest wound occurs when an object punctures the chest. Through the open chest wound air enters directly into the chest cavity causing serious breathing problems.
• Some or all of the following signs and symptoms may be present:
  • sounds of air being sucked into the chest when the casualty breathes in
  • blood-stained bubbles at the wound site when the casualty breathes out
  • coughing up of frothy blood
  • inability to expand one or both sides of the chest
  • laboured breathing
  • signs of shock
• The casualty may complain of:
• pain during breathing

First aid for a penetrating chest wound

• If the casualty is responsive:
  • Call for medical help - 911
  • Expose the wounds
  • Cover the wound with the casualty's hand
  • Check the quality of breathing
  • Check circulation (shock) and perform a rapid body survey to determine if there is an exit wound or other injuries.
  • Position the casualty injured side down and cover the wound with an airtight dressing and tape on three sides.