Fractures of the Skull, Face, Jaw, Upper Body, Arm and Hand, and Ribcage

A skull fracture is a very serious injury since it is often associated with some form of damage to the brain, Concussion and compression may both accompany skull fractures. If a person has a fracture to the bones of the face or jaw, the airway is your overwhelming priority.

TREATING A FRACTURED SKULL

1. Keep the victim still while she is conscious. Encourage her not to move her head.
2. Keep a constant check on the airway, breathing, and circulation.
3. Be prepared to resuscitate or turn into the recovery position if necessary.
4. Call for emergency help as soon as possible.

HOW TO TREAT FRACTURES OF THE FACE AND JAW

1. Ensure that any blood in the mouth is allowed to dribble out-- encourage the victim to spit into a bandage or handkerchief.
2. Gently remove any teeth or bits of broken bone from the mouth and give the victim a pad to hold against the injured part for additional support and comfort.
3. A cold compress may help to reduce pain.
4. Get the victim to hospital because she will require medical treatment.
5. Do not pinch a broken nose to control bleeding-- hold a pad under it.

SIGNS AND SYMPTOMS OF A SKULL FRACTURE

Along with these signs and symptoms, consider what happened. Skull fractures may be caused by direct and heavy impact to the head or by indirect impact, for example, a fall from a great higher on to the feet that may have cause the force to move up the body, stopping when it hit the skull.

• Bruising to the eye socket
• Pain
• A bump or a dent
• Straw-colored fluid coming from one or both ears
• Deterioration in the level of consciousness of the victim

Does the person respond slowly to questions pr commands? Is he having problems focusing?

If any of these things is present, assume a skull fracture with a potential injury to the brain.

CONCUSSION

In itself, concussion is not a serious injury as the victim will recover when the disturbance caused by the impact stops. However, because concussion often accompanies violent head movement, there is always the possibility of a skull fracture or more serious, longer-term brain injury, such as compression. It is important therefore that even a seemingly recovered victim with concussion should seek medical treatment.

HOW TO TREAT CONCUSSION

1. Place the victim in the recovery position if necessary and monitor ABC.
2. Call an ambulance if the victim does not recover after 3 minutes or if there are signs of skull fracture or compression.
3. Advise the victim to seek medical advice if recovery appears to be complete.
4. Encourage the victim to keep still while recovering because this reduces dizziness and nausea.
5. Be aware of the increased likelihood  of neck injuries.

COMPRESSION

Compression is a very serious injury that occurs when pressure is exerted on the brain, either by a piece of bone, bleeding, or swelling of the injured brain. It may develop immediately after a head injury or stroke, or some hours or even days later.

SIGNS AND SYMPTOMS OF COMPRESSION

• Person becomes increasingly drowsy and unresponsive.
• Flushed and dry skin.
• Slurred speech and confusion.
• Partial or total loss of movement, often down one side of the body.
• One pupil bigger than the other.
• Noisy breathing  which becomes slow.
• Slow, strong pulse.

HOW TO TREAT COMPRESSION

If some or all of these symptoms are present, suspect compression and carry out the following treatment.

1. If the victim is unconscious, place in the recovery position and monitor airway, breathing, and circulation.
2. If conscious, lay the victim down with the head and shoulders slightly raised, maintaining a close check on the ABC. Call an ambulance, and be prepared to resuscitate.

WARNING!

Do not give anything to eat or drink-- the victim may need a general anesthetic in hospital.

FRACTURES OF THE UPPER BODY
The collarbone can be broken by direct impact. However, it is most commonly fractured by indirect force moving up the arm following a fall on to an outstretched hand, and often happens after a fall from a bicycle or a horse. A broken shoulder often follows a heavy impact to the site of injury. It is therefore important to do a careful examination to rule out back or rib injury.

BROKEN COLLARBONE. Along with potential swelling, bruising, and tenderness above the site of the injury, the victim is most likely to be supporting the injured arm, with the shoulder on the injured slumped. Since the collarbone is close to the skin it is particularly important to look for an open fracture.

BROKEN SHOULDER.  If you are confident that the shoulder itself is broken then the treatment is to work with the victim to find the best position. The application of an arm sling may provide some support, but more commonly the victim will want no bandages, setting instead for steady support from another person if available. The pain of the injury may make it necessary to call for an ambulance rather than transporting the victim to hospital in a car.

WARNING!
Do not give anything to eat or drink-- the victim may need a general anesthetic in hospital.

TREATMENT. If the bone has pierced the skin, place a light dressing over the wound. Bleeding is likely to be minimal and your main concern is to prevent infection.
     Work with the injured person to find the most comfortable position for the arm and for the body as a whole. Generally this will be sitting up with the arm supported at the elbow. The victim may wish to go to hospital in this position, but she should be offered the option of an elevation sling, which will help alleviate pressure on the collarbone and provide some comfort.

APPLYING AN ELEVATION SLING. The elevation sling has a range of uses. As well as the treatment of a broken collarbone, it also provides comfort in the treatment of crushed or broken fingers and hands, relief in the treatment of burns to the arm, and is an aid in controlling bleeding through elevation.

1. Place the injured arm with the fingers by the collarbone on the uninjured side.
2. Place the triangular bandage with the point resting at the elbow on the injured side.
3. Tuck the bandage underneath the hand and down underneath the injured arm.
4. Tie at the collarbone in a square knot (or a bow)
5. Fasten the spare material at the elbow with a pin or twist it and tuck it away.
6. Extra support can be gained by placing a triangular bandage folded into three (a broad fold) around the arm and body.

FRACTURES OF THE ARM AND HAND AND RIBCAGE

There are three long bones in each arm-- one in the upper arm and two below the elbow. These are among the most commonly broken bones in the body. There is also a number of small bones in the wrist that are vulnerable to breaks. Fractures to the hand or fingers can be extremely painful because of the many nerve endings.

The principles of treatment are, as for all broken bones, to provide support to the injured part and to stop it from moving too much. Most people with a broken arm will be able to make their own way to the hospital or health center, so treatment focuses on providing support that is appropriate when walking and stabilizes the injured limb. This can be done with an improvised sling using clothing, or by using a triangular bandage to form an arm sling.

HOW TO MAKE AN ARM SLING

1. Gently place the bandage under the victim's arm, placing the point underneath the elbow.
2. Pass the top end of the bandage around the back of the victim's neck, leaving a short end to be tied by the collarbone on the injured side.
3. Bring the bottom end of the bandage up carefully, ensuring that it fully supports the injured arm. Tie into place with a square knot or bow.
4. For additional support, you can tie another triangular bandage. Fold into three (a broad fold) around the arm, avoiding the site of the fracture, to stop the arm from moving.

BROKEN ELBOW OR AN ARM THAT CANNOT BEND. If the broken bone is on or near the elbow it may not be possible for the person to bend the arm, either because of the pain or because the joint is fixed. In this case you need to treat the arm in the position found-- do not try to bend the arm.

1. Help the victim into the most comfortable position; this will often be lying down on the ground, but it may also be standing up with the arm hanging straight down.
2. Place padding around  the injured part, both between the arm and the body and on the outside of the arm.
3. The victim will need to be transported by ambulance. Do not attempt to bandage the arm if help is on its way because this will cause further discomfort and may make the injury worse.

FRACTURED WRIST. In older adults, the wrist may be broken by a fall onto an outstretched hand, causing a break very low down on the radius (one of the long bones in the lower arm) known as a Colle's or silver fork fracture. Other injuries can break one of the small bones to the wrist or cause a sprain that is particularly difficult to distinguish from a break.

TREATMENT. Provide support and immobilization in the same way as for a break to the upper or lower arm. Remove watches and bracelets because these may contribute to cutting off circulation to the hand if the injury swells.

HAND FRACTURES. Direct impact may break one or two of the small bones in the palm or fingers. Crushing injuries may break several bones and cause considerable bleeding. In addition the thumb, and even some of the fingers, may become dislocated.

TREATMENT

1. Gently cover any open wounds with a dressing or clean, non-fluffy piece of material. Encourage the victim to raise her arm. This helps to reduce swelling and bleeding and also provides some pain relief.
2. If possible, remove rings and wrist-watches before the injury starts to swell. If jewelry has been crushed into the hand or swelling prevents its easy removal, pass this information on as soon as possible to the medical staff as early treatment will be needed to prevent damage to the circulation in the fingers.
3. Cover the injured area with a pad of soft fabric or cotton wool (taking particular care if there are open wounds not to get strands of material stuck into the injury). This padding can be held in place with a cover created from a triangular bandage, which can also be adapted for crush injuries to the foot and for burns to the hand or foot.

FRACTURE OF THE RIBCAGE

Simple fractures, characterized by bruising and tenderness over the fracture site, are usually confined to one broken rib, with no underlying damage to the lungs or to other internal organs. Multiple, or complicated, rib fractures will often result in the victim having difficulty in breathing, as the chest wall is unable to move effectively. There may also be lung damage. Broken ribs are generally not strapped up because the chest needs to expand normally during breathing to reduce the risk of pneumonia.

TREATING A SIMPLE BROKEN RIB. The best treatment for a simple fractured rib is to put the arm on the injured side into an arm sling and to advise the victim to seek medical aid.

MULTIPLE BROKEN RIBS. In a case of multiple rib fractures there may also be lung damage, in which one or a number of ribs have punctured one or both of the lungs. There may also be an open break on the chest wall where ribs have sprung out. Remember that the ribs extend around the back of the body and there may be injuries here as well as on the front. Rib injuries may be accompanied by a sucking wound to the chest, creating a direct passage between the external environment and the lungs.

1. Treat any sucking wounds by covering, initially with a hand and then with plastic. Treat any open breaks.
2. If the victim is conscious, lay him down. He is most likely to find breathing easier in a half-sitting position.
3. Lean the victim toward the injured side. This allows any blood to drain into the injured lung, leaving the good lung free to breath. Place the arm on the injured side into an elevation sling.
4. Treat for shock.

If the victim loses consciousness, monitor the airway and breathing and place the person into the recovery position with the injured side upward.

WARNING!

Do not give anything to eat or drink-- the victim may need a general anesthetic in hospital.

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Written by Unknown

Frederick Luneta is a 24-year old guy and he is a Computer Engineering student and a young part time blogger. Currently lives in the Philippines. He knows a lot about computer.