Emergency Childbirth and Minor Wounds

It is very unlikely that you will have to deliver a child in an unplanned-for situation. Even the second stage of labor can allow enough time for an ambulance or midwife to arrive. However, if you are called upon help with an emergency birth, take comfort from the fact that there is little that you can do to affect the birth process. Your key role is to support the mother, to ensure that medical help has been called, and to care for the mother and baby after the birth.

WHAT CAN YOU DO TO HELP?

1. Ensure that the midwife or doctor has been called. If labor is in the early stages, ask the mother where she wants to be and make arrangements for transport.
2. If at any time there is severe bleeding or signs and symptoms of shock, call 911.
3. Support the mother in her most comfortable position. This will usually be standing or squatting-- gravity helps the delivery process. Ask her what she would like you to do to help with the pain. Potential options include a warm bath, rubbing the small of her back, and offering frequent sips of water. Encourage her to breathe out as breath-holding makes pain worse by increasing muscle tension. Most pregnant women will have a pregnancy record. Help her to find this because it contains useful information for both you and the medical staff.
4. If labor has progressed to the second stage and birth is imminent, ensure that:

• The woman has removed the clothes from her lower body.
• The ambulance is on the way-- the ambulance control or midwife may give you instructions over the phone.
• You and the environment are as clean as they can be.
• You have a warm covering for the baby and mother.

     5. Help the mother into a position she finds comfortable.

     6. Support the mother while she pushes out the baby as it descends.

     7. Support the head and shoulders as the baby appears-- this will happen naturally and quickly. Do not pull the baby. If the cord is wrapped around the neck, check that it is loose and gently pull it over the head.

     8. Gently lift the baby and place on the mother's stomach. There is no need to cut the cord. If the baby does not show any signs of movement, check its airway and breathing and be prepared to resuscitate if necessary.

     9. Keep mother and baby warm while waiting for the ambulance. The placenta and cord will follow shortly-- keep this for the medical staff to check. Gently massaging below the navel may help stop bleeding.

IF THE BABY IS BREECH (NOT HEAD FIRST)
The concern with a breech birth is that the largest part of the body (the head) may not be easily delivered. If the baby is breech a foot, knee, or buttock may come out first. If this happens:

1. Ensure that the medical help has been called.
2. Allow the birth to continue-- do not try to stop the baby coming out.
3. Support the baby's body as it is delivered.
4. If the head is not delivered within 3 minutes of the shoulders, gently raise the baby's legs to the ceiling until you can see the face (do not pull the baby from the mother). Wipe the face clear and encourage the mother to keep pushing until the head is delivered.

MINOR WOUNDS

Most minor wounds can be treated in the home without the need for further medical attention. First aid treatment can promote recovery and prevent infection. However, further medical advise should be sought if: there is a foreign body embedded in the wound; the wound shows signs of infection; the wound has the potential for tetanus and the injured person's immunization is not up-to-date; the wound is from a human or animal bite.

TREATING MINOR WOUNDS. If possible, wash your hands before treating the wound. Check that there is nothing in the wound. If the wound is dirty, clean it under running water. Pat dry with clean, non-fluffy material. Clean the wound from the center out with gauze swabs or antiseptic wipes using a fresh piece for each wipe. Cover the wound with an adhesive dressing to apply pressure and protect from infection. Elevate the wound if necessary to help control bleeding.

1. Check there is nothing embedded in the wound and clean and dry it.
2. Clean the wound with antiseptic wipes or swabs, then cover it with a dressing for protection and to apply pressure.
3. Raise the wound if necessary to reduce blood flow to the affected area.

IF THERE IS GRAVEL OR GRIT IN THE WOUND

If there is loose debris on the wound, this can be easily washed away with water or taken off by gently dabbing with clean gauze. If there are small bits of debris embedded into the wound these should be treated as foreign bodies. Gently cover with a clean dressing and bandage the dressing into place, taking care not to press on the embedded debris. Raise the injure part if appropriate and seek medical advice.

BRUISING. A bruising is the sign of internal bleeding. Usually caused by direct impact, bruises are sometimes painful but generally heal swiftly with little intervention needed.

     A bruise goes through several changes n appearance as it heals and may not appear for some time, even days, after the accident. Initially, the injured part may be red from the impact; over time this may become blue as blood seeps into the injured tissue; as it heals it becomes brown and then fades to yellow.

     Severe bruising can also be the sign of serious internal bleeding. If bruising is extensive and is accompanied by any of the following signs and symptoms, assume that serious internal bleeding is present. Treat the injured person for shock and seek medical help.

SIGNS AND SYMPTOMS

• Victim is known to have had an accident (not necessarily in the immediate past)
• Signs and symptoms of shock
• Bruising
• Boarding-- this most commonly occurs where there is bleeding into the stomach area; the quantity of blood combined with the tissues swelling results in a rigidity to the tissues
• Swelling
• Bleeding from body orifices

Most bruises, however, are not serious. First aid can reduce pain and promote recovery from an uncomfortable bruise.

TREATMENT OF MINOR BRUISING

• Check for underlying injuries such as broken bones or sprains
• Apply a cold compress to the site of the bruise to reduce swelling
• Raise and support the injured part as appropriate.

By: Unknown On 11:38 PM

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Poisoning from Industrial Chemicals, Drug and Alcohol

The use of hazardous industrial chemicals is strictly controlled and regulated, and those who work with such substances are aware of the specific first aid and safety requirements. For most people, contact with dangerous industrial chemicals will be through a chemical spill at a road accident or a problem at an engineering plant.

TREATMENT. Many industrial chemicals can be absorb through the skin or inhaled, so it is important not to approach an accident scene unless you are sure you can do so safely. If you are at all unsure of the risk, do not approach the scene. Instead, call 911 immediately, giving as much information about the incident as you can. Encourage victims who can to move away from the source of any danger.

Inhaled poisons. Where possible, remove the victim from the chemical. If this is not possible, ensure that the area is well-ventilated (open doors and windows). If in doubt, do not stay in the room yourself. Many chemicals have no odor or obvious effect and you may not be aware that you are being poisoned.

1. Monitor and maintain the victim's airway and breathing and be prepared to resuscitate if necessary.
2. If the victim becomes unconscious, place in the recovery position.
3. If the victim is conscious, help into the most comfortable position. If there are breathing problems, this position is most likely to be sitting up.
4. Call 911 and provide as much information as you can.

Poisons on the skin

1. Do not contaminate yourself. Wear protective clothing if available.
2. Wash away the chemical with water, taking care to flush the contaminated water away from both yourself and the victim.
3. Monitor and maintain the victim's airway and breathing and be prepared to resuscitate if necessary.
4. Call 911 and reassure the victim until help arrives.

DRUG POISONING

Drug poisoning can be deliberate or accidental. Drugs may be prescription only, illegally supplied, or freely available from the chemist. Signs and symptoms of drug poisoning will vary, depending on the drug that has been taken.

TREATMENT

1. Keep yourself safe. The effect of some drugs, both legally and illegally supplied, can be to cause aggression or irrational behavior in the person who has taken them. If this is the case, do not approach the victim. Call 911 instead and explain the situation. They will make a decision about weather the police need to be called.
2. Monitor and maintain the airway and breathing and be prepared to resuscitate if necessary. If it is safe for you to do so.
3. If the person becomes unconscious, place him or her into the recovery position.
4. Call 911 and stay by the victim until assistance arrives.
5. Look for clues as to the cause of the poisoning and inform medical staff.

COMMON TYPES OF DRUGS AND THEIR EFFECTS

Analgesics (painkillers)

• Act on the brain and spinal cord to stop the perception of pain. Produce a state of well-being and relaxation. While they have legitimate medical use, they are among the most commonly abused drugs. Side effects include nausea, vomiting, constricted pupils, constipation, and slow and shallow breathing. Overdose may lead to unconsciouness and death.

Non-opioids

• Act in a similar way to the opioids but with fewer side effects. Signs of an overdose may not be immediately obvious but if the antidote is not administered swiftly, fatal liver failure can set in, even in an adult who appears to be healthy. Signs include pain, nausea, and vomiting.

NSAIDs (Non-steroidal anti-inflammatories)

• Act at the site of pain to prevent the painful stimulation of nerve endings. While generally safe, they can irritate the stomach lining, causing pain and bleeding, particularly in those susceptible to stomach ulcers.

Sleeping drugs and antidepressants 

• Act by depressing brain function. Minor side effects include slow mental activity and drowsiness. Effects of overdose include gradual decline into unconsciousness, shallow breathing, and abnormal pulse rate.

Stimulants and hallucinogens

• Act by stimulating the central nervous system (the brain and spinal cord). Signs include out-of-character behavior, hallucinations, energetic sweating, and increased heart rate.

ALCOHOL POISONING

Alcohol depresses the central nervous system, which is the center of our thoughts, feelings, and senses, and is responsible for coordinating all movement and body processes. In the early stages of drinking, this creates a relaxed feeling and impression of increased confidence. Continued drinking can affect the ability to make rational decisions and, as consumption increases, will slow down breathing and can even cause loss of consciousness. The effect of alcohol on the body is affected by factors including weight, body fat, and history of alcohol intake. What may be a safe level for one person may have serious effects for another.

EFFECTS OF HIGH INTAKE. There are four key risks following a high alcohol intake:

• Injury, as a result poor decision-making and clumsiness.
• Vomiting, leading to choking in an unconscious person.
• Hypothermia-- caused by alcohol dilating the blood vessels, making exposure to the cold a greater risk.
• Slower breathing and, ultimately, breathing stopping.

TREATMENT

1. Monitor and maintain the person's airway and breathing. Be prepared to resuscitate the person if necessary.
2. If the person becomes unconscious, place into the recovery position. The person is extremely likely to vomit, so watch carefully for signs of vomit and remove from the mouth as needed.
3. If the person is conscious, help into a comfortable position and encourage him or her to keep still.
4. Check for additional injury and give treatment as appropriate.
5. Protect from extremes of cold to reduce the risk of hypothermia developing. If the person is unconscious, you suspect further injury, you are worried that other substances may have been consumed, or you have any other doubts as to their condition, call 911. Do not underestimate the risk of alcohol poisoning.

SIGNS AND SYMPTOMS

• What has happened. Consider this carefully-- a person who has suffered a head injury or stroke may show similar signs and symptoms to somebody who is drunk
• Strong smell of alcohol
• Lapsing in and out of consciousness. Rousable at first but eventually slipping into full unconsciousness
• Red, sweating face
• Deep, noisy breathing-- sounds of snoring
• Strong, fast pulse

Eventually, breathing may become shallower and the pulse weaker and faster.

LONG TERM EFFECTS OF ALCOHOL

Drinking alcohol within safe limits may be beneficial  for health, helping to protect against stroke and heart disease, but if you have more than a couple of alcoholic drinks a day, there are more risks than benefits.

• Weight gain: alcohol contains many calories and regular drinkers often put on weight.
• Reduced intellectual function: brain cells that control memory and learning are damaged by alcohol. Alcohol is damaging to mental health, causing increased anxiety and depression.
• Increased risk of developing many types of cancer (this risk is  even higher if you smoke as well).
• Reduced fertility in both men and women and damage to the fetus if you drink heavily during pregnancy.
• Damage to the liver and other organs; digestive problems such as ulcers.

By: Unknown On 7:27 AM

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Poisoning

A poison is any substance that enters the body and cause temporary or permanent harm. Some substances, such as acetaminophen or alcohol, only become harmful to the body when taken in a large quantity. Others, such as some herbicides, need only to be taken in very small amounts to be harmful.

HOW DO POISONS AFFECT THE BODY?
Different poisons have different effects. The effect is modified by the quantity and the time since exposure.

POTENTIAL EFFECTS OF POISONS
Vomiting. This is a common response to many poisons, particularly those that have been eaten, as the body tries to remove the poison from the system.

Impaired consciousness. A person may be confused and slowly lapse into full unconsciousness.

Breathing difficulties. Poison may eventually cause breathing to stop.

Change in heart rate. Some poisons speed up the heart rate; others slow it down. Poisons may eventually cause the heart to stop.

Erratic and confused behavior
Always suspect poisoning in these instances.

Burns. Some poisons burn the skin, some swallowed poisons burn the digestive tract, bringing the additional risk swelling around the mouth and throat.

Pain. Some poison will cause pain.

Liver and kidney problems. As the liver and kidneys struggle to remove poisons from the body they may become affected themselves.

KEY FIRST AID PRINCIPLES FOR DEALING WITH POISONS

1. Protect yourself and bystanders from the source of the poison by making the scene safe and wearing protective clothing if necessary.
2. Monitor and maintain the victim's airway and breathing and be prepared to resuscitate if necessary.
3. Seek appropriate medical help or call the Poison Control Hotline to deal with dangerous substances.
4. Monitor the victim's level of consciousness and be prepared to turn into recovery position if necessary.
5. Support the victim if he vomits and place in the recovery position until medical help arrives.
6. Treat any burns caused by corrosive poisons by flooding the affected area with running water.
7. Try to identify the source of the poison because this will help determine appropriate medical treatment.

THERE ARE FOUR KEY WAYS IN WHICH POISONS CAN ENTER THE BODY

Eating(ingestion)

• Examples
• Food carrying bacteria that cause food poisoning
• Prescription drugs taken as a deliberate or accidental overdose
• Alcohol in excess
• Household chemicals (children particularly are prone to drinking from chemical containers while playing)
• Plants (for example, magic mushrooms may be eaten deliberately when seeking an effect, or by accident)

Breathing(inhalation)

• Examples
• Carbon monoxide (in exhaust fumes)
• Fumes in house fires

Injection

• Examples
• Prescription drugs taken as a deliberate or accidental overdose
• Illegal drugs
• Insect bites and stings

Through the skin (absorption)

• Examples
• Many industrial chemicals
• Herbicides

CLUES TO IDENTIFYING POISONS

The early identification of a poison will help medical staff determine an appropriate course of treatment. Potential clues that you as the first person at the scene of the incident may be able to provide include:

• Medicine bottles/pills containers (do not assume that an empty bottle means that all the pills were taken).
• Samples of vomit: if the victim is sick, keep the vomit for inspection.
• Details of what happened from the bystanders or from the victim.
• Identification of animal or insect: if the poisoning route was a bite, try to get a description of the creature. If it is safe to do so, take the poisonous animal or insect to hospital.
• Chemical containers: be able to describe any HAZMAT symbol or label if you can get close enough to do so without putting yourself at risk. Do not touch these yourself. Remember that many household substances are toxic.

POISON FROM HOUSEHOLD CHEMICALS

Many everyday household substances are potentially poisonous if misused. Unfortunately, many hospital admissions are the result of children drinking household chemicals while playing. Inside the home, cleaning materials are often the biggest risk, while in the garden herbicides, pesticides, and paint stripper are common culprits. Most household chemicals cause problems when they are swallowed. Many are corrosive and together with the effect of the poison may also cause burns to the mouth and food canal (digestive tract).

MANAGING SWALLOWED POISONS

TREATMENT
Make sure that it is safe for you to approach. Do not inadvertently kneel in chemicals or otherwise expose yourself to any risk.

1. Monitor and maintain airway and breathing. Be prepare to resuscitate if necessary.
2. Monitor consciousness. If the person becomes unconscious, put into the recovery position.
3. Call 911 or the Poison Control Hotline for advice on how to proceed.
4. Treat any burns, wearing protective clothing if necessary.
5. Support the person if he vomits and place in the recovery position if necessary.
6. Reassure the person while you are waiting for emergency assistance to arrive.
7. Identify the poison if possible because this will help medical staff determine what treatment is appropriate.

SIGNS AND SYMPTOMS

• Signs of bottles, information from the victim, or from bystanders
• Burns to the mouth
• Vomiting
• Pain
• Impaired consciousness
• Difficulty in breathing

DO NOT!

Do not try to make the person vomit. If a person burns on the way down to the stomach, it will burn on the way up.

IF THERE ARE MOUTH BURNS. If the person stops breathing you will need to provide rescue breathing. However, if there are mouth burns because the poison was corrosive, you must take care not to put yourself at risk. Use a face shield or mask while rescue breathing. This should be placed between the teeth. The plastic shield forms a barrier as you give mouth-to-mouth.

     If there is no shield available, consider providing rescue breathing mouth-to-nose. Tilt the head and lift the chin as you would normally. Then close the mouth (using a piece of material as barrier against the poison if appropriate) and seal your mouth around the victim's nose. Provide rescue breathing at the same rate and ratio as you would when giving mouth-to-mouth. Take your mouth away after each breath and open the victim's mouth between breaths to let the air out.

     If the victim is breathing and conscious, you may provide relief from the burning by giving frequent sips of cold water. This will help relieve pain and reduce swelling.

PREVENTION OF POISONING FROM HOUSEHOLD SUBSTANCES

• Put all household cleaning materials and medicines up high out of the reach of children
• Consider putting any dangerous substances in a locked cupboard
• Always read instructions for use carefully. Some household chemicals should be used only in a well-ventilated room or with some protective clothing.
• Always store chemical in the container they came in or a clearly marked alternative. Never store chemicals in drinks containers or unmarked bottles
• Keep gardening supplies securely in the shed or garage in a locked container
• Where possible, buy medicines and cleaning materials in childproof containers

By: Unknown On 8:26 PM

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Extreme Cold and Heat

Hypothermia, a condition that occurs when the body temperature falls below the normal range, is caused by a low surrounding temperature and can lead to death. Freezing temperatures cause frostbites, whereby ice forms in the body tissue and destroy it. The risk of frostbite is increased by windy condition.

CAUSES OF HYPOTHERMIA. Hypothermia (low temperature) occurs when the body temperature falls below the normal range, and can lead to death. The average temperature of a healthy adult is 96.8-100.4 F. Hypothermia occurs when the body's core temperature falls below 95 F. Survival is unlikely, but not unheard of, below 79 F.

There are a number of factors that heighten the risk of becoming hypothermic. These include:

• Age
• The elderly are at greater risk from hypothermia: low mobility combined with poor circulation, a reduced sensitivity to the cold, and greater potential for slips and falls means that an elderly person may develop hypothermia in temperatures that a healthy younger adult could tolerate. The very young are also at an increased risk because the mechanisms for controlling their own body temperature are poorly developed. They may look healthy but their skin will feel cold and their behavior may be abnormally quite or listess.
• Exposure to wind or rain
• Immersion in cold water
• Lack of food
• Alcohol and drugs

SIGNS AND SYMPTOMS OF HYPOTHERMIA

Early signs:

• Shivering
• Pale, cold skin
• Cold environment
• Presence of an increased risk factor as listed left

As the condition gets worse:

• No shivering, even though the person is cold
• Increasing drowsiness
• Irrational behavior and confusion
• Slow, shallow breathing
• Slow, weak pulse

TREATMENT

If the person is unconscious

Open the airway and check for breathing. Be prepared to resuscitate if necessary. Hypothermia slows the body's functions down before stopping the heart, and it is therefore not uncommon to hear of people with hypothermia being successfully resuscitated some time after the heart has stopped.

If the person is conscious

1. Improve the surroundings. If the person is outdoors, bring them in or take them to shelter. If the person is indoors, warm the room but do not overheat (77 F).
2. Replace wet clothes with dry warm clothing if possible.
3. A healthy adult may be best rewarmed by soaking in a warm bath of 104 F. Do not use this technique on an elderly person or child.
4. Wrap the person up and give high energy foods and warm drinks. Remember that heat is lost through the extremities so cover the head, hands, and feet.
5. Check for other conditions or injuries that may have occurred. The confusion caused by hypothermia may mask other signs and symptoms. If there is no improvement, or the level of consciousness deteriorates, seek medical advice. For young children and elderly, who are particularly vulnerable, always seek medical attention if you suspect hypothermia. Warm them slowly.

FROSTBITE

Frostbite occurs in freezing conditions and is the freezing of body tissue at the extremities, most commonly the fingers, toes, and earlobes. If it is not treated early enough it can lead to gangrene and to amputation. Frostbitten skin is highly susceptible to infection.

Treatment

1. Remove tight items such as rings and watches that may further damage circulation. Warm the injured part slowly by holding it.
2. Get the person to shelter. Do not attempt to thaw the injured part if it is liable to be re-exposed to cold, because this will do more damage.
3. Handle the injured part carefully because the tissue is very fragile and may be easily damaged. Do not apply direct heat, rub, or allow the injured person to apply pressure to  (for example, do not let the person walk if the toes are affected). Place the injured part in warm water if available. Otherwise continue warning the injured part with your hand.
4. Pat dry and then cover with a light gauze bandage. Remember that the injured part will be exceptionally painful for the victim.
5. Raise the injured part to help alleviate pain and swelling and allow the injured person to take acetaminophen if able to.
6. Watch for hypothermia and treat as appropriate.
7. Seek medical attention particularly if the site of the freezing does not regain a healthy color or is black.

SIGNS AND SYMPTOMS OF FROSTBITE

• Freezing environment

Early signs

• Tingling
• Pale skin

As the condition gets worse

• Numbness
• Hardening of the skin
• Skin color changes to white through blue and finally black

When thawed, the injured part is extremely painful and there may be blistering  of the skin.

EXTREME HEAT

Heat exhaustion is a condition resulting from the loss of fluid and salt, usually through excessive sweating. Heatstroke generally occurs rapidly when the brain's temperature regulator fails to work effectively. This tends to occur when a person has been in a very hot environment or has a fever caused by a condition such as malaria.

HEAT EXHAUSTION. Heat exhaustion is very similar to shock in that fluid is being lost from the body. It most commonly occurs when a person has been exercising and not replacing fluid content: cyclist and joggers are common sufferers from the condition.

TREATMENT

1. Lay the victim down in a cool place and raise her legs.
2. If the victim is conscious give sips of weak salt solution (one teaspoon to one liter of water).
3. Maintain a check on the victim's consciousness level. If deteriorates, place the victim in the recovery position and call for emergency assistance.
4. If the victim's condition improves rapidly advise her to see a doctor.

SIGNS AND SYMPTOMS OF HEAT EXHAUSTION

• History of exertion
• Pale, cold, and clammy skin
• Fast, weak pulse
• Fast, shallow breathing
• Nausea
• Dizziness and disorientation
• Lapse into consciousness

HEATSTROKE. In heatstroke, the body becomes very hot very quick and this condition can be fatal. The signs and symptoms are very similar to those of a stroke.

TREATMENT

1. Check airway and breathing. If unconscious, turn the victim into the recovery position. Be prepared to resuscitate if necessary.
2. If the victim is conscious, move to a cool environment. If this is impossible or the victim is unconscious, try to cool the environment (use fans, open doors, and keep crowd away).
3. Call for emergency assistance and reassure the victim if he or she is conscious.
4. Remove outer clothes and wrap the victim in a cold, wet sheet. Keep it wet. Continue the cooling process. If the body temperature drops, replace the wet sheet with a dry one
5. \Continue to monitor the victim while you wait for help.

SIGNS AND SYMPTOMS

• Hot, flushed, and dry skin
• Slow, full, and bounding pulse
• Noisy breathing
• High body temperature
• Headache
• Disorientation
• Lapse into unconsciousness

SLIP SLAP SLOP

The three simple rules for prevention of sun-related problems are:

Slip into a T-shirt

Slap on a hat

Slop on the sunscream

By: Unknown On 8:31 AM

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Chemical Burns and Eye Burns

While the general rules for the treatment of burns are the same, regardless of the type of burn, there are some additional considerations for chemical burns. The key point when dealing with chemicals is not to contaminate yourself. Chemical spills are not always obvious-- some very toxic chemicals look like water-- so look signs such as a HAZMAT (hazardous material) label, empty chemical containers, or guidance from bystanders. If in doubt, call 911 rather than approach the injured person yourself. Remember that some household substances, particularly cleaning materials such as oven cleaner, can cause chemical burns.

TREATING CHEMICAL BURNS

1. If you feel that you can safely approach the victim, then do so carefully. 
2. If necessary, wear protective clothing to protect yourself from contamination.
3. Ventilate the room if possible because many chemicals affect breathing.
4. When cooling the burn with water, ensure that the contaminated water drains away from both the victim and yourself. It may be necessary to flood the injured part for longer to ensure that the chemical is totally washed away. This may take more than 20 minutes.
5. Call 911. Make sure you have mentioned that it is a chemical burn so that additional help can be sent for if necessary and so that any antidotes can be sent with the ambulance.
6. If possible, remove contaminated clothes from the victim because these may keep burning, but only do this if you can do it without contaminating yourself or causing the victim more harm.
7. Cover the burn with a clean, non-fluffy material as appropriate and tie loosely in place if necessary.
8. Treat for shock and reassure the victim until emergency help arrives on the scene.

WHAT IF THE CHEMICAL REACTS WITH WATER?

Some industrial chemicals do react badly with water. Where such chemicals are used, people working with them should have been trained in the use of an antidote. If there is nobody around with this expertise, do not waste time looking for an antidote-- apply liberal amounts of water to try to wash the chemical away.

CHEMICAL BURNS TO THE EYE. Chemical burns to the eye can be very serious. Early rinsing of the eye with cold water will help to flush away the chemical and reduce scarring.

TREATMENT

1. Protect yourself, the victim, and bystanders from further contamination.
2. Hold the affected eye under cold running water for at least 10 minutes to flush out the chemical, allowing the injured person to blink periodically. You may need to hold the eyelid open. Make sure that the water flow is gentle. Do not allow contaminated water to fall across the good eye and so contaminate that eye also.
3. Ask the injured person to hold a non-fluffy sterile or clean pad across the eye, tying it in place if hospital treatment may be delayed.
4. Take or send the person to hospital with details of the chemical if possible.

SIGNS AND SYMPTOMS OF CHEMICAL BURNS TO THE EYE

• Known exposure to chemical
• Intense pain
• Redness and swelling
• Reluctance or inability to open the eye
• Tears from eye

FLASH BURNS TO THE EYE. Caused by looking into very bright light, flash burns damage the surface of the cornea, the transparent front of the eyeball. Recovery can take some time and in some instances the damage can be permanent (for example, if a person has looked at the sun through a telescope without appropriate protection).

TREATMENT

1. Check the history to rule out chemical burns or a foreign body in the eye.
2. Reassure the injured person, and wear gloves to prevent infecting the eye.
3. Place pads over both eyes and bandage in place if it will be some time until medical help arrives. Remember that this will effectively blind the person temporarily so stay with her to reassure and guide.
4. Take or send the person to hospital because she will need medical attention.

SIGNS AND SYMPTOMS OF FLASH BURNS TO THE EYE

• Known exposure to intense light (which may have happened some time ago)
• Intense pain
• Feeling that there may be something in the eyes
• Redness and watering
• Both eyes affected

CONTACT LENSES

Where there has been any injury to the eye, encourage the injured person to leave contact lenses in place.

By: Unknown On 6:29 PM

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Burns and Scalds

Burns and scalds, a type of burn caused by wet heat, are potentially fatal injuries. They can cause life-threatening shock through serious fluid loss and, if around the face and neck, can restrict breathing.

WHAT ARE THE RISK FROM BURNS? In burns, fluid is lost in three main ways:

• Blistering
• Swelling around the injury
• Directly from the injury

While the fluid loss may not be visible as liquid lying around the victim it is nevertheless lost from the blood as a straw-colored substance known as plasma. Severe burns therefore can and often do prove to be fatal.

     The second risk from burns is infection. The damaged tissue provides little or no resistance to infection and serious problems may arise some time after the initial injury. The risk of infection increases with the size and depth of the burn, and the victim will probably suffer from shock as well.

CAUSES OF BURNS

Dry heat. This is the most common type of burn and include burns caused by hot objects such as exhaust or by cigarettes or lighters.

Wet heat. Also know as a scald, wet heat usually refers to hot water or steam but it can also include other hot liquids such as oil or fat.

Friction.  When two objects rub together very quickly friction generates heat, causing another kind of dry burn.

Chemical burns. Industrial and household chemicals can cause serious burns.

Electrical burns. These can be caused by the everyday low-voltage currents found in switches, wires, and appliances around the home or from the high-voltage cables scattered around the countryside in the form of power lines, subway tracks, and so forth. In rarer cases electrical burns can be caused by lightning strikes.

Radiation burns. While this may sound dramatic, most of us have suffered some degree of radiation burn at some point in our lives-- more commonly known as sunburn.

DEPTH OF THE BURN

First degree burns involve only the outer layer of skin and, although often extremely painful, are generally not life-threatening unless a very large surface area of the body is covered. The burned area is very sore and is usually red and possibly a little swollen. If good first aid treatment is applied and the area burned is not extensive, then further medical treatment is unlikely to be needed.

Second degree burns include the top layers of skin and involve blistering. They are characterized by red, raw-looking skin, blisters that weep clear fluid, and pain. The risk of shock is high with second degree burns and any burn of this type needs medical attention. Second degree burns covering a substantial percentage of the body can kill.

Third degree burns involve damage to all the layers of skin, usually including the nerve endings and other underlying tissues and organs. Characterized by charred tissue often surrounded by white  waxy areas of dead skin with damaged nerves, third degree burns will always need emergency medical attention and in the long term will often require plastic surgery.

AREA OF THE BODY BURNED. Generally, the larger the area of the body burned, the more serious the burn. Any burn to the face or neck need urgent  medical attention. As a general principle, if the victim has other injuries, appears to be in great deal of pain, is showing signs and symptoms of shock, is having difficulty breathing, or you have other reasons to suspect that his or her condition is more serious, then call an ambulance whatever the extent or depth of the burn.

HOW DO YOU TELL HOW SEVERE A BURN IS?

Many burns are minor and can be safely treated at home  or with help from a local doctor or pharmacist.

     However, the size and depth of the burn will tell you if it needs urgent medical treatment.

TREATING OTHER TYPES OF BURNS

The general principle of treating burns remains to cool and cover the affected area but some types of burn need extra consideration. With burns to the neck and mouth, beyond the risk of shock and infection, the greatest potential problem is the risk of airway obstruction due to swelling. The obvious additional danger with electrical burns is the combination of water as a treatment and electricity as the cause.

TREATING BURNS TO THE NECK AND MOUTH

1. Check the victim's airway and breathing and be prepared to resuscitate if necessary.
2. Call an ambulance and reassure the victim until help arrives.
3. Get the victim into a position where his breathing is comfortable (this will usually be sitting up).
4. Loosen any constriction around the neck to ease breathing. Keep the airway clear.
5. Cool any burns continuously-- do not attempt to cover.
6. Maintain a check on the victim's airway and breathing.

LIGHTNING

Although rare, lightning strikes do happen and can kill. If caught outside in a thunderstorm, seek shelter in a car or building .

If there is no shelter, make yourself as low as possible, minimize your contact with the ground by crouching and avoid single trees, bodies of water, and tall objects.

If a person has been struck by lightning, check their airway and breathing, be prepared to resuscitate, treat any burns, and call for help.

ELECTRICAL BURNS. If a victim has suffered from an electrical shock, do not attempt to touch the person unless you are absolute certain that he or she is no longer contact with live equipment. If the person is still attached to an electrical current, your best option is to turn the electricity off at the main breaker. If you cannot access the breaker, you may be able to turn off electrical equipment at the wall socket but particularly careful that you do not touch the victim or any live equipment.

     If there is no way to turn the electricity off, you can attempt to move the victim away from the point of contact using a non-conducting material such as a broom handle, be possible by wearing rubber gloves and shoes, and by standing on a telephone directory.

Electricity demands respect-- if in doubt, call in professional help. Do not put yourself in any danger.

TREATING ELECTRICAL BURNS

A victim suffering from an electrical burn may well have respiratory or circulatory difficulties. An electrical discharge across the heart can make the heart stop beating, so be prepared to resuscitate the victim over and above the treatment of any burn that may be present.

1. Make absolutely sure that there is no further risk from the electricity.
2. Check to see whether the victim is conscious. If unconscious, check airway and breathing and take action as appropriate.
3. Treat any burns with cold water if safe to do so.
4. Cover burns as appropriate with sterile, non-fluffy dressings.
5. Seek urgent medical attention. Stay with the victim and reassure him until medical help arrives.

HIGH-VOLTAGE ELECTRICITY

High voltage electricity (power lines, subway tracks, overhead power cables, etc.) usually kills immediately, causing severe burns, heart problems, and potentially even broken bones and internal injuries as the victim is thrown by the shock.

If somebody has been hit, your first priority is to keep yourself and other bystanders safe. High-voltage currents can jump some distance so keep people back at least 60 feet and call for professional help via 911.

HOW TO TREAT BURNS AND SCALDS

The general treatment of all burns is very simple : cool and cover the affected part, and seek appropriate medical help. Before you do anything else, make sure that you protect yourself. This is particularly important at accident scenes. Ensure that the fire is out, any electrical equipment is safely disconnected, and that any chemical spills are not going to affect you.

TREATMENT

1. Monitor the victim's airway and breathing. This is particularly important if the victim has burns to the mouth and airway. Be prepared to resuscitate if necessary.
2. If possible lay the victim on the ground to help reduce the effects of shock.
3. Douse the burned area with cool liquid. Cooling the burn will reduce the pain, swelling, and risk of scarring. Restrict the cool liquid to the injured part wherever possible because over cooling could lead to hypothermia, particularly if the surrounding air temperature is low. If applying water from a shower, hose, or tap, ensure that the pressure is minimal because water hitting burned skin at speed will add to the pain and the damage.
4. Make an assessment about whether or not an ambulance is needed and call for help. If in doubt, call 911.
5. Keep cooling the injured part until the pain stops. Often 10 minutes is sufficient but if the victim still complains of pain after this time then continue with the cooling treatment.
6. Remove rings, watches, and other potential constricting items such as burns swell up. Take care to return these items to the casualty.
7. Once the pain has eased, cover the wound to prevent infection. These should be done with a sterile bandage if possible, tied very loosely over the burn. If in any doubt as to whether material may stick to the wound, do not attempt to cover but continue to cool the burns continuously until medical help arrives. If you are having to improvise, any clean, non-fluffy material can be used-- ideal examples are clean handkerchiefs, cotton pillowcases, or plastic wrap.
8. If possible, raise the injured part as this can help to reduce swelling.

Stay with the injured person until help arrives or, if the burn is less serious, accompany her to further medical attention.

• Continue to treat for shock
• Maintain a check on the victim's airway, breathing, and circulation
• Keep checking bandages to ensure that they are not too tight.

WARNING!

• Do not over-cool the victim.
• Do not apply water under pressure.
• Do not remove burned clothing if it is sticking to the wound.
• Do not put cotton wool or any other fluffy material on to a burn as it will stick to the injury.
• Do not put any creams or ointments on to a burn because these will need to be removed at the hospital.
• Do not burst blisters because this may increase the risk of infection.

By: Unknown On 10:46 PM

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Injuries to the Lower Leg, Lower Body/ Sprain & Strain

The long bones, the knee, and the foot are often injure during sports. There are two long bones in the lower leg. The tibia (shinbone) lies very close to the surface and if broken will often pierce the skin, causing an open fracture. The fibula lies behind the tibia. It is more difficult to break this bone and may not obviously affects the ability to walk. The knee is a complex joint vulnerable to fractures of the patella (kneecap), dislocation, strains, and cartilage (tissue) injury. It is unusual to break just one bone in the foot-- generally, multiple fractures of the small bones in the foot and the toes are caused by crush injuries.

TREATING BROKEN LONG BONES

1. Help the injured person into the most comfortable position-- generally, lying down.
2. Examine the injury carefully to see whether there is an open break. If there is a wound, cover gently with a sterile dressing or clean, non-fluffy material, pad around the broken area and tie gently but firmly into place.
3. Gently support the injury above and below the site of the break. Place padding such as cushions or blankets around the site of the injury.
4. If you have been trained to do so, applying traction may help alleviate the pain and any potential damage to the circulation.
5. Treat for shock and reassure.

TREATING A BROKEN LEG

A person with a broken leg is most likely to be transported to hospital by ambulance and the treatment in most settings is therefore limited to steady support and help with immobilization.

TREATING KNEE INJURIES. In addition to the normal signs and symptoms of bone and soft tissue injuries, there may be an obvious displacement of the kneecap or an inability to bend or straighten the leg.

1. Help the injured person into the most comfortable position. He will generally need to be transported to hospital by ambulance.
2. Check the injured area carefully for an open break and treat as appropriate.
3. Pad around and under the injured area to provide support, gently tying the padding in place if needed.
4. Treat for shock and reassure the victim until help arrives.
5. Do not try to bend the leg because you may cause more damage. Keep it still.

TREATING A BROKEN FOOT

1. If possible, carefully remove the shoes and socks, tights, or stockings because the foot is likely to swell and these items of clothing may damage the circulation.
2. Cover any wound with a sterile dressing or clean, non-fluffy material.
3. Raise the foot to reduce swelling and pain and support with a large comfortable pad such as cushion or blanket.
4. Wrap the foot in padding, if necessary, this can be held in place with a cover bandage. A cold compress may further alleviate pain and swelling.

Take or send the injured person to hospital.

WARNING!

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

INJURIES TO LOWER BODY
A broken bone in the lower body is a serious injury that requires hospital treatment. The pelvis is a large bone and is generally very difficult to break. Severe impact such as a fall from a height or a car accident are the most common cause in young, fit adults. In the elderly a broken pelvis (or hip) happens more often and can be caused by a relatively minor impact. In healthy adults it takes a major impact to break the thighbone and there are likely to be other injuries.

BROKEN PELVIS. The pelvis protects the urinary system and the biggest danger is that sharp bone ends may burst the bladder, creating the possibility of infection. Internal bleeding is another likelihood with a fractured hip, because the impact required to break the bone is likely to have caused other damage.

TREATMENT

1. Call an ambulance immediately and reassure the victim while you wait.
2. This is very serious condition and it is best not to move the victim because you could easily make things worse.
3. If the ambulance will be some time, tie the legs gently together at the ankles and knees using triangular or improvised bandages.
4. Treat the victim for shock.

SIGNS AND SYMPTOMS OF A BROKEN PELVIS

• Bruising and swelling over the hip area
• Urge to urinate
• Blood-stained urine
• A sensation of falling apart: the pelvis is like a girdle and break means that it may not be able to hold itself together
• Legs rotate outward as the support at the pelvis

Because the pelvis can also be broken at the back, it is easy to mistake a pelvic fracture for a spinal injury. If in doubt, treat for a broken spine.

FRACTURE FROM THE UPPER LEG. The key risk with fractures of the femur (thigh bone) in the upper leg is shock. The thighbone protects the main artery in the leg, the femoral artery, and if broken may pierce it, causing severe internal bleeding.

     A person with a broken thighbone will require transportation by ambulance. The general treatment is therefore nothing more than immobilize the injured part and treat the victim for shock. Do not bandage the leg if helps is on its way-- this is likely to cause more pain and potentially cause further damage.

     Support the leg above and below the site of the fracture if possible, placing padding around the broken leg to further help to reduce movement of the injured limb. If you have been trained in the use of traction then you may apply this gently to the leg to help to reduce pain and circulatory damage.

The injured person may benefit from immobilization of the broken leg by using the good leg as a splint, particularly if there will be a delay before medical help arrives.

1. Apply broad fold triangular bandages under the ankles, knees, and above and below the site of the fracture.
2. Place padding between the legs to help immobilize them.
3. Gently but firmly tie the bandages on the injured side.
4. Take care to check the circulation below the bandages to ensure that they do not become too tight as the leg swells.

WARNING!

• Do not give anything to eat or drink-- the victim may need a general anesthetic in hospital.
• Do not move the victim unless he is in danger or needs resuscitation.

SPRAIN AND STRAINS

Strains occur when the muscle is overstretched, leading to a particular tear. Sprains are injuries to a ligament, a tough band of tissue that links two bones together at or near a joint. Commonly sprained joints include the wrist, knee, and ankle.

TREATMENT. The person suffering the injury may often sense that the area is not broken-- she may have suffered similar injuries before, particularly if the injury has occurred through sport. If both of you are confident that there is no other injury, then the best treatment is :

• Rest
• Ice
• Compression
• Elevation

1. Place the injured part at rest. This prevents any further damage. Help the person into a comfortable position-- for a leg injury, this will usually be lying down with head and shoulders supported.
2. Apply a cold compress. Wrap some ice in a triangular bandage or other clean piece of material and hold gently on the site of the injury. This will help relieve pain and reduce swelling. Do not apply ice directly to the injury because this may damage the skin. Cool the injury for 10-15 minutes, keeping the compress cold with refills as necessary.
3. Apply a compressing gauze wrap. This will help reduce pain and swelling and will provide support for the injury.
4. Elevate the injured part. Elevation will help reduce swelling and pain. If the arm is injured, use either the other arm or elevation sling as appropriate to provide additional support.
5. Seek medical assistance and make sure the victim keeps the limb raised and supported until help arrives.

By: Unknown On 7:08 PM

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Recognizing Back and Spinal Injury

The spine is made up of a number of small bones called vertebrae. These form the backbone or spinal column, through which runs the spinal cord (the part of the central nervous system connecting all parts of the body with the brain) and major blood vessels. Injuries to the back are caused in a number of ways: through direct impact (such as a heavy blow to the neck or back); indirect impact (landing on the head or feet without bending the legs, thus allowing the force to travel up the body); and whiplash, when the head is violently thrown forward and backward (common in traffic accidents).

COMPLICATIONS WITH BACK INJURY. The biggest danger with back injuries is the risk of nerve damage. The spinal cord containing the spinal nerves runs down the center of the vertebrae and fractures can sever or pinch these nerves, leading to partial or full paralysis. If the fracture is high in the neck, breathing may stop. Displaced vertebrae or swelling due to blood loss can also apply pressure to the spinal cord, leading to nerve damage.

     Not all broken backs result in immediate damage to the spinal cord. However, the risk of spinal cord injuries is greatly increased if bones are broken, and any suspected fracture of the spine should be treated with extreme care.

Suspect a broken back or potential nerve damage if the accident involved:

• Rapid slowing down of movement.
• A fall from height.
• A sharp blow directly to the back
• Injury to the face or skull (because this often results from the head being thrown backward and forward).

SIGNS AND SYMPTOMS

• Dent or step in the spine, which may indicate a displaced vertebra.
• Bruising or swelling over the backbone
• Complaint of pain in the back
• Tenderness over the area of the break.

TREATMENT. Any spinal injury is potentially serious and you should seek emergency assistance immediately. The treatment for injuries to the back is to keep the injured person still while monitoring and maintaining airway and breathing. The general rule for dealing with broken bones or spinal cord damage is to keep the victim in the position that you found him until a doctor arrives, taking particular care to ensure the head is immobilized.

     Unless the person is in danger or unconscious and requires resuscitation, do not move him from the position in which he was found. If you have been trained to do so, you can move the head into the neutral position before immobilization. Remain in this position until emergency help arrives.

1. If the victim is conscious and already lying down, leave him where he is. If the victim is still walking around, support him in lying down on the ground. If you can, put a blanket or coat underneath before you lie the person down.
2. Ensure that an ambulance has been called at the earliest opportunity.
3. Tell the person to keep still until medical help arrives and reassure him.
4. Hold the victim's head still by placing your hands over the ears and your fingers along the jawline.
5. Do not remove your support from the head until help arrives.

If the victim is unconscious, maintaining a clear airway is your first priority.

BACK PAIN. There are many causes of back pain. Among the most serious is damage to the spinal cord, which may lead to paralysis or meningitis. More commonly, neck or lower back pain can be caused by muscle strain or damage to the ligaments or the disks between the vertebrae (the back bones). Broken ribs or damage to the muscles between the ribs at the back may also cause back pain.

TREATMENT

• Check the nature of the incident carefully-- if the pain is related to a recent heavy fall or other accident, assume that there may be spinal cord damage and treat as for a broken back.
• Help the person to lie down. Usually the most comfortable position will flat on the back on a hard surface.
• If the symptoms do not ease, seek medical attention promptly.

SIGNS AND SYMPTOMS

• Dull or severe pain, usually made worse by movement
• Tension in the neck or shoulders
• Pain travelling down limbs

If back pain is accompanied by signs of spinal cord damage, such as numbness,tingling, or by headaches, nausea, vomiting, fever, or a deterioration in the level of consciousness (e.g. increasing drowsiness), call 911.

THE SPINE

The spine or backbone enables the body to stand upright, supports the head, and protects the spinal cord. Joints between vertebrae give the spine flexibility; ligaments and tendons stabilize the spine and control movement.

SIGNS AND SYMPTOMS OF SPINAL CORD DAMAGE

• Loss of movement below the site of the break
• Tingling in the fingers or toes or throughout the body
• Feeling strange, perhaps "jelly-like"
• Numbness

If any of these signs and symptoms is present, or if the nature of the accident indicates a potential fracture, assume that a bone is broken and keep the person still until help arrives.

WARNING!

• Do not give anything to eat or drink-- the victim may need a general anesthetic in hospital.
• Do not move the victim unless he is in danger or requires resuscitation.

IF YOU HAVE TO MOVE THE VICTIM

The two key reasons for moving someone wit a spinal injury are: to turn the person onto her back in order to resuscitate her; and to move her into the recovery position if she is unconscious and in a position that does not allow her to maintain a clear airway.

NEUTRAL POSITION. The best position for a person with a suspected neck or spinal injury is the neutral position. Here the head is in line with the neck and spine. To move a person into the neutral position, grip the head firmly over the ears and move it slowly into line. Once in this position, do not give up this support until medical help arrives to take over from you.
     Only use this technique if you have been trained to do so.

LOG ROLL. One of the most effective ways of turning a person over is the log roll technique. Log roll can also be used to turn somebody with a spinal injury onto her side as an alternative to the recovery position. It is also commonly used to move people with other injuries, such as broken leg or pelvis, onto a stretcher or blanket.
     Ideally, six people should be used to carry out this technique, with one person taking the lead and control of the head.

1. Place your hands over the ears with your fingers along the chin. Hold the head in the neutral position.
2. Ask the supporters to gently move the arms to the side of the body and to move the legs together.
3. Ask the supporters to support the spine and limbs and to follow your commands.
4. Roll the victim like a log, keeping the head and chin in line with the neck and spine.

If you are by yourself and the injure person is not breathing, do not waste time searching for help. Turn the person as carefully as you can with any help available to you.

WARNING!

• Do not give anything to eat or drink-- the victim may need a general anesthetic in hospital.
• Do not move the victim unless she is in danger or needs resuscitation.

SPINAL INJURY RECOVERY POSITION

1. Support the victim's head as described above. Make yourself comfortable, because you will have to continue to do this until the ambulance arrives.
2. Ask a bystander to put the arm nearest the victim's shoulder gently underneath the victim's body, ensuring that the fingers are flat and the elbow straight. Bring the furthest arm across the body. The first responder must support the face.
3. The victim's furthest leg should be bent upward and the bystander's arm placed on the thigh just above the knee.
4. Working under orders from the first responder at the head. the victim should be gently turned, unsuring that the head, trunk, and toes stay in line.
5. Once the victim has been turned over, the neck should continue to be supported while the bystander ensures that the victim is stable, either by supporting the body himself or by placing coats or rolled-up blankets, for example, around the victim.

Alternatively, you can use the log roll technique.

UNCONSCIOUS VICTIM
This is a particularly difficult situation to deal with. The victim's airway is always your first priority. The person may have a broken back that could cause nerve damage and paralysis, but if you do not protect the airway and ensure that the victim continues breathing, she will die.

TREATMENT.  If you come across an unconscious person for whom the nature of the accident or the positioning indicates that she may have broken her back (for example, a bystander tells you the victim fell, or the person is wearing motorcycle leathers and lying next to a damaged motorcycle), your priority remains to check the airway.

1. Ask a question to find out if the victim is conscious. Do not shake the victim.
2. Carry out your ABC checks, taking care to tilt the head gently. If the head is already extended a suitable way, do not move it any further. Instead, just use the chin lift and carefully check the mouth.
3. If the victim is not breathing, provide rescue breathing and full CPR as needed. Call 911 as soon as possible.
4. If you have to roll the victim onto her back to resuscitate, then you should aim to keep the victim's head, trunk, and toes in a straight line. If possible, get bystanders to help move the victim over, but do not waste time looking for help because the victim needs air as soon as possible.
5. If the victim is unconscious and lying in such a way that the head is extended and she is on her side, allowing fluid to drain from the mouth, then leave her alone.
6. Hold the victim's head still by placing your hands over the ears and your fingers along the jawline. Ensure that the airway is monitored.
7. If the victim is unconscious and either the head is not extended or she is not lying on her side, you need to move her into the recovery position, ideally, with enough bystanders, you should use the log roll, if not, be prepared to roll the victim into the recovery position with all available help.

By: Unknown On 8:03 AM

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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.

By: Unknown On 3:41 AM

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Fractures, Dislocations, and Soft Tissue Injuries (How to Treat Fractures)

Fracture is just another word for a broken bone. A dislocation occurs at the site of a joint and is where a bone is fully or partially displaced. Soft tissue injuries include sprains, strains, and ruptures. They are often caused in the same way as fractures and generally are hard to distinguish from broken bones.

BROKEN BONES. There are two main types of broken bone. The first is a closed (simple) break or fracture, where the bone has broken but has not pierced the skin. A closed fracture is sometimes difficult to diagnose, even for experienced medical staff, who will usually rely on an X-ray to determine whether or not the bone is definitely broken. The second type is an open (compound) break or fracture, where the bone has either pierced the skin or is  associated with an open wound. The greatest risk with open breaks is infection. Both open and closed breaks can result in injury to underlying organs or blood vessels and may also be unstable if the ends of the broken bone are moving around. In young children the bones are not fully formed and may bend rather than break (termed a greenstick fracture).
     While it is possible to give some general guidance for the recognition of broken bones, no two people are identical in their response. The first general rule therefore is, if in doubt, assume that a bone is broken and treat as such. Be particularly aware of potential fractures if the accident involved a sharp blow, a fall, a rapid increase or decrease of speed, or a sudden twist.

DISLOCATIONS. The most common sites for dislocations are the shoulders, thumbs, and hips. Dislocations are usually characterized by intense pain and an obvious deformity. There may be signs and symptoms similar to a broken bone, including feelings of tingling or numbness below the site of the injury, caused by trapped nerves or blood vessels. Do not attempt to replace the bone. Make the victim comfortable and take or send him to hospital.

SOFT TISSUE INJURIES. Strains are an overstretching of the muscle, leading to a partial tear. Ruptures are complete tears in muscles.Sprains are injuries to a ligament at near a joint. The signs and symptoms of soft tissue injuries will be similar to the signs and symptoms of a fracture and will generally follow a sharp twisting or stretching movement.

SIGNS AND SYMPTOMS OF BROKEN BONES
Pain. This accompanies most, but not all, fractures and is caused by the broken bone ends pressing on nerve endings.

Deformity. An injured part may appear deformed, particularly when compare to the uninjured side.

Swelling. Some swelling may be present at the site of a fracture.

Tenderness. This accompanies most broken bones and can often only be felt when the injured part is gently touched.

Shock. The signs and symptoms of shock will often accompany major fractures. There may be reddening or bruising over the site of the break, but this often takes some time to appear. You may also hear the ends of broken bone rubbing together, a sound known as crepitus.

Another potential sign of a broken bone is lack of feeling or tingling sensation below the fracture site. This may indicate nerve damage or a reduction in circulation caused by the bone pushing on either the nerves or the blood vessels. The treatment for injuries displaying these symptoms is the same as for any broken bone. However, if you have been trained to do so, applying traction may alleviate the problem.

If the victim is displaying any combination of this signs and symptoms or the nature of the accident suggest that a fracture is likely, assume that a bone is broken.

HOW TO TREAT FRACTURES
The general rule for treating all broken bones is to immobilize them, because this reduce pain and the likelihood of further injury. The risk of infection is also and important consideration in the treatment of open fractures and requires action. Do not give a person who has a broken bone anything to eat or drink in case he needs a general anesthetic in hospital.

KEEPING A BROKEN BONE STILL

1. The victim will often have put the injured part in the position that is most comfortable for him and will generally be guarding the injury and keeping it still. If the victim has not done this, encourage him to keep still and help him into a comfortable position.
2. Once the victim is still you can help to steady and support the fracture using your hands. By helping the victim keep the injured part still you enable him to relax. The very act of relaxing the muscles reduces the pull on the broken bones and often alleviates pain.
3. If you have to transport the victim yourself, or if it is going to be a while until help arrives, then you can immobilize the broken bone further with bandages or improvise with a coats or blankets, for example.

The key points to remember with any type of bandaging are:

• Not to tie the bandage too tightly.
• To pad around the site of the break.

Do not move the injured area unnecessarily.

1. Place the dressing over the wound and build up padding alongside the bone.
2. Tie both the padding and the dressing in place, using firm pressure.
3. Remember that broken bones do swell and that you may need to loosen the bandage if the circulation below the site of the break becomes impaired.

TREATMENT OF OPEN BREAKS. In the first instance, the wound should be protected using either a sterile dressing or an improvised dressing made from a piece of clean, dry, and non-fluffy materials. If the bleeding is profuse, or you are going to have to wait some time for further help, this dressing should be held in place using the same principles as you would apply if there were a foreign object in the wound.

CHECKING FOR DAMAGE TO CIRCULATION

With any bandaging, you run the risk of cutting off the circulation to the area below the site of the bandage. While this can in part be avoided by not trying bandages too tightly and by never using a tourniquet, the nature of wounds means that they swell and this can cause a once satisfactory bandage to become too tight. There are a number of ways to check whether a bandage is cutting off circulation:

• If the skin below the site of the bandage becomes white, gray, or blue, or feels cold to the touch.
• If the victim complains of tingling, numbness, or of a lack of circulation.
• If the pulse in the limbs slows or stops.
• If the color does not quickly return to the skin after the skin is gently pinched or the nail compressed.

If you notice any of these signs, gently loosen, but do not remove, the bandage until the blood flow returns.

By: Unknown On 2:26 AM

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