What are the mechanisms of injury that can cause sprains, dislocations, and fractures?
Sprains, dislocations, and fractures may result from:
- Angular force (e.g., fall on an outstretched hand)
- Direct blow
- Compression force (e.g., fall from height landing on feet)
- Crush injury (e.g., object falling on pelvis)
Define a sprain and describe its signs and symptoms.
A sprain is a stretching or tearing of a ligament at a joint.
- Signs and symptoms include pain, swelling, point tenderness, and pain on movement that stretches the injured ligaments.
What is the management approach for simple muscle strains or ligament sprains of the back or spine?
Management includes:
- Thorough assessment using PQRST for pain evaluation.
- Application of ice packs for up to 20 minutes, every 1-2 hours.
- Over-the-counter analgesics or anti-inflammatories (e.g., acetaminophen, ibuprofen).
- Encouraging gradual return to activities of daily living while avoiding complete rest.
- Documenting all findings and recommendations in the First Aid Record
When should a patient with a sprain or strain of the back be referred for medical attention?
Refer if:
- Mechanism of injury suggests possible spinal injury.
- Presence of pain, numbness, tingling, or weakness in extremities.
- Bowel or bladder symptoms.
- Persistent or worsening symptoms despite initial management.
What are the signs and symptoms of a dislocation?
Signs include:
- Severe pain around the joint.
- Obvious deformity and irregularity.
- Inability to move the joint.
- Joint locked in a deformed position.
What management steps should be taken for a suspected fracture?
Steps include:
- Assessing using SAMPLE history and physical examination.
- Immobilizing the injured limb using splinting techniques.
- Applying ice packs if swelling is present.
- Referring to medical aid promptly for definitive care.
Describe the signs and symptoms that indicate a fracture.
Signs include:
- Sudden and extreme pain localized to the fracture site.
- Deformity or angulation of the limb.
- Point tenderness at the fracture site.
- Swelling, discoloration (ecchymosis), and loss of stability.
- Crepitus or a grating sound when bones rub together.
How are fractures classified?
Fractures are classified as:
- Closed (simple): Skin is intact.
- Open (compound): Skin is broken, allowing contaminants to enter.
When should a patient with a dislocation or fracture be referred for medical aid?
Refer if:
- Dislocation or fracture is open or compound.
- Significant pain, deformity, or inability to move the joint.
- Signs of neurovascular compromise (e.g., numbness, tingling, pale or cold extremity).
What approach should be followed for the evaluation and management of workers with limb injuries?
The Priority Action Approach, which involves conducting a scene assessment, performing a primary survey with critical interventions, conducting a secondary survey, and managing life-threatening conditions before addressing fractures or dislocations.
What are the principles of examination for limb injuries?
Listen to the patient’s history and assess the mechanism of injury. Look for signs like swelling, shortening, and angulation. Palpate gently for deformity, swelling, and point tenderness. Assess nerve damage by checking distal sensation and motor function. Evaluate circulation by checking color, temperature, and distal pulses.
When is manual traction and limb manipulation appropriate?
Manual traction and limb manipulation may be necessary when the limb is cold, pulseless, and angulated, aimed at restoring circulation under direct medical guidance.
What are the reasons for splinting limb injuries?
Splinting is necessary to immobilize the limb and prevent further injury and bleeding. It helps stabilize fractures and dislocations, reduces pain, and facilitates safe transportation.
What types of splints are commonly used for limb injuries?
Common types include:
- Prepared wooden splints
- Spine boards and scoop style stretchers
- Vacuum splints
- Malleable foam-covered splints (e.g., SAM® Splints)
- Anatomic splints using the patient’s body for support.
What are the principles of immobilization for limb injuries?
- Support and steady the injured limb.
- Cover open wounds with sterile dressings before splinting.
- Assess and maintain circulation distal to the injury.
- Immobilize in the position found unless realignment is necessary.
- Pad the splint to prevent pressure sores and ensure comfort.
- Anchor the splint from proximal to distal to the injured site to avoid unnecessary movement.
What considerations are essential for splinting in limb injuries before transport?
Splint all fractures and dislocations before transport, unless the patient is in the Rapid Transport Category. Splints should be applied securely but not tightly enough to compromise circulation or cause discomfort.
What are the steps for managing life-threatening conditions in limb injuries?
Prioritize the ABCs (Airway, Breathing, Circulation) and manage shock or severe bleeding first before addressing limb injuries to ensure patient stability.
How should the OFA attendant approach limb injuries involving potential vascular injuries?
Assess for signs of vascular compromise (e.g., absent distal pulses) and differentiate between shock and vascular injury. Rapid Transport Category applies to patients with no circulation distal to the injury.
What post-splinting care considerations are important for limb injuries?
After splinting, elevate the limb if circulation is not impaired, provide ongoing monitoring, and ensure all findings and interventions are documented accurately.
What type of splinting material is a malleable foam splint?
A malleable foam splint is made of lightweight aluminum with closed-cell foam bonded on both sides. It is soft, adaptable, and suitable for upper limb splinting.
How should a malleable foam splint be applied to an injured limb?
Read and follow manufacturer’s instructions. Measure and mold the splint to the patient’s uninjured limb or use the OFA attendant’s limb as a guide if necessary. Secure with crepe bandages from proximal to distal, ensuring circulation and neurological function are assessed before and after splinting.
Describe the position of function for an injured hand
Place the injured hand in a position of function: wrist extended, hand relaxed, and fingers slightly flexed. Maintain with a pad in the palm or a suitably formed splint. Splint fingers if markedly displaced.
What is the role of crepe bandages in splinting?
Crepe bandages secure splints to upper limbs. Start bandaging at the proximal stable part of the limb, securing from stable to unstable areas.
How should circulation be assessed for upper limb injuries?
Assess radial pulse for circulation; compare injured and uninjured limbs. Note any changes and document for medical review.
