1. Chapter 15
Extremity Injuries

2. Extremity Injuries
Injuries to the extremities are common because people are involved in active lifestyles that include sports and wilderness activities.

3. Extremity Injury Assessment
Look for
Examine the extremities using
Compare
Use
Consider the

4. Types of Extremity Injuries (1 of 2)
Contusions
Strains
Sprains

5. Types of Extremity Injuries (2 of 2)
Tendonitis
Dislocations
Fractures

6. Care for Extremity Injuries

7. RICE Procedures (1 of 7)
Acronym
Recommended
The first

8. RICE Procedures (2 of 7)
R = .

9. RICE Procedures (3 of 7) I

10. RICE Procedures (4 of 7) C

11. RICE Procedures (5 of 7) E

12. RICE Procedures (6 of 7)
R =
I = .

13. RICE Procedures (7 of 7)
C =
E =

14. Shoulder Dislocation
Occurs
Result of
Second in

15. Recognizing a Shoulder Dislocation (1 of 2)
Victim holds
Arm cannot
Extreme
Shoulder appears

16. Recognizing a Shoulder Dislocation (2 of 2)
Injury results in.
History of
Numbness or paralysis

17. Care for a Shoulder Dislocation
Do not
Place a
Apply
Apply.
Seek

18. Clavicle Fracture
Common
Usually result of
Most occur in the

19. Recognizing a Clavicle Fracture (1 of 2)
Fell on
Direct
Severe
Holding injured arm

20. Recognizing a Clavicle Fracture (2 of 2)
No movement

21. Care for a Clavicle Fracture
Treat for
Apply and swathe.
Apply ice pack:
___ minutes, __to __times during 24 hours
Seek _______medical care.

22. Contusions
Caused by
Often called

23. Recognizing Contusions
Pain at
Feeling of
Black-and-blue discolorations

24. Care for Contusions
Apply an ice pack:
Place arm in sling and swathe.

25. Tendonitis
_________of the shoulder
Result of

26. Recognizing Tendinitis
Constant or
Limited _____of shoulder
“_______” sound
_________over the area

27. Care for Tendonitis
Use an ice massage for __ minutes before and after exercise.
Use a
Use pain medication.
Seek medical advice.

28. Humeral Fracture
Shaft of the humerus can be

29. Recognizing a Humerus Fracture
Direct blow
Twist or fall
Severe
Deformity
Tender if touched
Inability
Holds

30. Care for a Humerus Fracture
______and treat for shock.
Apply an ice pack for ___minutes.
Stabilize the arm.
Seek immediate medical care.

31. Elbow Injuries
Should be considered serious
Treat with extreme care.

32. Recognizing Elbow Fractures and Dislocations
Immediate
Severe
Possible
Restricted, painful motion
Numbness

33. Care for Elbow Fractures and Dislocations
Do not
Treat for
Splint the
Apply
Seek

34. Tennis Elbow
Results from
Inflammation of the

35. Recognizing Tennis Elbow
Pain increases
Gradual grip
Injured
Very tender on

36. Care for Tennis Elbow
Apply heat
Apply ice pack
Seek

37. Golfer’s Elbow
Equivalent to
Pain is on

38. Recognizing Golfer’s Elbow
Pain increases
Gradual
Injured elbow

39. Care for Golfer’s Elbow
Apply
Apply an ice pack for __ minutes after activity.
Seek medical advice.

40. Radial and Ulnar Fractures
The radius and ulna are the two large bones in the forearm.
When one bone is broken, the other acts as a splint, and there may be little or no deformity.
When both are broken, the arm usually appears deformed.

41. Recognizing Radius and Ulna Fractures
Pain in
Deformity
Severe pain
Inability to

42. Care for Radial and Ulnar Fractures
Assess and treat for shock if indicated.
Apply an ice pack for __ minutes.
Apply
Seek medical care.

43. Wrist Fracture
Wrist usually

44. Recognizing a Wrist Fracture

45. Care for a Wrist Fracture

46. Hand Injuries—Crushed Hand
May be fractured by:

47. Recognizing a Crushed Hand

48. Care for a Crushed Hand

49. Finger Injuries
The __bones that make up each finger are the most commonly broken bones.
The finger has three joints:

50. Finger Fracture
Finger bones can move when they are broken.

51. Recognizing Finger Fractures

52. Testing Finger Fractures
If possible,
Tap the
Pain

53. Care for Finger Fractures
Do not try
Gently apply an ice pack.
Splint the finger.
Seek medical care.

54. Finger Dislocation
Common
Same causes of fractured fingers

55. Recognizing Finger Dislocation

56. Care for Finger Dislocation
Do not try to realign.
Apply an ice pack for 20 minutes.
Splint the finger.
Seek medical care.

57. Sprained Finger
Upper joints of the fingers have a ligament on each side of the joint.

58. Recognizing a Sprained Finger“
Pain and swelling
Unable to make a fist
Weakness
Weakness or pain

59. Care for a Sprained Finger
Apply an ice pack for ___ minutes.
Reevaluate.
Seek medical care if pain and weakness exist.
“______” tape the fingers.

60. Nail Avulsion
Injury in which a nail is partly or completely torn loose

61. Recognizing a Nail Avulsion
Nail may be

62. Care for a Nail Avulsion
Secure
Apply antibiotic ointment.
Secure a.
Do not trim away loose nail.
Consult a physician.

63. Splinters
Sharp splinters, usually wooden, can be impaled into the skin or under a fingernail or toenail.

64. Recognizing Splinters
Small puncture wound
Sliver may be seen.

65. Care for Splinters Use tweezers to remove it.
If splinter is impaled under a nail and breaks off flesh:

66. Blood Under a Nail
Blood

67. Recognizing Blood Under a Nail

68. Care for Blood Under a Nail.

69. Ring Strangulation
Within ___ or ___ hours

70. Recognizing Ring Strangulation
A ring has become tight on a finger.

71. Care for Ring Strangulation (1 of 2)
Spray onto finger.
Massage finger from tip to hand.
Smoothly wind.

72. Care for Ring Strangulation (2 of 2)
Lubricate finger well, and then
Cut the _________part of the ring.
Inflate an ordinary balloon.

73. Hip Joint Injuries
Hip joint is a
Requires great force to dislocate

74. Recognizing Hip Dislocation
Severe pain at injury
Swelling at injury
Hip is flexed and knee is bent and rotated inward toward opposite hip.
Visible injury

75. Care for Hip Dislocation
Assess and treat for shock.
Stabilize injury.
Check for ankle pulse.
Seek medical care.

76. Hip Fracture

77. Recognizing a Hip Fracture
Severe pain in groin area
Inability to lift injured leg
Leg may appear shortened and be rotated with the toes pointing abnormally.

78. Care for a Hip Fracture Treat for shock. Stabilize injured leg.
Monitor ankle pulse.
Seek immediate medical care.

79. Femur Fractures Femur injuries can occur in any part of the femur.
Femur fractures often include open wounds.
External bleeding may be severe.

80. Recognizing a Femur Fracture
Severe pain at injury
Deformity
Swelling
Severe pop or snap

81. Care for a Femur Fracture
Assess and treat for shock.
Cover wound with sterile dressing.
Stabilize injured leg.
Monitor ankle pulse.
Seek immediate medical care.

82. Muscle Contusion
The muscle group on the front of the thigh is the quadriceps group.
Often gets bruised

83. Recognizing a Muscle Contusion
Swelling
Pain and tenderness
Tightness or firmness of site
Visible bruise

84. Care for a Muscle Contusion
Follow the RICE procedures.
Stretch the muscle.

85. Muscle Strain Occurs when a muscle is overstretched
A first aider will be unable to determine its degree.

86. Recognizing a Muscle Strain
Pop or pulling sensation while running or jumping
Tenderness
Stiffness and pain
Swelling
Visible bruise appears days later.

87. Care for a Muscle Strain
Follow the RICE procedures.
Apply an ice pack.
20 minutes, three to four times a day for 48 hours
Stretch the muscle.

88. Knee Injuries .

89. Recognizing a Knee Fracture
May look like a dislocation
Deformity
Tenderness
Swelling

90. Care for a Knee Fracture
No deformity:
Feel for pulse in the ankle.
If pulse is felt, splint the leg with the knee straight.
Significant deformity:
If pulse is felt, splint the knee in the position found.
Seek medical care immediately if pulse is absent.

91. Knee Dislocation A knee dislocation is a serious injury.
Deformity will be grotesque.

92. Recognizing a Knee Dislocation
Excruciating pain
Deformity
Pulse may be absent in the ankle.

93. Care for a Knee Dislocation
Stabilize the knee in the position found.
Seek medical care immediately.

94. Patella Dislocation Must be treated immediately
Most commonly occurs in teenagers and young adults who are engaged in athletic activities.

95. Recognizing a Patella Dislocation
A blow or twisting causes kneecap to move outside of the knee joint.
Swelling
Inability to bend or straighten knee
Pain
Deformity

96. Care for a Patella Dislocation
Follow the RICE procedures.
Do not try to relocate.
Splint knee in position found.
Seek medical care.

97. Knee Sprain
Ligament injury
Can range from mild to complete tearing

98. Recognizing a Knee Sprain
Severe pain
Pop or snap at the time of injury
Locking sensation
Inability to walk without limping
Inability to bend or straighten the knee
Swelling
Bruising

99. Care for a Knee Sprain
Follow the RICE procedures.
Seek medical care.

100. Knee Contusion
Caused by:
A direct blow
Falling on the knee

101. Recognizing a Knee Contusion
Pain
Swelling
Tenderness
Black-and-blue discoloration

102. Care for a Knee Contusion
Follow the RICE procedures.

103. Lower Leg Injuries Tibia and Fibula Fractures
Can occur at any place between the knee joint and the ankle joint
Deformity may occur when one bone is broken.
When only one bone is broken, little deformity may be present.

104. Recognizing Tibia and Fibula Fractures
Severe pain
Swelling
Deformity
Tenderness

105. Care for Tibia and Fibula Fractures
Stabilize the leg.
Apply an ice pack.
Seek medical care.

106. Recognizing Tibia and Fibula Contusion
Victim received a direct hit directly on shin.
Tender when touched
Sharp pain
Black-and-blue mark
Difficulty moving ankle up and down
Numbness or coldness in toes or foot

107. Care for a Tibia and Fibula Contusion
Expose the injury.
Apply the RICE procedures.
Use an ice pack.
20 minutes, three to four times daily for 48 hours
If numbness or tingling exists, seek medical care.

108. Muscle Cramp Temporary condition
Usually occurs in the calf and sometimes in the thigh or hamstring

109. Recognizing a Muscle Cramp
During or after intense exercise sessions
Painful muscle contraction or spasm that disables the victim

110. Care for Muscle Cramps Gently stretch. Apply pressure.
Apply ice to the muscle.
Pinch the upper lip hard.
Drink lightly salted, cool water.
Drink a commercial sports drink.

111. Shin Splints
Pain in the front of the lower leg or shin

112. Recognizing Shin Splints
Ache subsides after activity stops.
Ache is a result of an increase in the workout routine.
Chronic problem that gets worse

113. Care for Shin Splints Apply an ice pack before activity.
Apply pressure.
Apply an ice pack for 20 minutes after activity.
Curtail activity until the shin is pain free.
Take anti-inflammatory pain medications.

114. Ankle and Foot Injuries
Frequently injured by twisting
Stretches or tears ligaments
Most ankle injuries are sprains that involve the outside ligaments.

115. Recognizing Foot and Ankle Injuries (1 of 2)
Two-part test to determine whether an X-ray is needed:
Press along the bones.
Pain and tenderness may indicate a broken bone.
Have the victim try to stand on it.
Ability to take four or more steps is most likely a sprain.
Inability to walk on it may indicate a break.

116. Recognizing Foot and Ankle Injuries (2 of 2)
If injured ankle cannot tolerate hopping on opposite foot, suspect a fracture.
Swelling
One sided indicates a sprain.
Both sided indicates a fracture.

117. Care for Foot and Ankle Injuries
Take shoes off.
Use RICE procedures.

118. Aftercare of an Ankle Injury (1 of 2)
Use the RICE treatment for 24 to 48 hours.
Use a contrast bath if swelling persists.
Begin range-of-motion exercises once initial swelling has decreased.
Begin gentle exercises.

119. Aftercare of an Ankle Injury (2 of 2)
Within 7 to 14 days, if pain and swelling have stopped, begin to stretch and strengthen the calf and ankle.
Brace or tape healed ankle.
Nonsteroidal anti-inflammatory drugs (NSAIDs)

120. Toe Injuries Include: Torn-off nails
Hematoma formation under the nails
Dislocations
Fractures

121. Recognizing Toe Injuries
Pain and swelling
Deformity

122. Care for Toe Injuries
Treat the same as a finger injury.