2 Extremity InjuriesInjuries to the extremities are common because people are involved in active lifestyles that include sports and wilderness activities.
3 Extremity Injury Assessment (1 of 2) Look for signs and symptoms of fractures and dislocations.Examine the extremities, using the mnemonic D-O-T-S.Compare one extremity with the other to determine size and shape differences.Use the “rule of thirds” for extremity injuries.
4 Extremity Injury Assessment (2 of 2) Consider the cause of injury (COI) when evaluating the possibility of a fracture and its location.Use the mnemonic CSM as a reminder to check for Circulation, Sensation, and Movement of fingers or toes.
5 Types of InjuriesTypes of injuries to the extremities range from simple contusions to complex open fractures.ContusionsStrainsSprainsTendinitisDislocationsFractures
6 Care for Extremity Injuries Use the RICE procedures.Apply a splint to stabilize fractures and dislocations.
7 RICE Procedure (1 of 2) R= Rest. Injuries heal faster if rested. I= Ice.Ice should be applied to the inured area as soon as possible after the injury.C= Compression.Compressing the injured area squeezes fluid out of the injury site.E= Elevation.Gravity slows the return of blood to the heart from the lower parts of the body.
9 Shoulder Injuries Three bones come together at the shoulder: Scapula ClavicleHumerusThe shoulder is the most freely movable joint in the body.
10 Shoulder DislocationA dislocation of the shoulder occurs when the bones of the shoulder comes apart.Shoulder dislocation is second in frequency only to finger dislocations.
11 Recognizing Shoulder Dislocation (1 of 2) Victim holds the upper arm away from the body, supported by the uninjured armDislocated arm cannot be brought across the chest wall to touch the opposite shoulderExtreme pain in the shoulder areaIn a dislocation, the shoulder looks squared off, rather than rounded.
12 Recognizing Shoulder Dislocation (2 of 2) Victim may describe a history of previous dislocations.Numbness or paralysis in the arm from pressure, pinching blood vessels or nerves
13 Care for a Shoulder Dislocation Do not try to force, twist, or pull the shoulder back in place.Place a pillow between the upper arm and the chest.Apply an arm sling and swathe.Apply an ice pack for 20 minutes.Seek immediate medical care.
14 Clavicle FractureFractures of the clavicle are common and usually are the result of falling with the arm and hand outstretched.80% of clavicle fractures occur in the middle third of the bone.
15 Recognizing a Clavicle Fracture (1 of 2) Usually the fracture is easy to detect because the clavicle lies immediately under the skin.The victim:Fell on an outstretched armReceived a direct blow to the clavicle or shoulder
16 Recognizing a Clavicle Fracture (2 of 2) AND if the victim has:Severe pain over the injured areaNot moved the arm because of painSwellingVisible deformityTenderness“Dropped” or drooped shoulderBruising
17 Care for a Clavicle Fracture Treat for shock.Apply an arm sling and swathe.Apply ice to the area for 20 minutes, three to four times during the next 24 hours.Seek immediate medical care.
18 Contusions Direct blows cause contusions around the shoulder. Often called shoulder pointersContusions of this type may cause severe discomfort
19 Recognizing Contusions SwellingPain at the injury siteFeeling of firmness when pressure is exerted on the shoulderTendernessDiscoloration under the skin
20 Care for ContusionsApply an ice pack to the area for 20 minutes, three to four times during the first 24 hours.Place the arm in a sling and swathe.
21 TendinitisGeneral cause of tendinitis in the shoulder is continuous overuse or unusual use.Examples include many of the throwing sports, such as baseball, and in swimming.
22 Recognizing Tendinitis Constant pain or pain with motion of the shoulderLimited motion of the shoulder“Crackling” sound when the joint is movedTenderness over the area
23 Care for TendinitisUse an ice massage for 10 minutes before and after exercise.Use a sling and swath to rest the shoulder.Use pain medication such as ibuprofen.Seek medical advice if needed.
24 Humerus FractureThe shaft of the humerus can be felt throughout its entire length along the inner side of the upper arm.
25 Recognizing a Humerus Fracture (1 of 2) The victim received:Direct blow to the areaTwist or fall on the outstretched armAND any one or combination of these occurred:Severe painSwelling
26 Recognizing a Humerus Fracture (2 of 2) Visible deformityTender if touchedMay be unable to move the armWill hold the arm against the chest for comfort
27 Care for a Humerus Fracture Treat for shock.Apply an ice pack for 20 minutes.Stabilize the arm by applying one rigid splint on the part of the arm away from the body.Apply an arm sling and swathe.Seek immediate medical care.
28 Elbow InjuriesAll elbow fractures and dislocations should be considered serious and treated with extreme care.Inappropriate care can result in injury to the nearby nerves and blood vessels.
29 Recognizing Elbow Fractures and Dislocations Immediate swellingSevere painPossible visible deformity; compare it with the uninjured elbow.Restricted, painful motionNumbness or coldness of the hand and fingers below the elbow
30 Care for Elbow Fractures and Dislocations Do not move the elbow.Treat for shock.Splint the elbow in the position found in order to prevent nerve and blood vessel damage.Apply an ice pack for 20 minutes.Seek immediate medical care.
31 Tennis ElbowResults from sharp, quick twists of the wrist (not just from playing tennis)An inflammation of the tendons on the outer side of the elbowCan be very painful whenever the wrist and elbow are used
32 Recognizing Tennis Elbow Pain increases while using the armCauses gradual grip weaknessInjured elbow fatigues quicker than normalVery tender on outer protrusion of elbow
33 Care for Tennis ElbowApply heat before an activity; the victim might wear a brace on the sore elbow.Apply ice for 20 minutes after completion of the activity.Seek medical advice for appropriate rehabilitation program.
34 Golfer’s ElbowThe equivalent of the more common tennis elbow but with pain on the inside of the elbowIt is tendinitis affecting the tendons attached to the bony protrusion, on the inside of the elbow.
35 Recognizing Golfer’s Elbow Pain increases while using the arm.Causes gradual grip weaknessThe injured elbow fatigues quicker than normal.
36 Care for Golfer’s Elbow Apply heat before an activity; the victim might wear a brace on the tender elbow.Apply an ice pack for 20 minutes after completion of the activity.Seek medical advice for appropriate rehabilitation program.
37 Radius and Ulna Fractures The radius and ulna are the two large bones in the forearm.When only one bone is broken, the other acts as a splint and there may be little or no deformity.When both bones are broken, the arm usually appears deformed.
38 Recognizing Radius and Ulna Fractures (1 of 2) The victim has pain in the forearm or wrist from:A direct blowFalling on an outstretched handAND has:A visible deformitySevere pain radiating up and down from the injury site
39 Recognizing Radius and Ulna Fractures (2 of 2) An inability to move the wrist or it is painful while moving the wrist.ORThe wrist is painful on the thumb side and pain continues into next day
40 Care for Radius and Ulna Fracture Treat for shock.Apply an ice pack to the area for 20 minutes.Apply two rigid splints on both sides of the arm from the tip of the elbow to the fingers.Place the arm in a sling and swathe with the hand in a thumb-up position.Seek medical care.
41 Wrist FractureThe wrist is usually broken when the victim falls with the arm and hand outstretched.
42 Recognizing a Wrist Fracture Injury to the wrist associated with a snapping or popping sensation within the wristPain in the wrist that is aggravated by movementTendernessSwellingUnable or unwilling to move the wristLump-like deformity on the back of the wrist
43 Care for a Wrist Fracture Use the RICE procedures.Stabilize the wrist with a splint.Seek medical care.
44 Hand Injuries—Crushed Hand The hand may be fractured by a direct blow or by a crushing injury.Recognizing a crushed hand:PainSwellingLoss of motionOpen woundsBroken bones
45 Care for a Crushed Hand Control the bleeding. Apply an ice pack for 20 minutes.Seek medical care.
46 Finger InjuriesThe three bones that make up each finger are the most commonly broken bones in the body.The three joints can also be injured.A so-called finger sprain may be a complicated fracture or dislocation.
47 Finger FractureContrary to popular belief, broken bones — especially the fingers — can move when they are broken.
48 Recognizing Finger Fractures (1 of 2) The finger or thumb has:A visible deformityImmediate pain and hurts with or without movementNumbnessSwellingPinpointed tenderness
49 Recognizing Finger Fractures (2 of 2) Test for a finger fracture:If possible, straighten the fingers and place them on a hard surface.Tap the tip of the injured finger toward the hand.Pain lower down in the finger or into the hand can indicate a fracture.
50 Care for Finger Fractures Do not try to realign the finger.Gently apply an ice pack.Splint the finger by one of two methods:Buddy taping the fractured finger to another for supportKeeping the hand and fingers in the position of function with extra padding in the palm
51 Finger Dislocation Finger dislocations are common. Same causes of fractured fingers can also cause a dislocated finger.
52 Recognizing Finger Dislocation The finger or thumb has:A visible deformityImmediate painSwellingShortening of the fingerMay be unable to bend the finger in the injured area
53 Care for Finger Dislocation Do not try to realign the dislocation.Apply an ice pack.Splint the finger by one of two methods:Buddy taping the fractured finger to another for supportKeeping the hand and fingers in the position of function with extra padding in the palmSeek medical care.
54 Sprained FingerThe upper joints of the fingers have a ligament on each side of the joint.
55 Recognizing a Sprained Finger The finger or thumb has been:“Jammed” or compressedStepped onForced or twisted sidewaysAND the victim:Has pain and swellingIs unable to make a fistHas weakness while curling the finger or gripping
56 Care for a Sprained Finger Apply an ice pack for 20 minutes.Reevaluate after the ice-pack application and seek medical care if pain and weakness exist.Tape fingers with buddy taping.
57 Nail Avulsion When a nail is partly or completely torn loose Recognizing a nail avulsion:Nail may be completely detached or partially held in place by the skin
58 Care for a Nail Avulsion Secure the damaged nail in place with an adhesive bandage.If part of all of the nail has been completely torn away, apply antibiotic ointment.Do not trim away the loose nail.Consult a physician for further advice.
59 SplintersSharp splinters can be impaled into the skin or under a fingernail or toenail.Recognizing splinters:Small puncture woundSliver may be seen or in other cases, not seen nor can it be felt
60 Care for Splinters If embedded in the skin, use tweezers to remove it. In some cases, you may need to tease it out with sterile needle.Clean the wound with soap and water.If the splinter is impaled under a fingernail or toenail and breaks off flush, cut a V-shaped notch in the nail to gain access to the splinter.
61 Blood Under a NailBlood collects under a nail when underlying tissues are bruised.Recognizing blood under a nail:Excruciating pain exists because of the blood pressure against the nailPain does not disappear until the collection of blood is drained
62 Care for Blood Under a Nail Apply an ice pack with the hand elevated.Relive the pressure using a knife or a red-hot metal paperclip or needle.Apply a dressing.
63 Ring StrangulationCan be a serious problem if it cuts of the blood supply long enoughRecognizing ring strangulation:The ring has become tight on the finger after an injury or swelling.
64 Care for Ring Strangulation (1 of 2) Try one of the following methods to remove a ring:Lubricate the finger with soap and water or some other slippery substance.Immerse the finger in cold water or apply an ice pack to reduce swelling.Liberally spray window cleaner onto the finger, then try to slide the ring off.
65 Care for Ring Strangulation (2 of 2) Massage the finger from the tip toward the hand to move the swellingLubricate the finger again and try removing the ringCut the narrowest part of the ring with a ring saw, jeweler’s saw, or fine hacksaw blade, taking care to protect the exposed parts of the finger.
67 Hip DislocationA hip can be dislocated by a fall, a blow to the thigh, or direct force to the foot or knee.Often a hip is dislocated when the knee strikes the dashboard during a motor vehicle crash.It is difficult to differentiate a hip dislocation from a hip fracture.
68 Recognizing Hip Dislocation Severe pain at the injury siteSwelling at the injury siteHip is flexed and the knee bent and rotated inward toward the opposite hipInjury usually quite visible
69 Care for Hip Dislocation Treat for shock.Stabilize the injury.Check for an ankle pulse.Seek medical care.This injury is best transported by EMS.
70 Hip Fracture Fracture of the upper end of the femur, not the pelvis Elderly people, especially women, are susceptible to this type of injury because of brittle bones.
71 Recognizing a Hip Fracture Severe pain in the groin areaInability to lift the injured legLeg may appear shortened and be rotated with the toes pointing abnormally outward.
72 Care for a Hip Fracture Treat for shock. Stabilize the injured leg against movement.Monitor the ankle pulse.Seek immediate medical care.This injury is best transported by EMS.
74 Femur FracturesBecause the femur is the largest bone in the body, considerable force is required to break it.Femur fractures often include open wounds and external bleeding may be severe.
75 Recognizing a Femur Fracture Severe pain at the injury siteDeformity may occurSwelling comes from severe damage to blood vesselsVictim may report having heard or felt a severe pop or snap at the time of injury.
76 Care for a Femur Fracture Treat for shock.Cover a wound with a sterile dressing.Stabilize the injured leg against movement.Monitor the ankle pulse.Seek immediate medical care.This injury is best transported by EMS.
77 Muscle ContusionThe muscle group on the front of the thigh is the quadriceps group and often gets bruised.Depending upon the force of impact and muscles involved, the contusion may be of varying degrees of severity.
78 Recognizing a Muscle Contusion Victim received a direct hit producing:SwellingPain and tendernessTightness or firmness of site when pressedVisible bruise that may appear hours later
79 Care for a Muscle Contusion Follow the RICE procedures.Stretch the muscle by bending the knee toward the victim’s chest.
80 Muscle StrainWhen a muscle is overstretched, it can result in a tear, called a strain.Different degrees of strains occur, but first aiders will be unable to determine their degree.
81 Recognizing a Muscle Strain While running or jumping, the victim:Feels a pop or pulling sensationAnd later has:TendernessStiffness and pain during movementSwellingA visible bruise appearing days later
82 Care for a Muscle Strain Follow the RICE procedures.Stretch the muscle but do not force stretching.
83 Knee Injuries Among the most serious joint injuries Their severity is difficult to determine, thus medical care is necessary if the injury is from being hit or twisted and not from overuse.
84 Knee Fracture Generally occurs as a result of a fall or a direct blow May occur at the end of the femur, at the end of the tibia, or in the knee cap
85 Recognizing a Knee Fracture Determining if a fracture exists is difficult.Some fractured knees may look like a discoloration.Other signs include:DeformityTendernessSwelling
86 Care for a Knee Fracture If a pulse can be felt in the ankle with no deformity, splint the leg with the knee straight.If a pulse can be felt in the ankle with significant deformity, splint the knee in the position found.Seek medical care.
87 Knee Dislocation A knee dislocation is a serious injury. Recognizing a knee dislocation:Excruciating painDeformityPulse may be absent in the ankleDo not confuse a knee dislocation with a patella dislocation
88 Care for a Knee Dislocation Stabilize the knee in the position found.Seek medical care immediately.
89 Patella DislocationA dislocated patella can be a very painful injury and must be treated immediately.Some people have repeated kneecap dislocations.A dislocated patella most commonly occurs in teenagers and young adults who are engaged in athletic activities.
90 Recognizing a Patella Dislocation Possible swellingAn inability to bend or straighten the kneePainDeformity
91 Care for a Patella Dislocation Follow the RICE procedures.Do not try to relocate a dislocated kneecap.Splint the knee in the position found.Seek medical care.
92 Knee Sprain Ligament injuries occur most often in sports. The knee is very prone to ligament injury, ranging from mild sprains to complete tearing.
93 Recognizing a Knee Sprain At the time of injury the victim has:Severe painThe feeling of a pop or snapA locking sensationThe victim may not be able to walk without limping, or bend the kneeLater, there may be swelling in the knee and bruising.
94 Care for a Knee SprainFollow the RICE procedures.Seek medical care.
95 Knee ContusionContusions of the knee are caused by a direct blow or by falling on the knee.Recognizing a knee contusion:PainSwellingTendernessBruise marksCare for a knee contusion:Follow the RICE procedures.
96 Lower-Leg Injuries Tibia and fibula fractures Tibia and fibula contusionMuscle crampsShin splintsAnkle and foot injuriesToe injuries
97 Tibia and Fibula Fractures Tibia and fibula injuries can occur at any place between the knee joint and the ankle joint.Injuries to the blood vessels, caused by extreme deformity, are common with injuries of the tibia and fibula, and the pain is usually severe.
98 Recognizing Tibia and Fibula Fractures Severe painSwellingVisible deformityTenderness when touched
99 Care for Tibia and Fibula Fractures Stabilize the leg using a splint.Apply an ice pack.Seek medical care.
100 Recognizing Tibia and Fibula Contusion Victim received a hit directly on the shin.Tender when touchedSharp painLater has:DiscolorationDifficulty moving ankle up and downNumbness or coldness in toes or foot
101 Care for a Tibia and Fibula Contusion Expose the injury.Apply the RICE procedures.If numbness or tingling exists, seek medical care.
102 Muscle CrampMuscle spasm or cramping usually occurs in the calf and sometimes in the thigh or hamstring.It is a temporary condition of little consequence.
103 Recognizing a Muscle Cramp Happens during or after intense exercise sessionsPainful, muscle contraction or spasm which disables the victim
104 Care for Muscle Cramps Try one or more of the following: Have the victim gently stretch the affected muscle.Relax the muscle by applying pressure to it.Apply ice to the cramped muscle.Pinch the upper lip hard to reduce calf-muscle cramping.Have the victim drink lightly salted, cool water.
105 Shin Splints Describes pain in the front of the lower leg Caused by repetitive stress in the leg such as running or walking
106 Recognizing Shin Splints The shin aches during activity, but:Ache subsides significantly after activity stopsAche is a result of an increase in the workout routineUsually a chronic problem that gets worse
107 Care for Shin Splints Apply an ice pack before an activity. Apply pressure with a 3-inch elastic bandage over the sorest point.Apply an ice pack for 20 minutes after the activity.Curtail activity until the shin is pain free.Pain medications that are anti-inflammatory drugs may be taken.
108 Ankle and Foot Injuries The ankle and foot frequently are injured, mainly by twisting.In some cases, the damage requires surgical correction.Most ankle injuries are sprains; about 85% of sprains involve the outside ligaments.
109 Recognizing Foot and Ankle Injuries Press along the bones to check for pain and tenderness.Ask the victim, “Have you tried standing on it?”If the victim hops on the good foot and the injured ankle cannot tolerate the jarring, suspect a fracture.Ankle sprains tend to swell on only one side of the foot; swelling on both sides usually accompanies fractures.
110 Care for Foot and Ankle Injuries Controversy exists about whether to remove a shoe from an injured foot.Shoe may act as a splint and retard swelling; however, taking the shoe off allows for better examination and care.Use RICE procedures to reduce swelling.