1. FRACTURES AND SOFT TISSUE INJURIES A fracture is a broken or cracked bone. Types of fractures include: Open fracture – is where skin has been broken and bone might protrude from the wound. There will be external blood loss. Closed fractures – This is where the skin has not been broken but there might be internal or organ damage/internal bleeding Complicated fractures – This may be open or closed with damage to underlying tissues, blood vessels or organs i.e. fractured ribs can pierce the lung.

2. Management of a fracture 1.DRABCD and get medical help ASAP 2.Keep casualty still 3.Handle gently. 4.Immobilise the limb. 5.Do not place bandages or direct pressure over the fracture site. 6.Cover wound or control bleeding. 7.Support the limb or affected area 8.Do not elevate the limb or affected area. 9.Provide reassurance. 10.Assess for and manage shock DO NOT IMMOBILISE A FRACTURE USING SLING/SPLINTS IF MEDICAL HELP IS READILY AVAILABLE IF IT IS AN OPEN FRACTURE, COVER WOUND WITH A LIGHT BANDAGE AND IMMOBILISE THE PROTRUDING BONE USING A RING PAD. DO NOT PLACE PRESSURE ON PROTRUDING BONE.

3. HEAD, NECK AND SPINAL FRACTURES Fractured Jaw 1.If unconscious, place in recovery position and support jaw to keep airway open 2.If conscious, ask casualty to support their jaw if possible and assist them to sit in position of most comfort Management of head, neck and spinal fractures: 1.Immobilise the head, neck and spine to prevent any form of movement 2.Closely monitor for signs of life.

4. FRACTURED SKULL Skull fractures can result in bleeding under the scalp, in the brain, and visible bleeding or straw coloured fluid leaking from the ear and/or nose. 1.Supporting the head, neck and spine, place the casualty in the recovery position with the bleeding side closest to the ground. 2.Place a pad or clean cloth under the bleeding ear/nose to collect the draining fluid. 3.Closely monitor for signs of life 4.Control bleed do not apply any direct pressure to the skull if you suspect a fracture.

5. CRUSH INJURY If the crushing force has been in place for an extended time, seek urgent medical advice before removing the object. 1.DRABC and call 000 2.If the casualty is unconscious, place him or her in the recovery position on their injured side. 3.If the casualty is conscious, position him or her for most comfort – usually leaning towards the injured side. 4.Assess for and treat any injuries. 5.Assess for and manage shock. 6.Provide reassurance.

6. SOFT TISSUE INJURIES Sprains, strains, bruising and dislocations are all examples of soft tissue injuries. If in doubt – treat like a fracture. SPRAIN, STRAIN, BRUSING INJURIES  DRABCD  RICE DISLOCATION  DRABCD  If in doubt, manage as a fracture  DO NOT attempt to move bones back into place  Support in position found  Get medical help