Australian Ski Patrol Association

1
Australian Ski Patrol Association

• Advanced First Aid
• Lesson 4
• Fractures, Dislocations, Sprains

2
FRACTURES

• Any break in the continuity of a bone
• Classification
• Closed
• Open
• Complicated

3
Causes of Fractures

• Direct Force
• Indirect Force
• Abnormal muscular action

4
Recognition of Fractures

• Pain
• Noise may have been heard
• Deformity
• Tenderness (esp. point)
• Swelling
• Crepitus
• Bruising
• Loss of function

5
Principles of Management
D R A B C

• Reassure
• Treat bleeding
• Immobilise the injured part using bandages,
  splints, slings
• Check for distal nerve function and circulation
• Treat for shock

R I C E
6
Dislocations

• A dislocation is a displacement of the bone ends
  that form a joint.
• Recognition
• Similar to signs and symptoms for fractures
• Pain especially with movement of joint
• Hearing or feeling a clunk, pop or crack at the
  time of injury

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Treatment for Dislocations

• As for fractures
• Do not try to reduce a dislocation

R I C E
8
Sprains Strains

• A Sprain involves damage to the ligaments around
  a joint
• A Strain is a stretched or torn muscle.
• Both are injuries to soft tissue which may vary
  in degree (more serious injuries are sometimes
  less painful)

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Recognition

• Pain and swelling
• Stiffness
• Loss of function
• Instability in more severe cases

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Treatment

• Rest
• Ice
• Compression
• Elevation
• For 72 hours avoid Heat, Alcohol, Running,
  Massage (HARM)

R I C E
11
General Principles for Splints

• Use broad bandages where possible
• Support limbs while securing bandages
• Ensure bandages are firm
• Pad splints in places of natural body shape
• Bandages should be placed above and below the
  injury
• Immobilise the joint either side of the injury

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Special Cases - Upper limbs

• Clavicle
• Upper arm
• Elbow
• Lower arm
• Wrist
• Fingers
• Thumb

13
Special Cases - Lower Limbs

• Pelvis
• Neck of Femur
• Femur
• Kneecap
• Fib/Tib
• Ankle

14
Head Injuries

• All head injuries should be regarded as serious
• Even a mild head injury requires careful
  observation
• SMA if there has been a noticeable change in
  conscious state
• Assume a spinal injury treat accordingly

15
Level of consciousness

• This is determined by observing the casualtys
  best verbal, eye-opening and motor responses
• To establish this
• ask questions
• give commands
• administer a painful stimulus
• Observe and note the responses at 10 minute
  intervals

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Types of Head Injury

• Concussion
• Contusion
• Compression

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Recognition of Head Injury

• History of the incident
• Loss of memory (esp of the event)
• Headache
• Blurred vision
• Altered abnormal responses
• Wounds to scalp and face
• Blood or CSF leaking
• Unequal pupils in unconscious person

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Management of Head Injury

• Support head and neck during movement
• Control bleeding - no direct pressure to skull
• Blood from ear - cover and place with injured
  side down
• If an eye is injured, cover both with pad
• SMA urgently

D R A B C
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Position of the Casualty
D R A B C

• At all times and unconscious casualty must be
  treated in a stable lateral position to ensure a
  clear airway. This takes precedence over all
  other injuries, including spinal injuries.

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Spinal Injury - Recognition

• Pain at or below injury
• Absent/altered sensation
• Loss of or impaired movement
• Tenderness

21
Spinal Injury - Treatment

• Support at all times when moving
• If possible wait for correct equipment to arrive
• backboard
• scoop stretcher
• stiffneck collars
• If unconscious - lateral position

D R A B C
22
Chest Injury

• Fractured Ribs
• Penetrating chest wound
• Flail chest

23
Practical Exercises

• Splints slings
• Arm Sling
• Elevation Sling
• Collar Cuff Sling
• Scenarios
• Lateral position - treating injuries in lateral
  position