First aid

Describe the common types of fractures
There are two types of fracture called open and closed. A closed fracture is where the skin is unbroken, but the internal damage to surrounding tissue can be seen as swelling. An open fracture has a wound. The bone may or may not be protruding. There is also internal damage to surrounding tissue.

Describe how to manage a fracture.
A casualty with a fracture needs to keep still and not move the injured part. The treatment for a closed fracture is to reduce the risk of further injury by preventing the casualty from moving the fracture and to get medical help. You need to: 1.Support the injured limb

2.Immobilise the affected part
3.Dial 999 or 112 for an ambulance
4.Treat for shock.
The treatment for an open fracture is to prevent blood loss and movement at the site of the fracture and to get medical help. You need to: 1.Control the bleeding without pressing on ant protruding bones. Protect the injury from infection. 2.Support and immobilise the limb.

3.Dial 999 or 112 for an ambulance.
4.Treat for shock.
Wear disposable gloves throughout if possible.

Describe how to manage a dislocation.
A dislocation is an injury in which the ends of your bones are forced from their normal positions. The cause is usually trauma resulting from a fall, an auto accident or a collision during contact or high-speed sports. In adults, the most common site of dislocation is the shoulder. In children, it’s the elbow. Dislocation usually involves the body’s larger joints. Because of its position on the hand, however, your thumb is also vulnerable if forcibly bent the wrong way. The injury will temporarily deform and
immobilize your joint and may result in sudden and severe pain and swelling. A dislocation requires prompt medical attention to return your bones to their proper positions. If you believe you have dislocated a joint:

1.Don’t delay medical care. Get medical help immediately.
2.Don’t move the joint. Until you receive help, splint the affected joint into its fixed position. Don’t try to move a dislocated joint or force it back into place. This can damage the joint and its surrounding muscles, ligaments, nerves or blood vessels. 3.Put ice on the injured joint. This can help reduce swelling by controlling internal bleeding and the build-up of fluids in and around the injured joint.

Describe how to recognise and manage head injuries
Any head injury must be treated seriously as it is potentially life threatening and can cause impaired consciousness. A head injury can result in: •Damage to the brain tissue
•Damage to blood vessels inside the skull
•A fracture to one of the bones in the skull
Always assume that a casualty with a head injury also has a neck injury and treat accordingly. You can recognise a head injury by: •Recent blow to the head
•Brief loss of consciousness
•Wound to the head
•Increased drowsiness
•Worsening headache
•Confusion, memory loss, strange behaviour and nausea
•Weakness to a limb
•Speech difficulties
•Dizziness, seizures or balance problems
•Sight problems, including double vision
•Clear fluid or blood leaking for the nose or ear
•Unusual breathing
To treat a conscious casualty you must:
1.Help the casualty sit down in a comfortable position.
2.Apply cold compress to the head injury
3.Monitor the casualty’s level of response and breathing. If they: •Become drowsy or confused
•Experience and worsening headache
•Develop double vision
•Start vomiting
Dial 999 or 112 for an ambulance and be prepared to perform CPR. Always advise the casualty to seek medical advice if there has been no emergency medical help at the incident and not to take alcohol or drugs until they have recovered properly. If they are unconscious:

1.If the casualty is breathing, maintain and open airway using the jaw thrust technique. 2.Dial 999nor 112 for an ambulance.
3.Monitor the casualty’s level of response and breathing until the paramedics arrive. Be prepared to perform CPR. A casualty who loses consciousness after a blow to the head must see a doctor.

Compression of the brain
Compression of the brain – a condition called cerebral compression – is very serious and almost invariably requires surgery. Cerebral compression occurs when there is a build-up of pressure on the brain. This pressure may be due to one of several different causes, such as an accumulation of blood within the skull or swelling of injured brain tissues. Cerebral compression is usually caused by a head injury. However, it can also be due to other causes, such as stroke, infection, or a brain tumour. The condition may develop immediately after a head injury, or it may appear a few hours or even days later. For this reason, you should always try to find out whether the casualty has a recent history of a head injury. Recognition

•Deteriorating level of response – casualty may become unconscious. There may also be:
•history of a recent head injury
•intense headache
•noisy breathing, becoming slow
•slow, yet full and strong pulse
•unequal pupil size
•weakness and/or paralysis down one side of the face of body •high temperature; flushed face
•Noticeable change in personality or behaviour, such as irritability or disorientation. Your aim
•To arrange urgent removal of the casualty to hospital.
•Dial 999 for an ambulance.
If the casualty is conscious:
•keep them supported in a comfortable resting position and reassure them •Regularly monitor and record vital signs – level of response, pulse, and breathing – until medical help arrives. If the casualty is unconscious:

•Open the airway using the jaw thrust method and check breathing (primary survey) •Be prepared to give chest compressions and rescue breaths if necessary •If the casualty is breathing, try to maintain the airway in the position the casualty was found.

The brain is free to move a little within the skull, and can thus be ‘shaken’ by a blow to the head. This shaking is called concussion. Among the common causes of concussion are traffic incidents, sports injuries, falls, and blows received in fights. Concussion produces widespread but temporary disturbance of normal brain activity. However, it is not usually associated with any lasting damage to the brain. The casualty will suffer impaired consciousness, but this only lasts for a short time (usually only a few minutes) and is followed by a full recovery. By definition, concussion can only be confidently diagnosed once the casualty has completely recovered. A casualty who has been concussed should be monitored and advised to obtain medical aid if symptoms such as headache or blurred vision develop later. Recognition

•Brief period of impaired consciousness following a blow to the head. There may also be:
•Dizziness or nausea on recovery
•Loss of memory of events at the time of, or immediately preceding, the injury •Mild, generalised headache.
Your aims
•To ensure the casualty recovers fully and safely
•To place the casualty in the care of a responsible person •To obtain medical aid if necessary.
•Check the casualties level of response using the AVPU code: oA – Is the casualty alert, eyes open and responding to questions? oV – Does the casualty respond to voice, obey simple commands? oP – Does the casualty respond to pain (e.g. eyes open or movement in response to being pinched)? oU – Is the casualty unresponsive?

•Regularly monitor and record vital signs – level of response, breathing and pulse. Even if the casualty appears to recover fully, watch them for any deterioration in their level of response •When the casualty has recovered, place them in the care of a responsible person. If a casualty has been injured on the sports field, never allow them to ‘play on’ without first obtaining medical advice •Advise the casualty to go to hospital, if following a blow to the head they develop symptoms such as headache, vomiting, confusion, drowsiness or double vision. Warning: if the casualty does not recover fully, or if there is a deteriorating level of response after an initial recovery dial 999 for an ambulance Skull fracture

If a casualty has a head wound, be alert for a possible skull fracture. An affected casualty may have impaired consciousness. A skull fracture is serious because there is a risk that the brain may be damaged either directly by fractured bone from the skull or by bleeding inside the skull. Clear fluid (cerebrospinal fluid) or watery blood leaking from the ear or nose are signs of serious injury. Suspect a skull fracture in any casualty who has received a head injury resulting in impaired consciousness. Bear in mind that a casualty with a possible skull fracture may also have a neck (spinal) injury and should be treated accordingly. Recognition

•Wound or bruise on the head
•Soft area or depression on the scalp
•Bruising or swelling behind one ear
•Bruising around one or both eyes
•Clear fluid or watery blood coming from the nose or an ear •Blood in the white of the eye
•Distortion or lack of symmetry of the head or face
•Progressive deterioration in the level of response.
Your aims
•To maintain an open airway
•To arrange urgent removal of the casualty to hospital.
If the casualty is conscious:
•Help them to lie down
•Do not turn the head in case there is a neck injury
•Control any bleeding from the scalp by applying pressure around the wound •Look for and treat any other injuries
•Dial 999 for an ambulance
•If there is discharge from an ear, cover the ear with a sterile dressing or clean pad, lightly secured with a bandage. Do not plug the ear •Monitor and record vital signs – level of response, pulse, and breathing – until medical help arrives. If the casualty is unconscious:

•Open the airway using the jaw thrust method and check for breathing (primary survey) •Be prepared to give chest compressions and rescue breaths if needed •Dial 999 for an ambulance
•If the position in which the casualty was found prevents maintenance of an open airway or you fail to open it using the jaw thrust, place her in the recovery position. If you have helpers, use the ‘log-roll’ technique.

Describe how to manage an infant and a child with foreign bodies in their eyes, ears and nose. How to recognise foreign objects in the eye:
•Blurred vision
•Eyelids in spasm
•Redness or watering of the eye
•Or most common in children, rubbing the eyes and crying or complaining of pain. How to recognise foreign objects in the nose:
•Difficult or noisy breathing through the nose.
•Swelling of the nose
•Smelly or blood-stained discharge.
Children having foreign bodies in their eyes, ears and noses are common things you will see this a lot if you were to work in a minor injuries unit. There are several things that can gets stuck in any of these places crayons, glitter and beads. Beads fit into the ears and noses incredibly well, it’s almost like they are asking for it to happen. When things get stuck up a child’s nose or ears, unless there is enough sticking out to get a firm grip on E.g. a crayon, and gently ease it out don’t touch it as the result will be it becoming further stuck in. In times like these you simply need to call the first aider of take the child to the hospital or the minor injuries unit for it to be removed. Try to keep the child calm It may only be a simple procedure but it still needs to be done professionally as if anything goes wrong it can usually be treated there and then. Most children will manage to get foreign bodies in their eyes, things such as: Paint, Dust, Sand, Eye lashes, Fluff, Glitter.

These sorts of things can be easily removed though by:
•Sit the child down and put on a pair of disposable gloves. •Gently pull down the lower eyelid and any visible foreign body removed with either a clean wet piece of tissue or a small piece of wet gauze swab. •Yet if this fails to works pull the upper eyelid over the lower lid and try to flush it out with tears. If it still remains in the eye try to wash the eye with water by: •Positioning the child’s head over the sink or bowl with their eye open, facing the bottom of the sink or bowl. •Using a plastic cup try to pour water on the eye from the tear duct outwards.

If none of this works and the eye is still red and the child still says it is painful then go to the nearest place and seek professional help

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