LIMBS INJURIES
LIMBS INJURIES
It involves physical damage to the arms and legs due to the action of some external energy, which has disrupted the continuity of the skin, subcutaneous tissue, muscles, nerves, blood vessels and the bone itself.
There are several divisions, depending on the mode of origin and the type of action of external forces.
Intentional (self - harm and injury by another person)
⦁ Unintentional
⦁ Mechanical (sports, falls, blows with a sharp or blunt object, firearms)
⦁ Thermal (burns and frostbite)
⦁ Chemical (corrosive, acids)
⦁ Easier
⦁ Heavy
Advances in science and technology have led to an increase in trauma. Injuries are common in traffic, sports, work and in war conditions. Limb injuries in themselves are rarely life-threatening, but joint injuries can be very dangerous. Certain injuries or combinations of skeletal injuries can result in permanent disability if not treated properly. Appropriate early treatment of patients with extremity injuries can reduce the risk of death, disability, shorten hospital stays and make treatment cheaper. That is why this chapter focuses on the initial treatment of limb injuries. Limb injuries that pose an immediate danger to life are primarily those with large, uncontrolled bleeding. Although it can be visible, life-threatening bleeding can be internal that is invisible. The presence of large fractures increases the risk of the syndrome of damage to the functions of many organs. The risk can be reduced with a reasonable plan of early treatment including early fracture stabilization. Injuries that are dangerous for the extremity include vascular injuries with poor blood circulation and nerve injuries with no sensation under the injury, open fractures, crushed limbs and sprains (complete separation of the joint bones) of the large joints.
ALWAYS THINK OF PERSONAL SECURITY BEFORE HELPING THE INJURED INJURED !!!
Hematoma - hemorrhage - accumulation of blood under the skin, due to the action of a mechanical force that led to the rupture of blood vessels and the outflow of blood into the surrounding tissue.
Wounds
Bleeding - Represents bleeding from a damaged blood vessel or heart due to trauma or a pathological process
⦁ Capillary spotting
⦁ Venous - dark red in color, blood spills over the skin
⦁ Arterial - bright red color, splashing in a jet in the rhythm of heartbeat
⦁ Exterior - visible
⦁ Internal - invisible (in blunt injuries, it can be dangerous in fractures of the femur-upper leg, where up to 2 L of blood can accumulate in the surrounding tissue from blood vessels that are damaged by sharp edges of broken bone).
Venous bleeding management
We use the "first bandage" that is in the first aid kits in cars, then we go to the first health facility. If we are able, we raise the injured limb above the level of the head.
In case of arterial bleeding
Most often by pressing on an artery above the site of the injury, in such a way that we exert strong pressure over a certain artery with our fingers or a closed fist in order to stop the flow of blood from the injured blood vessel.
This type of bleeding is very difficult to stop and the injured person is in danger of death due to the rapid distortion that can occur in just a few seconds, so we must act quickly and call an ambulance.
Another way to stop arterial bleeding is to use a compression bandage, using the first bandage or bandage we have on hand, a clean cloth, over which we will place an extra unopened bandage or a tightly bent piece of cloth or an object, over which we will again tighten the bandage or triangular scarf or similar. to stop the bleeding.
In the event that we have not been able to stop the bleeding in this way, we will resort to tying the limbs above the site of the injury, placing a wide-folded triangle scarf or belt, or the like. and additionally, using a stick, tighten such a bandage in order to stop the bleeding, provided that we have to remember and write down the exact time of its placement.
This method of stopping bleeding is used in traumatic amputation. After that, the injured limb must be placed in a resting position and raised above the level in relation to the rest of the body.
Bone and joint injuries
Fractures
There has been an interruption in the continuity of the bone structure, there may be closed or open fractures.
Signs and symptoms of a closed fracture are: swelling, redness, bone mobility where it is unusual, pain.
Signs and symptoms of open fracture: bleeding, projection of part of the bone into the external environment, pain
Joint injuries - sprains (slight stretching of joint ligaments, possible ruptures, pain on movement, swelling) and sprains (where there was a rupture of joint joints and removal of joint surfaces, severe pain, joint immobility, swelling and visible deformity of the joint). br>
Any suspicion of a bone fracture or joint injury requires immobilization (placing a certain part of the body in a resting position, at the level of first aid using hand tools, planks, slats, cardboard splints, etc.). which unprofessional manipulation of bone fragments can only harm the injured. There is a real danger of injury to surrounding structures (blood vessels, nerves, ligaments, muscles, tendons), or of turning a simple, closed fracture into a complicated, open fracture if the bone fragment breaks through the skin. After immobilization, the injured person can be moved or transported by car to a medical institution.
How to immobilize a limb
⦁ In case of a broken bone, it is necessary to immobilize the broken bone and two adjacent joints, and in case of sprain or dislocation of the joint, it is necessary to immobilize the injured joint and two adjacent bones.
2. The immobilizer must be well attached to the injured limb with a bandage or hand tool (a piece of cloth, rope, belt, etc.) - otherwise the fragments may move. However, the bandage or hand tool must not be too tight as it may disrupt circulation and / or damage nerves.
3. If a handy tool is used, it must be wrapped in cotton wool (or cloth) to prevent tissue damage due to pressure.
4. Before setting the immobilization, remove clothing and footwear with scissors, very carefully without moving the extremities so as not to cause additional pain and injury, if we are not able to do this then we do not remove anything.
5. The wound, if any, should be bandaged sterile (or at least clean) before the immobilizer is placed.
Injury of the joints of the extremities
Closed injury of the wrist and leg.
Open injury of the wrist and leg.
Burns
Burns - is a type of hyperthermic injury that can be caused by electricity, chemicals, dry heat, hot liquid and gas, radiation or friction.
Burns are distinguished by surface and depth. Since the skin has a protective and thermoregulatory role, we must take burns seriously and treat them adequately. To make it easier to determine the percentage of burns on the surface, we use Wallace's "rule of nine" (A. Wallace, 1951), and we can most easily estimate using the size of the victim's hand, 1 hand = 1%.
According to the depth, we distinguish 3 degrees of burns.
How to help the injured
⦁ If we are safe, remove the cause of the burn (extinguish the fire, stop the flow, etc.)
⦁ Evacuate the injured person from the danger zone
⦁ Remove contaminated clothing
⦁ Rinse the burnt part with cold water
⦁ Give the injured person as much water as possible if possible
⦁ Cover the burnt surfaces with sterile gauze, if not then with a clean cotton cloth
⦁ If he cannot do it alone, place the injured person in a comfortable position and transport him to a medical institution or call an ambulance.
Frost
They represent damage to the skin and subcutaneous tissue due to prolonged exposure to low temperatures. The formation of frostbite is facilitated by tight and wet shoes. The extremities of the body are most often exposed, as well as the hands and feet, and above all the toes.
Symptoms and signs
⦁ Cold is felt first
⦁ Later pain
⦁ When the pain disappears it is a sign that the freezing has started
⦁ The edges are pale or blue and cold
⦁ Bubbles may or may not occur
As with burns, we distinguish 3 degrees of frostbite.
How to help the injured
⦁ Bring the injured person into a warm room
⦁ Free him from shoes and clothes
⦁ If there are rings, do not remove them by force but cut them slowly with scissors
⦁ Cover with sterile gauze or a clean cotton cloth
⦁ Immobilize
⦁ Hot drinks
⦁ Transport to a healthcare facility
Note
Every person has the right to health care and the opportunity to achieve the highest possible level of health in accordance with the provisions of this law and the Law on Health Insurance, as well as regulations adopted on the basis of these laws. Every person is obliged to take care of their health. No one should endanger the health of other people. Every person is obliged to provide first aid to an injured or sick person in accordance with their knowledge and abilities, and to provide them with access to the nearest health institution (Article 3. LAW ON HEALTH CARE "Official Gazette of the Federation of BiH", No. 41/10 / 8/4/2010 /).