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IMPORTANT
Fractures, sprains, strains and dislocations may be hard for the lay person to tell apart. For this reason, first aid treatment of any of these conditions is handled as though the injury was a fracture.
Assessment
First-aid assessment of orthopedic injuries is completed with the DOTS assessment technique (Deformity/Open wound/ Tenderness/Swelling). Deformity of a bone or joint indicates a severe problem. An open wound might indicate a severe problem. Other signs of injury include localized tenderness and/or swelling, or the inability to bear weight.
Treatment
The RICE method (Rest, Ice, Compression, and Elevation) is the appropriate treatment for most minor soft-tissue injuries.
- Rest—Stop using the injured area. This might include the use of a splint.
- Ice—Apply cold therapy for 15 to 20 minutes every four hours. Never apply ice directly to the skin; instead, place a thin cloth between the ice and the skin to prevent skin damage.
- Compression—An elastic bandage can help prevent swelling and provide support. Remember: Do not wrap it so tightly that it cuts off circulation. Be sure to check for circulation, sensation, and motion after applying the wrap and periodically thereafter. Signs to check for include decreased sensations; throbbing pain that is different from the injury; tingling, bluish or mottled skin; or a decreased pulse. If any of these signs are present, the wrap should be released and reapplied.
- Elevation—Raise the injured extremity above the level of the heart when possible. This will help reduce swelling.
Advanced, immediate medical care is required for any open wound directly over a deformity or other orthopedic injury, puncture wounds, or if symptoms persist (swelling, pain, deformity, or inability to bear weight). All victims with fractures, dislocations, sprains and strains require professional medical attention.
Moving Victims
Victims with traumatic injuries, such as those caused by automobile accidents, falls etc. should not be moved except by trained rescue workers. Head, neck and back injuries are serious and require special care for movement and transport of victims with these conditions. In exceptional circumstances, such as when a victim is at risk of further injury unless moved, the victim’s head and neck should be stabilized and the body moved with minimal flexing of the head, neck or spinal cord.