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Definition:
A fracture is any break in a bone, including chips, cracks, splintering, and complete breaks.
Types of fracture
1. Direct Force
The bone breaks at the spot of application of the force e.g., direct hit over a bone,
bullet injury.
2. Indirect Force
The bone breaks away from the application of force somewhere else, e.g. after falling
on outside stretched hands.
5. Twisting Forces
Such injuries are often seen in football and skiing accidents where a person's foot is
caught and twisted with enough forces to fracture a leg bone.
Types:
A) Improvised:
Rolled newspaper
Wood
Strong cartons
Cane
Ironing board
Any object that can provide stability
B) Commercially Available Splints:
Rigid splints (padded board, aluminum splint)
Inflatable splints
Traction splints
General Principles Of Splinting:
1. The clothing is best removed from the area of any suspected fracture or dislocation
2. Note and record motion and sensation status distal to the site of injury
3. The splint should immobilize the joints above and the joints below the fracture.
4. During splint application, minimal movement of the limb should be allowed.
5. Severely deformed limb should be straightened with constant gentle manual traction
so that the limb can be incorporated in to the splint.
6. If gentle traction increases the patient's pain significantly or if resistance to the limb
alignment is encountered, the limb must be splinted in the position of deformity.
7. Cover all wounds with dry sterile dressing before applying a splint.
8. Pad the splint to prevent local pressure.
9. Do not move or transport patients before splinting extremely injuries.
10. when in doubt, splint.
3
Hemorrhage
External hemorrhage
- Types:
o Arterial bleeding: loss of blood from arteries
o Blood loss is rapid and profuse
o The color of blood is bright red
o Blood spurts as the heart beats
o Venous Bleeding: loss of blood from veins
o Blood loss is a steady flow
o The color of blood is dark
o Capillary Bleeding: loss of blood from capillary bed
o Blood flow is slow
o The color of blood is red but less bright
- Methods used to control external bleeding
o Direct pressure: is a most effective method
o Apply direct and firm pressure to the wound
o Elevation of the limb
o Pressure point on the artery
o Splinting: used in sever laceration or cut extends over
the length of the extremity.
o Blood pressure cuff: the cuff is placed above the wound,
and can be left for up to 30min.
o Mast Garments: pneumatic counter-pressure devices for
serious abdominal bleeding
o Applying Tourniquet: is a last resort used only when
other methods to control bleeding have failed.
4
Internal hemorrhage
- Detecting internal bleeding: assume internal bleeding whenever the following are
present
o Wound that have penetrated the skull
Blood in the ear
Vomiting or coughing up blood
Epistaxis
Epistaxis (nose bleeding): means hemorrhage from the nose, due to mainly spontaneous
rupture of minute vessels.
- Local causes:
o Trauma
Blow on the nose Nose picking
Foreign body
o Infection: acute / chronic rhinitis
o Violent sneezing
o Eroding neoplasm in the nasal cavity, nasopharynx, or sinuses.