|
Featured Articles : Other Common Injuries
& Ways To Treat It.
Eye and Ear Injuries
THE EYE is a robust, but also a delicate, organ. It can sustain
quite severe damage, and with the proper treatment, recover to its
former state. In some instances, though, it can suffer what would be
considered to be a minor injury, and be permanently damaged.
Consideration should always be given to avoiding eye injury, and
sufficient protective means taken. Generally, eye injuries are
considered as either minor or major injuries.
MINOR EYE INJURIES
These are injuries where the eye has been struck by a foreign
object, or has a small object adhering to its surface, causing
irritation. It is characterised by a bloodshot eye, irritation, and
an urge to rub the eye.
CARE AND TREATMENT
irrigate the eye and wash the object out
if this fails, touch the corner of a clean cloth to the object and
lift it off the surface
refer to medical aid if vision is affected
cover the affected eye if appropriate
avoid 'pushing' the object around the eye's surface
only use eye-drops if prescribed by a doctor
MAJOR EYE INJURIES
These are injuries that involve the penetration of the body of the
eye, or involve severe blunt trauma to the eye. These are
characterised by blood in the eye, penetrating objects, disturbance
of vision, protrusion of eye contents, and severe pain and spasms.
Casualty care in this case is critical, and should be left to the
experts.
CARE AND TREATMENT
lay the casualty supine with complete rest
call 000 for an ambulance
cover the affected eye with a ring bandage or similar
reassurance
if tolerated by the casualty, cover the unaffected eye, but remove
it if the casualty becomes anxious
reassurance
avoid attempting to remove any penetrating object
attempts to transport the casualty other than by ambulance should be
resisted
eye-drops are not to be used under any circumstances
'WELDER'S FLASH'
'Welder's Flash' is the result of staring or inadvertently looking
at the intense light caused during metal welding, while not wearing
the correct eye protection. Care must be taken to supervise children
if welding is being conducted near them, and they should be removed
from the location. The damage caused to the eye's cornea by exposure
to this intense light can be painful and, in some cases, permanent.
CARE AND TREATMENT
apply cool compresses and cover the eyes with pads
urgent medical attention if pain or 'spots' persist
THE EAR
The ear has two functions, as the receptacle of the auditory senses
(hearing), and as the organ of balance. Injuries to the ear usually
affect the hearing function, rather than balance. Children are
especially at risk of ear damage by inserting small objects into the
ear canal. This can have serious effects on the tympanic membrane,
or 'eardrum'. An old, but sensible, saying is that 'nothing smaller
than the elbow should be poked in the ear'.
CARE AND TREATMENT FOR EAR OBSTRUCTION
if an insect, attempt to float it out with warm water or clean light
vegetable oil
if object immovable, seek medical aid
poking into the ear should be avoided
The tympanic membrane or eardrum is easily damaged. Holes or tears
may be caused by swimming and diving beneath the surface, change in
altitude (flying), or by vigorous nose-blowing when 'stuffed up'
with a cold or flu. Eardrums usually spontaneously repair themselves
over a period of hours.
CARE AND TREATMENT FOR RUPTURED EARDRUM
place cover over affected ear to guard against infection
seek medical aid
avoid using eardrops unless directed by a doctor
avoid swimming or water sports
Head Injuries
HEAD INJURIES can easily mislead the first aid provider by not
exhibiting the expected signs and symptoms immediately after the
incident. In many instances, the casualty has appeared unaffected
after the incident only to collapse with life-threatening symptoms
some hours later. This may be due to a small bleed in the brain that
eventually increases and applies excessive pressure on the brain
tissue.
As a first aid provider, you should always examine the history of
the incident, and the mechanism of injury. If, in your opinion, the
incident had the potential to cause serious injury, assume the worst
and treat as a head injury.
Any casualty that has been rendered unconscious or received a hard
blow to the head should always be examined by a doctor - NO
EXCEPTIONS!
Head injuries are generally classified as either:
OPEN - a head injury with an associated head wound; or
CLOSED - with no obvious sign of injury
In many instances, serious head injury is readily identified by
certain signs peculiar to the injury. These may include:
A straw-coloured fluid oozing from the nose or ears. This is cerebro-spinal
fluid (CSF), which surrounds the brain. When a fracture occurs,
usually at the base of the skull, the fluid leaks out under pressure
into the ear and nose canals.
'Raccoon eyes' and 'Battle's sign'. The kinetic energy from a blow,
which is transmitted through the head and brain is expelled through
soft tissue, eg. the eyes, and behind the ears. Bruising at these
points indicates that the head has suffered exposure to considerable
force. It should be remembered that just because a casualty has two
black eyes, this does not necessarily mean that he or she has been
struck in the face. 'Raccoon eyes' may indicate a forceful impact
elsewhere on the skull.
Blurred, or double vision. This symptom is common with concussed
casualties. It indicates that the brain has been dealt a blow that
has temporarily affected its ability to correctly process the sight
senses.
CONCUSSION is a closed head injury. Of all the head injuries, this
is the most insidious, and many casualties have succumbed several
hours after the incident. Be especially observant during contact
sports or activities involving children - the myth that you can 'run
off' your concussion by playing on is a dangerous attitude, and has
caused grief to many players, parents and coaches when the casualty
eventually collapses. Concussion is potentially very serious, and an
indifferent attitude is to be discouraged.
FACIAL INJURIES are also head injuries, and the first aid
provider should not be unduly distracted by obvious facial injuries
and forget to assess the casualty for associated brain injury.
Facial injuries are also a complication where the airway is
concerned.
SIGNS AND SYMPTOMS
Any, or all, of the following:
history of trauma
head wounds
deformation and/or crepitus of the skull
altered level of consciousness
evidence of CSF leaking from ears or nose
may have unequal pupils
headache
'raccoon eyes' or 'Battle's sign'
nausea and/or vomiting
restlessness and irritability, confusion
blurred or double vision
'snoring' respirations if unconscioustor
avoid swimming or water sports
CARE AND TREATMENT
DRABC
call for an ambulance
apply a cervical collar only if trained to do so
treat any wounds
complete rest — DO NOT allow concussed casualties to `play on'
if unconscious or drowsy, put casualty in the stable side position
while supporting the cervical spine
allow any CSF to drain freely — if in stable side position, put
that side down with a pad over the ear
REMEMBER — Head, neck and spinal injuries are all related.
Any person with a head injury who has a disturbed level of
consciousness may have sustained a neck injury as well.
Spinal Injuries
THE SPINAL COLUMN consists of a series of interconnected bones,
called vertebrae, which enclose the SPINAL CORD, an integral part of
the central nervous system. It is the spinal cord, through its
attached nerve roots, which provides the means by which we breathe,
move and sense.
Between each vertebra are discs of cartilage, which act as shock
absorbers and allow the spinal column a degree of flexibility. The
spine is divided into:
the cervical spine (neck), 7 vertebrae;
the thoracic spine (chest), 12 vertebrae;
the lumbar spine (back), 5 vertebrae;
fused vertebrae of the sacrum
a small vertebra called the coccyx.
Any injury to the spinal cord has serious ramifications for our
ability to function normally, and a separation, or 'lesion, of the
cord may cause quadriplegia, paraplegia, or chronic painful
conditions, dependent on the location of the injury.
It is generally the case that a lesion high in the cervical spine is
fatal. Damage to the spinal cord further down to the level of the
upper two thoracic vertebrae usually indicates quadriplegia to
varying degrees. Lesions down to the lower thoracic vertebrae may
give rise to paraplegia. Even if the casualty is not affected to
these degrees of severity, spinal injury causes chronic back pain
and restricted spinal flexibility.
Spinal injuries can be caused by a variety of physical incidents. A
common cause of spinal injuries is motorcycle accidents. Riders and
pillion passengers are thrown unprotected to the roadway and
invariably land heavily in an awkward attitude, putting stress on
the spinal column. It benefits the first aid provider to carefully
assess the history of the incident and the mechanism of injury
before applying active treatment. Road traffic accidents, diving
accidents, and sporting accidents provide the majority of
casualties.
SIGNS AND SYMPTOMS
history of trauma
generally slow pulse
LOOK at the casualty, does the posture seem unnatural?
may have pale, cool, clammy skin
'tingling', unusual, or absent feeling in extremities
absence of pain in extremities
inability to move arms and/or legs
penile erection
onset of shock
CARE AND TREATMENT
DRABC
call for an ambulance
extreme care in initial examination
if unable to control airway - carefully remove helmet
apply cervical collar if trained to do so
treat for shock
treat any other injuries
maintain body heat
if movement required, `log roll' and use assistants
always maintain casualty's head in line with the shoulders and spine
SPINAL SHOCK is an injury where the spinal column is subject to a
forceful blow, but no lesion occurs. The reaction of the nervous
system is such that it mimics a severed spine, and the signs and
symptoms are identical. Some time later the casualty gradually
resumes the use of his or her limbs. For the first aid provider,
however, initial examination of the casualty will indicate a spinal
lesion, so treat it as one.
Chest Injuries
The potential for serious complications exists when injuries are
sustained involving either the chest or the abdomen, or both.
Serious chest injuries usually involve the lungs, and compromised
breathing is common. Abdominal injuries indicate that the organs
contained within may have been damaged to varying degrees.
Chest and abdominal injuries are difficult for the first aid
provider to manage, and casualties with these injuries should be
referred to medical aid as a matter of priority.
The major chest injuries encountered by the first aid provider are
FRACTURED RIBS, FLAIL CHEST and PENETRATING CHEST WOUND.
FRACTURED RIBS
Ribs are composed of successive layers of flat bone, which give the
ribs their flexibility, or 'spring'. When ribs fracture, often the
'spring' is reduced, rather than the entire bone being detached from
the spinal column or the sternum. Rib injuries cause distress due to
the difficulty the casualty has in breathing.
SIGNS AND SYMPTOMS
history of trauma to the chest
pale, cool skin
pain at the site, especially on inspiration
rapid pulse
rapid shallow breathing
'guarding' of the injury
CARE AND TREATMENT
DRABC
put the arm on the injured side in a 'collar and cuff' sling to act
as a splint
bind the upper arm close to the side
seek medical aid
observe for respiratory compromise
FLAIL CHEST
FLAIL CHEST is an injury to the ribs where a section of the chest
wall has been detached due to multiple fractures. Generally there is
an associated collapsed lung (pneumothorax). Flail chest should be
considered a life-threatening injury due to its complications.
SIGNS AND SYMPTOMS
pale, cool clammy skin
rapid, weak pulse
shallow, difficult breathing
paradoxical chest movements, where the injured area moves in the
opposite direction to the rest of the chest
cyanosis
pain, especially on inspiration
CARE AND TREATMENT
DRABC
call 000 for an ambulance
apply a firm pad over the flail section
apply a firm bandage in place (if pain permits)
posture the casualty in a position of comfort, usually sitting
if unconscious, posture on the injured side
reassurance
observe carefully for signs of breathing difficulties
PENETRATING CHEST WOUND
A PENETRATING CHEST WOUND may be a wound where the object is still
in place in the wall of the chest, or it may be an open wound left
by the object, eg., a stab wound, or bullet wound. If the object is
still in place — DO NOT REMOVE IT. If it is too long or too
awkward to manage, obtain urgent expert assistance to have it cut,
but resist removing or cutting the object yourself..
SIGNS AND SYMPTOMS
history of the incident
object still in place
open wound in the chest wall (look for both entry and exit wounds)
pale, cool clammy skin
rapid, weak pulse
rapid, shallow breathing
cyanosis
may be pain at the site
onset of shock
CARE AND TREATMENT
DRABC
call for an ambulance
if object in place, stabilise with a pad around entry wound
if open wound, apply non-adherent pad, taped on three sides only
leaving bottom side untaped
posture casualty in position of comfort
reassurance
observe for breathing difficulties
|
Scouting
Resources
