Fractures & Dislocations

Picking up from where we left off last week in strains and sprains, it was mentioned that when in doubt, always treat as a fracture, so in this week's post we will be covering the topic of fractures and dislocations.

Fractures and dislocations can often be obvious to identify, in such ways like a deformed limb or cracking sound upon impact. Below is a more detailed list of these.

Signs and symptoms:

• pain at or near the site of the injury
• difficult or impossible normal movement
• loss of power
• deformity or abnormal mobility
• tenderness
• swelling
• discolouration and bruising

Management of a Fracture or Dislocation

1. Follow DRSABCDYou can find more details on the DRSABCD Action Plan in my previous first aid blog post. Linked here: https://c20wellbeing.blogspot.com.au/2017/09/drsabcd-action-plan.html
2. Control any bleeding and cover any wounds.
3. Check for fractures:
   Open, closed or complicated.
4. Ask the patient not to move injured part.
5. Immobilise the fracture.
   Use broad bandages (where possible) to prevent movement at joints above and below the fracture.Support the limb, carefully passing bandages under the natural hollows of the body.
   Place a padded splint along the injured limb.
   Place padding between the splint and the natural contours of the body and secure tightly.
   For leg fracture, immobilise foot and ankle.
   Check that bandages are not too tight (or too loose) every 15 minutes.
6. Monitor patient carefully.
   Watch for signs of loss of circulation to foot or hand.
7. Ensure an ambulance has been called - triple zero (000)
   Where in the case of life threatening injury or patient is alone, calling an ambulance is fine. But if it is only a minor fracture and they have someone to take them to the hospital, this option is much preferred.

Fractured leg: bandage and padded splint

St John sling: fractured clavicle (collarbone)

Note:

• it can be difficult to tell whether the injury is a fracture, dislocation, sprain or strain. If in doubt, always treat as a fracture.
• if collarbone fractures, support arm on injured side in a St John sling.
• If dislocation of a join is suspected, apply RICE management (see Sprains and Strains). https://c20wellbeing.blogspot.com.au/2017/10/sprains-strains.html

Written by: James // @TheJamesFeng

References:
Emergency First Aid. (2013). 2nd ed. Barton, A.C.T.: St John Ambulance Australia.
St John Ambulance Australia. St John Sling. [image] Available at: http://stjohn.org.au/assets/image-cache/uploads/sidebar%20gallery/Training/87.54a9616c.jpg.