Topic No. 8. First aid for dislocations and broken bones

First aid for childhood injuries

All mothers know for sure: something always happens to children! Either they fall into a puddle, or they stick their fingers in a socket. In order to be prepared for any emergency, we will describe all the necessary actions of the parent before the ambulance arrives. After all, the main thing in this matter is not to harm, but to help.

Sun or heatstroke

The situation arises when a child spends a long time in the open sun without a hat. Due to the rush of blood to the brain, the following symptoms appear:

• nausea;
• vomit;
• shallow breathing;
• convulsions;
• loss of consciousness.

In order to provide first aid, it is necessary to move the victim into the shade, open or remove his clothes and lay him down so that the head is higher than the body. The baby's face, neck and chest should be wiped with cold water. You should also place a cold, wet towel on your forehead to cool down. Reduce the temperature with children's antipyretics. Give as much to drink as possible.

Frostbite

Damage to tissue under the influence of cold can occur not only in severe frosts, but even at temperatures of 0 - +3 degrees. This situation often arises if the child has been walking in wet clothes or in a strong wind.

To provide first aid, it is necessary to maintain a sub-zero temperature on the surface of the damaged area of ​​skin. To do this, apply a thermal insulating bandage, which includes 4 layers: bandage + cotton wool + oilcloth (or plastic bag) + scarf. The child must be given a warm drink and covered with a blanket.

Attention! Under no circumstances should you rub the skin in the area of ​​frostbite with snow or mittens. This will damage the skin and may result in infection. Also, you should not warm up a frostbitten area with warm (and even more so hot!) water - serious consequences can occur.

Burn

According to statistics, burns are considered the most common injuries in childhood. If a burn occurs, it is necessary to irrigate the affected area with a cold stream of water. Continue these manipulations for 10-15 minutes. You should never treat a burn with iodine, potassium permanganate, or oil. No “peeing” on damaged skin, no applying potatoes and other unthinkable methods! With an extensive burn, every second is important - we wrap the child in a clean, freshly ironed sheet, give him warm tea and take him to the clinic as soon as possible.

Electric shock

If a child receives an electrical injury, immediately remove it from the source of electricity. However, it should be understood that at this moment the victim himself becomes a conductor of current, and can only be touched while wearing rubber gloves or standing on a rubber surface. Electrical wires can also be pulled away from the child using a dry branch.

In case of respiratory arrest, it is necessary to perform a cardiac massage. To do this, press your hands on your chest 30 times, then exhale air into your mouth 2 times. The steps should be repeated until the ambulance arrives.

Even if a child who has received an electric shock does not complain of feeling well, he or she must be shown to a doctor in any case. The negative effects of current on the body may not appear immediately.

Injury

Bruises are injuries to body tissues without compromising the integrity of the skin. The main symptom of a contusion is a bruise or hematoma. After an injury, the child feels pain and swelling may occur.

The main action of parents for bruises is to apply cold to the damaged area. Any frozen product from the freezer, pre-wrapped in a scarf or thin towel, will do. After 2-3 days, on the contrary, a warm heating pad is applied to the site of the bruise. In case of a bruise in the joint area, it is necessary to immobilize it.

Attention! In case of a strong blow, it is imperative to show the child to a doctor to exclude serious dislocations and fractures.

Sprained or torn ligaments

In most cases, when a ligament is sprained or torn, the ankle joint is affected. After a child twists his foot, he feels a sharp pain. At this time, swelling appears on the outer surface of the joint.

When a ligament is sprained or torn, cold must be applied to the damaged joint and secured with a figure-of-eight bandage. To ensure that a sprained leg does not cause a bone fracture, it is recommended that the child be shown to a doctor.

Fracture

This is one of the most dangerous injuries, requiring not only knowledge of immediate care, but also subsequent rehabilitation. Open fractures are considered the most dangerous, as there is a high risk of infection through damaged tissue.

In the case of an open fracture, the first action of the parent is to stop the bleeding using a sterile bandage (we will discuss bleeding in more detail below). If the ends of bones and fragments are found, do not under any circumstances try to bury them deep into the wound. Broken limbs must be immobilized using a splint made from scrap materials. These can be boards, sticks, pieces of cardboard, etc. If your arm is broken, you can bandage it to your body. The broken leg can be carefully bandaged to the uninjured leg. The victim must be moved very carefully, without causing additional injury.

If the spine is fractured, the child must be moved in a lying position. A sitting position is not allowed. Transportation takes place on a shield or stretcher with a solid frame. If a fracture of the pelvic bones is suspected, the victim should be placed on a stretcher, placing a bolster under his bent, separated knees.

Wound

Any, even the smallest, wounds are an open gate for infection. Often, infection occurs as a result of improperly provided care.

If a wound occurs, clean the damaged skin from dirt (movements are made from the edges of the wound to its outer part), cover with a sterile bandage. When providing assistance, do not examine the wound with your fingers and do not wash it with any liquids. When treating with brilliant green or iodine, make sure that the product does not get on the wound itself, only on its edges.

If the applied bandage becomes saturated with blood, do not try to remove it; it is better to apply another additional layer of bandage on top.

Bleeding

The tactics to stop bleeding depend on its type. So, in case of venous or capillary bleeding, the child’s injured limb should be raised and a pressure bandage applied to the wound. For arterial disease, a tourniquet will be required.

In order to apply the tourniquet correctly, it should be fixed on a soft lining (any fabric will do). When applying, it is necessary to monitor the bleeding: as soon as it has stopped, the pressure of the tourniquet must be left at this level. No need anymore!

It is necessary to record the time of application of the tourniquet and ensure that the duration of the tightening in the summer does not exceed 40 minutes, in the winter - 20. To control the situation, you should not cover the tourniquet with clothing.

Traumatic brain injury

The main task of parents when a child receives a skull injury is to create complete peace. In case of an open wound, apply a tight sterile bandage. If vomiting occurs, care must be taken to ensure that the child does not choke on the vomit. It is better to carry the victim in your arms to the doctor.

Attention! For any traumatic brain injury, a child must be seen by a doctor. Underestimating the seriousness of the incident can lead to serious consequences: headaches, memory impairment, fatigue, etc.

All these recommendations will help you not to get confused in the event of an accident and provide your child with competent pre-medical care in a timely manner. But to avoid having to do this, take care of your children!

Lesson summary: First aid for sprains, dislocated joints and broken bones

Topic: First aid for sprains, joint dislocations and bone fractures

Purpose of the lesson : to introduce students to the main types of injuries associated with the musculoskeletal system and methods of providing first aid (PMP).

Tasks:

Educational:

• introduce students to the types of injuries to the musculoskeletal system: sprains, dislocations, fractures; introduce relevant concepts;
• review signs of sprains, dislocations, fractures and types of fractures;
• formulate rules of adequate behavior in extreme situations;
• study methods of providing primary care (application of fixing bandages, splints, possible methods of transporting victims);
• summarize students’ knowledge about the musculoskeletal system; based on knowledge about the composition of bones, find out the causes of fractures in different age groups;
• establish a connection between the structure of joints, bones and signs of their damage.

Educational:

• develop students' knowledge of safe behavior;
• promote the development of interest in anatomy.

Educational:

• to form a scientific worldview;
• promote professional orientation of students;
• hygienic education.

Equipment: educational tables, stands, bandage application diagrams, fracture types diagram, “Emergency Actions” diagram; bandages, splints.

Lesson type: combined.

Teaching methods:

• verbal (story, conversation, explanation);
• visual (showing tables, diagrams, drawings);
• demonstration (method of applying a bandage, splint);
• practical (students providing assistance to a conditionally injured person).

During the classes

I. Organizational moment.

II. Knowledge control.

1. Why is the crown the most vulnerable part of the skull? (Remains of the largest spring)
2. Why is a blow to the temporal region more dangerous than a blow to the frontal region? (The temporal bone is the thinnest)
3. Which part predominates in the human skull: facial or cerebral? (Brain)
4. Why can the shin bone support the weight of a car? (There are fibers inside that give strength)
5. What is the importance of the arch of the foot? (The arch of the foot is needed to make a person’s gait more springy, since it is the arch of the foot that supports the entire weight of the skeleton and internal organs)
6. From a skeletal point of view, explain why teenagers should not carry heavy things. (In adolescents, a large amount of cartilage remains in the skeleton, so when carrying heavy objects, curvature of the spine and flat feet may develop)
7. Which joint has a complex structure and is the most vulnerable? (Knee-joint)
8. How does bone composition change with age?
9. Name the function of joint fluid. (Joint fluid acts as a lubricant that reduces friction)
10. Why does joint mobility decrease with age? (Organic substances are replaced by mineral ones; the amount of synovial fluid decreases, joints lose their elasticity)
11. Why is a person’s height 1–2 cm longer in the morning than in the evening? (Intervertebral discs, consisting of cartilage, flatten because they support the entire weight of the body)

III. Learning new material

There are closed and open injuries. The most common are closed ones.

Let's write it down

The first type we will consider is sprains and ruptures of joint ligaments.

All data will be entered into the table “Damages to the musculoskeletal system.”

Sprains and tears of ligaments occur as a result of sudden and rapid movements. These injuries are most often observed in the ankle, knee and wrist joints.

Sharp pain appears, especially at the first moment, rapidly developing swelling, bruising, limitation and pain in movements in the joint. As first aid, it is necessary to ensure complete rest and an elevated position of the affected limb, cold lotions and ice.

For sprains, a bandage on the joint is recommended, but very tight bandages should not be applied. Why? (Prevents bleeding). Further treatment should be carried out as directed by the doctor. A stirrup bandage is applied to the ankle joint. Examine it at the stand, and our experts will demonstrate the application rules during practical work.

Damage to the musculoskeletal system

Let's move on - dislocation .

When jumping and falling from great heights, strong blows and bruises, some joint or the entire limb suddenly ceases to function. The skin around the joint swells, and attempts to move it cause severe pain. This is usually due to a violation of the location of the bones in the joint - dislocation. What to do? Under no circumstances should you try to “reduce” the joint. It is necessary to ensure his complete immobility and peace. The arm should be bandaged to the body or a bandage should be used, and a splint should be applied to the leg. A splint is a specially made device to ensure immobility during fractures. There are special medical splints that take the shape of a limb.

**Demonstration (if possible).

What to do if she is absent? (You can use improvised means: plywood, stick, tree branch, cardboard, ski). It is very important to reduce pain. For this purpose, painkillers and cold are used. In case of dislocations of the upper extremities, victims can come to a medical facility themselves or can be transported by any transport in a sitting position. Patients with dislocation of the lower extremities are transported in a lying position.

The next type of damage is fracture . From the very name of the damage, try to define it.

A fracture is a violation of the integrity of a bone.

The fracture can be complete or incomplete. With an incomplete fracture, some part of the diameter of the bone is broken, most often in the form of a longitudinal gap - a bone crack. Let's look at the diagram:

Fractures come in a wide variety of shapes: transverse, oblique, comminuted, and “green twig” type (Table demonstration).

Look carefully at the diagrams. Which type is dramatically different? How? This is an open fracture. It is dangerous primarily due to the possibility of wound infection and bleeding. Therefore, it is important to remember two rules about asepsis and antiseptics.

Asepsis is the preventive destruction of microbes and prevention of their penetration into the wound. Asepsis is achieved by strict adherence to the basic rule - everything that comes into contact with the wound must be sterile (free from germs). Do not touch the wound with your hands, remove splinters or scraps of clothing from it, or use non-sterile material to close the wound.

Antiseptics is a method (method) of treating bacterial contamination and infected wounds by combating infectious agents that have penetrated into the wound or tissue.

• What rule is important to follow when applying a bandage for an open fracture (about asepsis).

A closed fracture seems less dangerous, but this is misleading. For example, fragmentation requires mandatory surgical intervention - surgery. To protect the skin from pressure when applying splints, place cotton wool or soft cloth under them. It is best to carry out splinting with two assistants to support and secure the splint while bandaging. Now your task is to familiarize yourself with first aid for fractures of various bones within 2 minutes (students are provided with printouts).

IV. Consolidation of the studied material.

So, you have to implement your knowledge. One conditionally injured person is selected from each team and receives a defeat card with a description of the damage. The victims are assigned to other teams and try to pretend to be injured to the best of their ability.

№1

Severe sharp pain in the left shin area, swelling. Abnormal leg mobility. In this case, there is swelling and pain in the ankle joint.

Determine the diagnosis. Help; determine transportation.

№2 Aching pain in the knee joint (right leg). Swelling and pain when moving gradually develop. In addition, the victim complains of pain in the shoulder (right) after a fall, but although moving the arm is painful, there are no other external signs. Determine the diagnosis. Help. Determine the method of transportation.

№3

After a sharp jump and falling on his side, the victim feels severe pain in his right thigh and it is impossible to move his leg. The left joint (ankle) was very swollen and turned blue. Assume the type and extent of damage. Provide assistance; method of transportation.

№4 The victim fell on his outstretched arm. The right elbow joint is swollen and feels severe pain. There is also swelling on the index finger of the right hand. Help. Suggest a method of transportation.

№5

The victim complains of pain in the forearm. Bone fragments sticking out of the wound. The patient periodically loses consciousness.

Determine the type of damage.

Help.

Suggest a method of transportation. **The correctness of the task is assessed by a medical professional, “bandage specialists from other teams.”

Additional questions for consolidation:

1. Why are fractures less dangerous in youth than in old age? (In youth, there is still a lot of cartilaginous tissue in the skeleton, and organic substances in the bones, so bone tissue is quickly restored).

2. Why does swelling appear when a ligament is sprained or torn? (Articular fluid leaks out, hemorrhage occurs - inflammatory effect).

3.What is “habitual dislocation”? Who does it happen to? (For athletes. There is a very large load on the joints, so the ligaments lengthen and the bones come out of the joints).

V. Summing up - generalization.

VI. Homework: § 8.

Dislocations

With dislocations, the surfaces of the bones adjacent to each other inside the joint are separated. One of them is radically displaced, and physiological movements become impossible. Often in such cases, the membranes of the joint are torn. If muscles, blood vessels, nerves or tendons are also damaged, the dislocation is considered complicated.

The most severe injury occurs when soft tissue gets caught between the surfaces of the joint and is compressed. Such a dislocation is called irreducible and can only be treated surgically.

How to recognize

• The joint looks deformed, bent, and very often turned in the opposite direction.
• Movement is impossible because the joint is not able to perform its function normally.
• The dislocated limb is in the wrong position, but any attempt to change it causes pain that is difficult to bear.
• In the damaged area, hemorrhage and swelling occurs due to rupture of soft tissue.

First aid for sprain

• The affected limb should not be pulled or bent until examined by a doctor, so that the damaged tissue does not become displaced. If your arm is injured, limit its mobility with a bandage made from a scarf thrown over your neck and tied at the back. It is permissible to fix the leg on a healthy leg or with the help of light improvised objects.
• With dislocations, as with bruises, swelling occurs. It is permissible to apply cold very carefully - so as not to change the position of the limb and not injure it additionally. The duration of the cold compress is 30–60 minutes, then you need a break of at least an hour. When hypothermia occurs, blood vessels narrow and less blood flows to damaged tissues.
• It is necessary to provide assistance for a dislocation as soon as possible to avoid further complications.

What is forbidden to do if you have a sprain?

If you jerk your arm sharply or fall on it, a dislocation, a fracture, or a sprain with a bruise is possible. A person without medical training is unlikely to distinguish between these injuries unless there are pronounced symptoms other than pain and swelling.

That is why it is strictly forbidden to reduce a suspected dislocation on your own before making a diagnosis. When sprained, the ligaments may rupture due to additional injury. In the event of a fracture, a sharp jerk can damage nerves, muscles, ligaments and permanently disable the limb.