Fractures Emergency treatment Social Pharmacy Practical Lab Manual
Social Pharmacy
Aim: Emergency treatment for Fractures.
Theory:
- First Aid Definition:
First aid is defined as essential and emergency treatment given to an accident victim and
victim of sudden illness in certain situations like snake bite, burn and fracture before the medical help arrives.
- Major principles of First Aid are:
1. To control hemorrhage if any.
2. To maintain respiration.
3. Prevention of shock.
4. Splinting or immobilization of fractures.
5. Careful observation of any other symptoms.
- Objectives of First Aid are:
1. Careful evaluation of the situation.
2. To maintain respiration and functioning of the heart of casualty.
3. Control of bleeding.
4. Prevention or management of shock.
5. Dressing of wounds.
6. Providing splint to the fractured part.
7. To provide the treatment quickly.
8. Prevent the deterioration of victims of disasters.
9. To provide the safety and security to the victim.
10. Attempt to improve the condition.
11. Transporting victims safely to the hospital.
12. Save the life.
13. Prevent the illness or injury from becoming worse.
14. Promote recovery.
- Management of a case :
It consist of:
Quick response:
The first aider should respond quickly and call for assistance. A prompt action is needed.
Calm and confidence:
The victim must be examined and treated confidently and quickly.and approached calmly and methodically.
Treating injuries:
Obvious injuries and dangerous conditions must be treated first. wherein general conditions of the patient should be accessed.
eg: 1) Pulse: Monitoring of pulse rate : if the pulse is weak and rapid it indicates severe bleeding.if the pulse is not felt it indicates cardiac arrest. In such cases CPR should be performed immediately.
2) Burn : In case of burns, the cause, degree and site of burn should be noted.
3) Breathing : Check for breathing , whether it is slow, fast or absent.if the patient is unable to breath, artificial respiration should be carried out at once and should be continued till the medical help arrives.
4) Fracture : Movements of joints should be checked for the fracture.
5) Poisoning : In suspected cases of poisoning, signs and symptoms should be observed carefully. The vomitus of the patient should be collected for identification of poison.
6) Bleeding : Signs of bleeding should be checked and corrective measures should be taken.
7) Other symptoms : It includes pallor ( whiteness) of tongue, conjunctiva & nails should be checked.
First aid material:
Available material should be used and if the standard material is not available then it is improvised to suit the condition.
Crowd:
It should be tactfully controlled since it deprives the victim of air and light required for the examination. If anyone in the crowd has the knowledge of first aid his or her service must be utilized.
Reassurance :
The victim must be reassured by speaking to him encouragingly . he must be advised to lie still with minimum movement .
Fracture
Definition:
Fracture is defined as a break in a bone or a crack in a bone, which may be caused by
Accident or violent act. Usually pain, swelling, inability to move the affected body parts are some of the important symptoms.
Types of fractures:
- Simple or close fracture :
Bone is broken in two pieces but there is no open wound or injury around or near the fracture.
- Open fracture :
The bone is broken and also there is a break in the skin or mucous
Membrane overlying the fracture.
- Impacted fracture :
The broken ends are driven into one another.
- Depressed fracture :
This occurs in the skull bones where the broken part of the bone is
Driven inwards.
- Compound fracture:
Bone is broken with wound ( torn skin) caused where broken bone
may protrude through the wound.
- Complicated fracture:
Here in addition to broken bone, injury is caused to surrounding
Structure as muscle, nerve, blood vessel, joint capsule, visceral
Organ etc.
- Comminuted fracture:
Feature of such fracture is bone is broken in several fragments or
Pieces.
- Greenstick fracture :
In case of children the bone may crack or bend without completely
Breaking.
General sign and symptoms of fractures:
1. Pain at the site of injury
2. Swelling at the site of fracture
3. Unnatural mobility of affected extremities
4. Loss of function
5. Bleeding at the site of injury
6. Tenderness or pain over the affected area on applying pressure and it is aggravated by movement.
General management of fractures:
1. Reassure the patient. And check the bleeding.
2. Cover the open fracture with sterile dressing to prevent infection and also the bleeding.
3. Immobilize the fracture parts immediately by using bandages or splints.
4. Examine for other injuries, cover wounds with sterile dressing.
5. Keep the patient warm.
6. Transfer the casualty to a hospital.
First aid treatment for fracture:
- Control bleeding if any by applying pressure bandage.
- Do not move fractured part unless required necessarily
- Cover all wounds with sterile dressings.
- Immobilization is important to prevent pain, further damage, to support tissues which are ordinarily supported by that bone and to accelerate rapid healing of that bone.
- Immobilize the fracture parts immediately by using bandages or splints. (It is a Support for broken bones like wooden planks, Cardboard, Metal etc.)
- Check the level of consciousness and vital parameters as pulse, B.P., respiration and Give symptomatic treatment.
- Analgesics may be given, if there is pain.
- Shift the patient to the hospital as early as possible
SPLINTS
Splints:
Definition: it is defined as an appliance which restricts the movement of an injured part .
Objectives: / uses:
- Used in first aid to prevent the complications of fracture during transport.
- They give rest to the part and relieve pain and quicken healing.
- They are helpful when limbs can’t be supported against the body.
Types:
- Wooden splints:
They are straight pieces of wood of varying length and width.
- Metal splints :
- Made of tin and aluminium
- They are moulded to fit the natural curves of the body.
- Wire splints :
- It can be cut to the desired length
- It can be bent to support the limb in any desired position
- Eg. Cramer’s wire splint
- Inflatable splints:
- These are inflated by mouth.
- Easy to use.
- Comfortable to the patient.
- Thomas splint:
- This are special type of metallic splints
- Useful in fracture of femur and other injuries of lower extremity.
Construction:
- It consist of outer longer rod
- Inner shorter rod
- An oval ring bent at 1200 to the inner rod.
- The ring is padded with felt and covered with leather. It c can be used either for the right or left leg.
- Miscellaneous :
Vacuum splint
Box splint
SLINGS
Slings are also used to give support to affected parts.
Types of splints available are:
- Collar and cuff slings :
It is used for the hand and wrist. In this there is a cuff attached to the wrist. The cuff is fixed to the collar through a sling. By this, the hand is elevated and it prevents edema.
- Triangular slings :
It is used for the forearm. A triangular bandage is placed in such a manner the apex lies under the affected arm beyond the elbow. One end of the base of the triangle passes over the opposite shoulder to the back of the neck. The affected forearm is now placed across the chest over the bandage , so that the wrist is at higher level than the elbow . The lower end of the base is brought up and tied with the other end of the base by the side of the neck . The apex is now brought forward and pinned in front .
References:
- N. Murugesh
- Health Education & Community Pharmacy: P.C.Dandiya, Z.Y.K.Zafar, Afifa Zafer.
- Health Education & Community Pharmacy: N.K.Jain.
- Health Education & Community Pharmacy: Ashok K.Gupta & Health Education & Community Pharmacy: S.P.S.Khurana.
ASSIGNMENT
Define fracture
What are types of fractures?
What are signs and symptoms of fractures?
Write a note of first aid treatment of fractures. What is a simple fracture?
