Index
This topic covers the identification and management of bruises, sprains, strains and dislocations.
The topic should take approximately 10 minutes to complete.
Introduction to Sprains, strains and dislocations
Injuries to bones, joints and muscles are common. Although, not usually life-threatening, they are painful.
Bones, joints and muscles may be injured by being overstretched as a result of twisting or a fall, or being struck by something hard. The outcome may be a fracture, strain or sprain. Fractures will be covered in the next topic.
A dislocation occurs when one or more bones are displaced at a joint e.g. At a shoulder or finger. This often occurs when a strong force acts directly or indirectly on the joint and wrenches the bone into an abnormal position.
Signs and Symptoms – Sprains
A sprain occurs when a joint such as the ankle is forced beyond its normal range of movement (e.g. stepping awkwardly on a kerb or stair).
This may stretch or tear the ligaments that hold the joint together.
Sprains can be very painful.
Often the casualty will be unable to put weight on the joint or move it easily.
Swelling and bruising are likely to occur very quickly after the incident.
4 Signs and Symptoms - Strains
Strains are the result of overstretching a muscle or tendon.
This usually happens as a result of:
· Lifting something too heavy
· Working a muscle too hard OR
· Making a sudden, uncoordinated movement
Common examples are the groin and hamstring strains of footballers.
The casualty will feel sharp, sudden pain in the region of the injury and on any attempt to stretch the muscle.
A strained muscle will usually be tender.
Strains are not usually accompanied by discoloration or swelling.
Signs and Symptoms – Dislocations
Dislocations are extremely painful.
They occur when a joint is so badly stretched that the bones are pulled out of their normal positions.
Sometimes the bones become locked out of joint.
A joint that is dislocated appears to be deformed because the dislocation causes an abnormal lump or depression. There may also be associated swelling.
RICE Management
Rest, Ice, Compression, Elevation.
The management of sprains and strains (and many bruises) is the same – RICE Management:
· Rest
· Ice
· Compression and
· Elevation.
The order in which you perform RICE Management is not critical. For example if you do not have ice handy it is better to make the casualty comfortable; elevate the limb; bandage the injured part; then go looking for ice or a cold compress.
RICE Management, Rest
Both the injured part and the casualty themselves must be rested.
This means getting the person into a comfortable position in which they are physically relaxed and the injured part is supported.
RICE Management, Ice
Icepacks, or a cold compress, wrapped in a wet cloth may be applied to the injury:
· 15 minutes every 2 hours for 24 hours then
· 15 minutes every 4 hours for 24 hours
If you have no ice, you could use:
· A bag of frozen vegetables
· Cloth wrung out in cold water – replace every 10 minutes
RICE Management, Compression
Compression bandages (conforming and elastic bandages) should be applied so that they support the injured part.
Make sure that they are applied well past either side of the injury so that they prevent excessive movement of the limb.
RICE Management, Elevation
One way of reducing pain and swelling is to raise the injured part above the level of the casualty's heart. This helps to slightly reduce the flow of blood to the limb and so reduce the pressure and swelling in the affected area.
Make sure the casualty is comfortable in the position you put them, and that hard edges of items used to raise the limb do not press on the body in a way that could stop circulation.
Management of a Dislocation
For a dislocation, you should:
· Rest and support the limb using soft padding and bandages.
· Apply icepacks
· Seek medical aid.
If in doubt, manage as a fracture.
Sprains, Strains and Dislocations – Summary
Use RICE Management for managing a sprain or strain.
Use Rest and Ice for managing a dislocation.
Sprains and Dislocations need medical aid. They can be extremely painful, and without medical attention they could lead to permanent loss of function of the affected area.
If in doubt and there is a lot of pain, manage as a fracture (see next topic).
For more information on sprains, strains and dislocations, see Australian First Aid, chapter 6.
Index