Geoscience Reference
In-Depth Information
4. Keep the victim comfortable. Loosen tight clothing and conserve body heat by bundling in
blankets or a sleeping bag.
Do not add heat from an external source,
as this will swell capillaries
in the skin and draw blood from vital organs.
5.
Do not give fluids by mouth.
6. Move the victim out of danger if you have to, but avoid rough handling. Check vital signs (ABCs)
every few minutes, including pulse and breathing rate and pattern. Restlessness and agitation may
be signs of worsening shock.
7. Make arrangements for rapid medical evacuation.
Time is of the essence!
Fractures and Dislocations
Dislocations occur when a joint is overstressed to the point where the bone pops out of location
(the joint is “dislocated”). Usually dislocations are accompanied by tearing and rupturing of the
soft joint tissues. A fracture occurs when a bone is overstressed to the point where it breaks. It
is often hard to tell whether a bone is fractured or dislocated, but the first-aid treatment for both
is usually the same. Fractures are divided into two types. In the case of an open fracture (also
known as a compound fracture), the broken bone ruptures the skin. The bone may be sticking
out of the wound, or it may retract back inside the flesh. Open fractures are very serious injur-
ies, because they are easily infected and can lead to bone infections and gangrene, which are
difficult to treat and may result in amputation if treatment is unsuccessful. Injuries that appear
to be dislocations may actually be fractures near a joint, and should be immobilized and treated
as fractures.
In general, it is recommended that untrained personnel do not try to reposition dislocations
or fractures. However, if you are in a remote location, or if you are sure that emergency medic-
al services will not be available for several hours, you should try to pop a dislocated joint back
into position, or tension and reposition a fractured limb. You must use your judgment on this
one. The Red Cross manuals state that fractures and dislocations should be immobilized in the
position they are found in, to minimize the risk of further damage while trying to reposition the
joint or break. Wilderness medicine manuals will tell you that you should attempt to reduce (re-
locate or “pop” back into joint) a dislocated joint as soon as possible after the injury, or swell-
ing and muscle spasms will make this task nearly impossible and will make rescue far more
difficult. Similarly, setting a fracture (realigning the break prior to splinting) may cause more
damage if done improperly, but if properly handled will reduce the risk of further injury by:
• Preventing a closed fracture from becoming an open (compound) fracture
• Reducing bleeding and pain at the fracture location
• Reducing the risk of shock complications
