The objectives of first-aid are :
1. Apply cold pads or ice in a polythene bag — these soothe the pain.
2. Rest the affected part.
3. Make the patient comfortable.
4. Prevent further damage.
5. Get medical aid at the earliest.
The first aid measures are as follows.
1. Treat bleeding, difficulty in breathing, shock and unconsciousness first.
2. Treat all fractures in the position in which the victim is found rather than move him to another place. This is not possible if there is bad weather or risk to the victim’s life if he is left there.
3. Immobilize the fractured limb with splints. Splinting can be done by different methods. The bandaging should be fairly firm so that there is no movement at the fracture site. But it should not cut off blood supply to the distal part of the limb. Place padding material in between so that when limbs are bound together they are comfortable. Never apply bandage over the area of fracture. Apply knots on the sound side.
• Bandage one lower limb to the other one.
• Bandage one upper limb to the body.
• Bandage one digit to the adjacent one.
4. Use a splint when it is available. A splint is rigid pieces of wood, plastic or metal. It should be well padded with cotton or cloth. It is tied to a fractured limb to support it and to prevent movement at the fracture site. Wide splints are better than narrow ones. A splint should extend enough to immobilize the joints above or below the fractured bones.
5. Raise the injured part after immobilizing it to reduce swelling. A rolled up blanket can be used for this purpose.
6. Shift him to a hospital immediately.
The skull is a closed box made of many bones that are united by immovable joints. It protects the brain. It can be fractured by a direct blow or trauma e.g. falling from a height, landing on the feet. Direct trauma usually fractures the vault of the skull, while indirect trauma fractures the base of the skull and causes injury to the vertebral column. Fracture of the skull is a very serious injury, because it may be associated with brain damage. The brain can be bruised. Or there may be bleeding outside the brain, and the hematoma compresses the brain. The fracture may be linear, depressed, or comminuted. The condition is diagnosed by the following features.
1. There is often a would on the scalp in case of direct trauma to the head.
2. Cerebrospinal fluid may be found leaking from the ear or nose, as clear fluid or watery blood.
3. Unconsciousness that lasts for more than three minutes is suggestive of a fracture of the skull.
4. There is a soft, boggy area or depression under the scalp at the site of the fracture.
5. Features of brain injury are seen, e.g. paralysis, altered sensorium, irritability and convulsions.
First-aid
1. If the victim is unconscious, place him in the recovery position.
2. If there is cardiorespiratory arrest, resuscitate him.
3. Do not move him unnecessarily.
4. Control any bleeding from the scalp. Look for, and treat, other injuries.
5. Send him to a hospital immediately.