Fracture of Vertebrae

Damage to the spine is caused either by direct or indirect violence (compression) and is not always readily recognizable. Pain may not occur until a few days later. Therefore find out how the accident came about (fall, skidding). Special attention is to be paid to fractures of the vertebrae, because of the risk of injuries to the spinal cord which may result in paralysis and or sensory disorders.

Whiplash syndrome: In rear end collisions the backward and forward jerking of the head can cause injuries of the cervical spine.

Symtoms and Signs

• Typical kind of accident
• Pain in the back, the casualty may be unable to stand up or to move his legs
• Tingling sensation or numbness in arms and legs

Danger
Damage to the spinal cord

In case of an injury of the cervical spine involving damage to the spinal cord respiratory disorders may occur. Such injuries may also be caused after the accident by inexpert moving and handling.

First Aid

• Do not change the casualty’s position until the doctor or the ambulance staff arrives at the scene of the accident.
• Move the casualty away only from the immediate danger zone. Draw the casualty gently to safety, but leave him other wise in the original he was found.
• Note that the crash helmet does protect the casualty’s head, but transmits the impact to the cervical spine (injuries of cervical vertebrae). If you have to take off the crash helmet, see how to help on Crash Helmet.
• If the casualty is unconscious, place him gently in a lateral position. The casualty’s head should be supported by a second helper. Do not tilt the head too far backwards.
• Treat for shock.
• Emergency call.

Fracture of Skull Cap

Any blow or fall on the head can cause damage, noticeable immediately or later. An injury of the cranium is only visible, if there is an open wound or an apparent deformation (dent) at the same site.

 

Symptoms and Signs

-         wound on the scalp

-         bone splinters may be visible

-         possible brain protrusion

-         possible symptoms of brain damage (disturbance of consciousness, unconsciousness)

 

Skull Base

A fracture of the skull base is an injury typical of road accidents due to the impact caused by head on collisions with the windshield, and of skiing and sledding accidents.

 

Apart from the base of the skull, blood vessel and nerves entering and exiting at the skull base can, likewise, be injured and cause bleeding and nerve failure. Brain injuries are also possible.

 

Symptoms and Signs

Suspect the fractured skull base, if blood, even a few drops only, is coming from inside the ear; bleeding from the nose or the eye socket (haematoma around the eye) might also be evidence of a fractured skull. Quite often signs of brain damage (unconsciousness) are apparent.

 

Danger

Danger of suffocation (when the unconscious casualty is lying on his back), brain pressure because of brain swelling or brain bleeding (unconsciousness, spasms, respiratory and circulatory failure), danger of infection in open skull injuries.

 

First Aid

-         If necessary, take immediately life-saving action

-         Cover the wound, do not apply any pressure to the wound

-         Raise the casualty’s head and thorax, if he is conscious.

-         If he is unconscious, turn him to his uninjured side.

-         Exception: if the skull is dented or broken, the casualty should lie on the uninjured side.

 

Bone Fractures

A fracture is a break of a bone caused by direct or indirect violence. The tensile strength and bending ability of the bone are exceeded and bone breaks.

There are two main types of fractures:

• Fracture without any visible wound (closed fracture),
• Fracture with a visible wound at the site of the broken bone (open fracture).

Symptom and signs

• Pain, swelling, pain-relieving stance
• Movement is difficult of impossible
• Deformity (abnormal shape and outline of the bone)
• Wounds

Danger

Shock owing to blood loss and pain. A wound at the side of the fracture carries the risk of infection. Inexpert aid can turn a closed fracture into an open fracture. Injuries of nerves, blood vessels and internal organs are also possible.

First Aid

• Do not move the affected arm.
• In case of an open fracture immediately apply a sterile dressing.
• Loosen tight clothing, remove wrist-watches and rings.
• Immobilize the broken arm with a sling formed of an open triangular bandage.
• Support with a ‘broad-fold-bandage’ or a second open triangular bandage.
• Treat for shock.
• Emergency call.

For Broken Leg

• Do not move the injured leg.
• Loosen tight clothing, shoelaces, etc., but do not take the shoes off.
• In case of an open fracture dressing.
• Immobilize the limb by supporting it with suitable padding between the legs.
• Treat for shock
• Emergency call.

Attempt to place bizarrely displaced or twisted limbs into the approximately correct position by applying gentle fraction, in order to prevent painful muscle cramps and circulatory disturbances, but stop if you feel resistance. If the position of the affected limb cannot be changed without resistance, refrain from doing so!.

Joint Injuries

Bones are connected by joints. These areas of the bones that form a joint are provided with a thick smooth cartilage layer. The joint capsule holds the joint together and is further reinforced by ligaments.

Sprain:
Sprain is a joint injury, in which the joint forming bones are displayed or twisted, momentary but almost immediately return to their nearly original position.

Symptoms and Signs

• Pain, especially when the affected joint is moved
• Swilling
• Bluish discoloration, often caused by a haematom

Danger
The joint capsule can lacerate, but the ligaments can, likewise, be overstretched or torn.

First Aid
Consult a doctor in case of:

• Extensive haematoma
• Suspicion of internal injuries

If the doctor does not diagnose any severe damage:

• Elevate and immobilize the affected limb.
• Apply cold compresses.

Dislocation:

Dislocation is joint injury, in which the joint forming bones are forced apart by violence, i.e. the ball is from or pushed from the socket and remains in an abnormal position.

Symptoms and Signs

• Pain
• Inability to move
• Abnormal position

Danger

Overstretching and tearing of the socket and the ligaments. Unlike manipulation can cause additional injuries (joint fracture).

First Aid

• Do not move.
• Do not attempt to relocate.
• Carefully immobilize the limb in the position as found.
• Emergency call.