FRACTURES

What is Fracture?


A fracture is a broken or cracked bone. There are a number of signs and symptoms, which can indicate that a person has a fracture:

• The injured part cannot be moved normally.
• The injured part may have an unnatural shape or position.
• There is swelling and sometimes bruising.
• There is loss of strength.
• There may be an irregularity or shortening of the affected limb.

Signs & Symptoms of Fracture

• A fracture is an injury to a bone.
• Fractures are the result of too much pressure being put on the bone.
• Fractures can be caused by hits, falls, or repeated pressure (as in running) to a bone.
• A dislocation is when two connected bones separate. They are common in the knee, shoulder, fingers, and other joints.
• Dislocations are the result of too much pressure being put on a joint.
• The symptoms of a fracture include pain, swelling, bruising, or not being able to move the injured area.
• Fractures or Dislocations are usually treated with rest, ice, compression, and elevation.
• To prevent these injuries, wear helmets and other protective gear during physical activities. Children should use car seats and seatbelts. Take steps to prevent falls.

Types of Fractures

• Simple
• Compound
• Comminuted
• Complicated
• Green Stick
• Impacted
• Spinal

Simple Fracture


A simple fracture is a broken bone that does not break the overlying skin. Tissue beneath the skin may be damaged.




Compound Fracture


A compound (open) fracture is a broken bone that breaks (pierces) the overlying skin. The broken bone may come through the skin, any trauma can also cause the phenomena.
An open fracture is contaminated and subject to infection.





Comminuted Fracture


This refers to a fracture when part of the broken bone is splintered into several fragments.
It is usually used when implying that exact anatomical restitution is difficult or impossible.
Usually occur in bone damaged by direct trauma.




Greenstick fractures

These occur in children as they have bones which are more springy than adult bones
The bone buckles or bends rather than snapping, often producing slight bulge in or altered curve to the edge of the bone on radiograph
Reduction is easy
Healing is quick
Typically seen in the clavicle, and the radius & ulna at the wrist








First Aid for Fractures
Treat severe bleeding and difficulty in breathing first.
Treat on the spot. Avoid unnecessary movement.
Immobilize the injured part; splint the joint above and the joint below the injury.

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BANDAGING

DEFINITION OF A BANDAGE:

A strip of material used mainly to support and immobilize a part of the body.



USES:

• To support - fractured bone
• To immobilize – Dislocated shoulder/Jaw
• To apply pressure – Stop bleeding & Improve venous blood flow.
• To secure a dressing in place.
• To retain splints in place.
  

Principles & Procedures for applying Bandages

• Wash hands. (Wear gloves where necessary)
• Assist victim to assume comfortable position on bed or chair and support the body part to be bandaged.
• Always stand in front of the part/victim to be bandaged except when applying a bandage to the head, eye and ear.
• Be sure the bandage is rolled firm.
• Make sure the body part to be bandaged is clean and dry.
• Assess skin before applying bandage for any breakdown.
• Observe circulation by noting pulse, surface temperature, skin color and sensation of the body part to be wrapped.
• Always start bandaging from inner to outer aspect and far to near end.
• When bandaging a joint, ensures flexibility of the joint. (except if immobilization of joint is required).
• Always start and end with two circular turns.
• Cover the area 2 inches above and 2 inches below the affected area (wound).
• Overlap turns and slightly stretch the bandage.
• Cover two third 2/3 of the previous turn.
• Where possible, leave fingertips or toe tips exposed for observation (adequacy of blood circulation).
• End the bandage on the outer side of the body. Do not end a bandage on wound or at the back of the body.
  
  

Methods of applying Bandages

• Circular
• Spiral
• Reverse Spiral
• Figure of Eight

Circular Turn

• Circular turns are used chiefly to anchor bandages and to terminate bandages.
  Apply the end of the bandage to the part of the body to be bandaged
• Encircle the body part a few times or as needed, each turns directly covering the pervious turn.
• Secure the end of the bandage with tape, metal clips or a safety pin over an uninjured area.
  

Spiral Turn

• Spiral turns are used to bandage cylindrical parts of the body that are fairly uniform in circumference, such as upper arm and upper leg.
• Make two circular turns to begin the bandage.
• Continue spiral turns at about a 30-degree angle, each turn overlapping the preceding one by two-thirds the width of the bandage.
• Terminate the bandage with two circular turns, and secure the end as described for circular turns.

Spiral Reverse Turn
Spiral reverse turns are used to bandage cylindrical parts of the body that are not uniform in circumference, such as the lower leg or lower fore arm

• Begin the bandage with two circular turns, and bring the bandage upward at about a 30-degree angle.
• Place the thumb of the free hand on the upper edge of the bandage.
• The thumb will hold the bandage while it is folded on it self.
• Unroll the bandage about 4-6” then turn the hand so that the bandage is folded down
• Continue the bandage around the limb, overlapping each previous turn by two-thirds the width of the bandage.
• Make each bandage turn at the same position on the limb so that the turns of the bandage will be aligned.
• Terminate the bandage with two circular turns, and secure the end as described for circular turns.
  

Figure of Eight Turn

• The figure-of-eight method of bandage permits flexibility of elbow, knee and ankle without disturbing the dressing.
• Begin the bandage with two circular turns.
• Carry the bandage above the joint, around it, and then below it, making a figure eight-continue above and below the joint, overlapping the previous turn by two-thirds the width of the bandage.
• Terminate the bandage above the joint with two circular turns, and secure the end appropriately.

Apply a Triangular Bandage Sling

A triangular bandage sling is usually made from a muslin bandage, but any material that does not stretch (such as a fatigue shirt, trousers, poncho, blanket, or shelter-half) can be used. Fold, cut, or tear the material into a triangular shape.

• Insert the material under the injured arm so that the arm is in the center, the apex of the sling is beyond the elbow, and the top corner of the material is over the shoulder of the injured side.
• Position the forearm so that the hand is slightly higher than the elbow (about a 10 degree angle).
• Bring the lower portion of the material over the injured arm so that the bottom corner goes over the shoulder of the uninjured side.
• Bring the top corner behind the casualty's neck.
• Tie the two corners together so that the knot will not slip. The knot should fit into the "hollow" at the side of the neck on the uninjured side.
  

Triangular Bandage to the Head
Turn the base (longest side) of the bandage up and center its base on center of the forehead, letting the point (apex) fall on the back of the neck.

• Take the ends behind the head and cross the ends over the apex.
• Take them over the forehead and tie them.
• Tuck the apex behind the crossed part of the bandage and/or secure it with a safety pin, if available.

Head Bandaging

Vertical bandage carried twice forwards and once backwards. Continue to pass the vertical bandage backwards and forwards each time a little to the left and right alternately, locking it with the horizontal bandage. Finally, pass horizontal bandage twice around the head, and pin in front.


Eye Injury & Bandaging
A penetrating eye injury is usually caused by a sharp object which has gone in, or is protruding from the eye.Warning:

• Do not touch the eye or any contact lens.
• Do not allow casualty to rub eye.
• Do not try to remove any object which is penetrating the eye.
• Do not apply pressure when bandaging the eye.

Bandaging:

Support casualty’s head to keep it as still as possible.

• Ask casualty to try not to move eyes.
• Place sterile pad or dressing over injured eye.
• Ask casualty to hold this in place.
• Bandage dressing in place, covering injured eye.
• If penetrating eye injury, lie casualty on back, place pad around object and bandage in place.
• If chemical or heat burn, or smoke in eyes, flush with water
  

Jaw Injuries & Bandaging

• Before applying a bandage to a casualty's jaw, remove all foreign material from the casualty's mouth. If the casualty is unconscious, check for obstructions in the airway.
• The dressing and bandaging procedure outlined for the jaw serves a two fold purpose. In addition to stopping the bleeding and protecting the wound, it also immobilizes a fractured jaw. •When applying the bandage, allow the jaw enough freedom to permit passage of air and drainage from the mouth.

Bandaging:

• Place the bandage under the chin and carry its ends upward. Adjust the bandage to make one end longer than the other.
• Take the longer end over the top of the head to meet the short end at the temple and cross the ends over.
• Take the ends in opposite directions to the other side of the head and tie them over the part of the bandage that was applied first.
  

Finger Bandaging

For finger and hand bandaging take a roller bandage varying in width from one inch to three inches wide and five yards long.

• After the dressing has been applied take two or three turns around the finger to hold the bandage from slipping, then from left to right making the distances neat and even, carry the roll around the finger.
• The figure of eight, which has the advantage of giving better compression is made by carrying, the bandage away from the person applying it on the upper stroke, then around the hand and toward the person on the down stroke, making the crossing point in the middle of finger, as illustrated, and having each crossing point one half inch higher up than the one preceding.

Securing Bandage

To the secure bandage apply the following:

• Tape
• Metal
• Safety Pin
• Binders:
• Binders used to secure a dressing in the rectum and perineal area.
• Abdominal binders (Scultetus).
• Ensure that there are no wrinkles or creases in the binder.

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BURNS & SCALDS

Burns & Scalds



Burns: Injuries to the skin & other tissue caused by Heat, Radiation or Chemicals.


Scalds: Burns caused by the Moist Heat, such as hot liquids & steam.


Types of Burns

1. Heat/Thermal Burns
2. Corrosive/Chemical Burns
3. Electrical Burns
4. Radiation Burns



Degree of Burns
• 1st Degree

Signs: Skin is red or bright pink but not broken; there are no blisters.

• 2nd Degree

Signs: Skin is red, tender, swollen, and blistered.

• 3rd Degree

Signs: Skin will look white and leathery or charred.

Treating Burns and Scalds

• First-aid treatment for burns involves removing the source of the burn, cooling the burn, and covering it. To treat burn victims:
• Remove the victim from the burn source. Put out any flames and remove smoldering clothing.
• Cool skin or clothing that is still hot by immersing in cool water for no longer than one minute or covering with clean compresses that have been wrung out in cool water. Water may be obtained from the bathroom, kitchen and garden hose.
• Use soaked towels, sheets, or other cloths. Use clean water. Do not apply water to third-degree burns except to put out flames. Treat all victims of third-degree burns for shock.
• WATCH FOR SIGNS OF HYPOTHERMIA. Cover loosely with dry, sterile dressings that keep air out, reduce pain, and prevent infection.
• Elevate burned extremities higher above the victim's heart.
  
  
  
  
  
  
  
  
  
  
  Cool the burnt area with running water
  
  
  
  
  
  
  
  
  
  If clothing sticks to the skin, leave it there and cut away the remaining fabric
  
  
  
  
  
  
  Do not break blusters
  
  
  
  
  
  
  
  
  
  Do not apply lotions, ointments or fat to the injured area.
  
  
  
  
  
  
  
  
  
  Cover the burnt area with plastic bag
  
  
  
  
  
  
  
  Cover the burn with a sterile bandage
  
  
  
  
  
  
  
  Remove the chemical from the skin or eyes by flushing the area with large amounts of cool running water
  
  
  
  
  
  
  
  
  
  CALL Doctor or emergency medical services (EMS)

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WOUNDS & BLEEDING

What is WOUNDS?

Any break in soft tissue of the body that results in bleeding.




Types of Wounds

Open Wound:

Break in the outer layer or skin, results in bleeding & allow Microorganisms (germs) to enter the body.

Close Wound:

No break in the outer layer of skin.

Wound Care

Objectives of wound care are to control bleeding and prevent secondary infection.

• Clean the wound by irrigating with water, flushing with a mild concentration of soap and water, then irrigating with water again. Do not scrub.
• Apply a dressing and bandage, after thoroughly cleaning the wound, to help keep the wound clean. (A dressing is applied directly to the wound. A bandage is used to holding the dressing in place.)
  

Use the following rules for dressings and bandages:

• If the wound is still bleeding, apply the bandage with enough pressure to help control bleeding without interfering with circulation. Check for color, warmth, and sensation to determine if the bandage is too tight.
• If active bleeding continues (the dressing is soaked with blood) redress over the existing dressing and maintain pressure and elevation.

Bleeding

Escape of blood from injured vessels. Severe bleeding is called Hemorrhage.

Severe bleeding treatment

• Put on disposable gloves.
• Apply direct pressure to the wound with a pad (e.g. a clean cloth) or fingers until a sterile dressing is available.
• Raise and support the injured limb. Take particular care if you suspect a bone has been broken.
• Lay the casualty down to treat for shock.
• Bandage the pad or dressing firmly to control bleeding, but not so tightly that it stops the circulation to fingers or toes.
• If bleeding seeps through first bandage, cover with a second bandage. If bleeding continues to seep through bandage, remove it and reapply.
• Treat for shock.
  

Amputations


Loss of a finger, hand, arm, or leg can be extremely dangerous. But, if you act quickly, you may be able to save the victim’s life.

When part of the body has been torn off, treat the victim:


Administer first aid:

Control bleeding, watch for signs of shock, and treat for shock as necessary.

Protect Body Part:

• Try to find out the severed part of the body.
• If found, save the tissue parts, wrap it in a plastic bag.
• Put a bag on ice, but don’t freeze.
• Take the part with victim to the Hospital.
• Mention name of victim and time of incident on plastic bag.

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PREPAREDNESS FOR AN EARTHQUAKE

Be prepared for an earthquake

“Earthquakes don’t kill people, un-safe buildings do”


By planning and practicing what to do before, during and after an earthquake, your family can learn to react correctly and automatically when the shaking begins. During an earthquake, most deaths and injuries are caused by collapsing building materials and heavy falling objects. Learn the safe spots in each room of your home. Participating in an earthquake drill will help children understand what to do in case you are not with them during an earthquake.

Before the tremors:

• Secure heavy furnishings and keep heavy objects on lower shelves
• Secure your water heater with wall and floor
• Do not hang decorative items, fancy lights, pictures and mirrors above beds or seating areas.
• Store weeds killers, pesticides and flammable products securely in close cabinets with latches and on bottom shelves.
• Check roofs and wall foundation for stability
• Repair defective electrical wiring and leaky gas connections
• Keep list of Emergency phone numbers, Police, Fire Service, Ambulance Service, Rescue, Electric & Gas Depts.
• Develop an emergency survival Kit
  Food items (rice, noodles, canned food, milk power, beverages, water) Solid fuel and matches – A First Aid Kit – A portable battery-operated transistor radio.
• Decide where family members will reunite if separated

During the tremors


Ground shaking in earthquake is lasting for not more than 15-30 seconds During these few seconds, stay calm, do not run or panic.

• If indoor, stay indoor and minimize your movements to a few steps to reach a nearby safe place. Know the danger & safe spot in home.
• Take shelter under a sturdy table, desk or bed and protect your head and face as that will provide you with provide you with air space and protection against falling objects.
• Stay away from windows, doors, walls, display shelves and heavy objects that could fall and hurt you, like lightings, furniture or fixtures.
• Do not use elevators, use stairways in multi-story buildings.
• If you are outdoors, stay away from buildings, trees, overhead power lines and overpass. Remain in the open until the tremor stops.
• If you are driving, stop as quickly as safety permits & stay in your vehicle. Avoid stopping near or under trees, buildings, bridges, over passes or overhead electrical cables.

After the tremor stops

• Check yourself and others for injuries…administer first aid quickly and carefully.
• Do not touch any damaged electrical wiring. Also, report to concerned authorities. Learn how to cut off utilities.
• Do not use candles, matches and other naked flames during and after tremors, as there might be a gas leak.
  Check your home for any structural defects. Get expert advice if there are signs of structural defects.
• Use the telephone to report life-threatening emergencies only.
  
  Be prepared for aftershocks which may cause additional damage and may bring weakened structures down. Aftershocks may occur hours, days, weeks, or even months after the quake.
  
  

Enhancing Your Survivability

If Trapped Under Debris or Rubble

• Avoid unnecessary movement so that you don’t kick up dust.
• Maintain moral and fighting sprits high.
• Periodically move your fingers and toes to ensure blood circulation.
• Cover your mouth and nose with anything you have on hand. Try to breathe through the available cotton material.
• Shout only as a last resort -shouting can cause a person to inhale dangerous amounts of dust.
• Tap on a pipe or wall so that rescuers can hear where you are.If available use a flashlight to signal your location.

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EARTHQUAKE

Earthquake

Earthquakes are sudden, rapid vibrations of the earth caused by sudden rupturing and shifting of rock beneath the earth surface.
The vibration of earth can range from barely noticeable to extremely destructive.
Earthquake vibrations occur in a variety of frequencies and velocities. The actual rupture process may last from a few seconds to as long as one minute for a major earthquake.

Classes of earthquake:
There are three classes of earthquake that are known & recognized as, tectonic, volcanic and artificially produced

• Tectonic: Tectonic quake are by far the most common, devastating and most difficult to predict. They are caused by stresses set up by movements of a dozen or so huge plates that form the earth’s crusts. Most earthquakes occur at the boundaries of these plates. Where two plates slides over and collides against each other; some earthquakes do occur in the middle of plates.
• Volcanic: Volcanic quakes are seldom very large or destructive; they often precede or accompany volcanic eruption.
• Artificial: Artificially produced earthquake are induced by activities such as the filling of new reservoir or the pumping of fluid deep into the earth through wells. This type of earthquake can be noticeable but are hardly destructive.

Affects of earthquake
Earthquakes are one of the most destructive of natural hazards. They may occur at any time of year, day or night, with sudden impact and little warning. Destroy buildings and or damage structure of the building, bridges, and communications -

• Loss of human lives
• Dense casualties/injuries
• Extensive property damages
• Disruption/Disturbance to normal human life activities
• Destabilize the government, economy and social structure of a country.

Secondary Hazards
When earthquake occur, a variety of secondary and related hazards can happen simultaneously. The ground shaking from earthquakes can cause landslides, rock fall, debris flow, soil liquefaction, avalanches, tsunami, fire etc.

Factors contributing the vulnerability
Several key factors contribute to vulnerability of human populations:

• Location of settlements in seismic areas, especially on poorly consolidated soils, on ground prone to landslides or along fault lines.
• Building structures, such as homes, bridges, dams, which are not resistant to ground motion.
• Dense groupings of buildings with high occupancy.
• Lack of access to information about earthquake risks.

Earthquake Fault line
An earthquake fault is a zone within the earth’s crust where the rocks have been weakened by previous earthquake, and where we expect earthquake slip to occur.

Where earthquakes most often occur?
The earth’s surface is broken into a dozen or so major plates, plus a number of smaller plates and those plates are moving with respect to each other. The motion between two major tectonic plates is the main causes of occurring of earthquakes.

Whether earthquakes are predicted?
The seismological research has indicated the seismic zones and geologic fault and has warned that where earthquakes are going to occur, but difficulty is that it cannot be predict when it will occur.

Foreshock and after shock
Foreshocks are small scale earthquakes that occur before a large earthquake. Aftershocks may occur hours, days, weeks, or even months following the large quake.

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What is Disaster Risk Management?

What is Disaster Risk Management?

Disaster Risk Management is a process of mobilizing a group of people in a systematic way towards achieving a common risk reduction objective which takes place in a geographically-defined living area (or) in sector groups.

The local people must know what disaster management and risk reduction stand for, what their own responsibilities are, how they can help prevent disasters, how they must react during a disaster and what they can do to support themselves when necessary.

Awareness and knowledge will built the risk perceiption of local people. The analysing and understanding the risk of particular hazard to their lives properties, local people can take steps to reduce those risks and minimize the damages caused by the hazard.

The involvement and awareness of local community are therefore a critical element of disaster risk management.
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Cycle of Disaster Risk Management

Generally, the disaster risk management process (cycle) is composed of the following main elements –

Prevention
Measures taken to avert a disaster from occurring, If possible! To impede a hazard so that it does not have any harmful effects. (Risk identification, analysis and prioritize)

Mitigation
Measures taken prior to the impact of a disaster to minimize its effects, sometimes referred to as structural and non-structural measures. (Planning and implementation of structural interventions and non-structural measurers for reducing the risk exposed to particular hazard).

Preparedness
Measures taken in anticipation of a disaster to ensure that appropriate and effective actions are taken in the aftermath. (activities and measures taken in advance to ensure effective response to the impact of a hazard).

Early Warning
Early Warning system is the provision of timely and effective information that allows individuals exposed to a hazard to take action to avoid or reduce their risk and prepare for effective action.

Response
Actions taken immediately following the impact of a disaster when exceptional
measures are required to meet the basic needs of the survivors.

Recovery
The process undertaken by a disaster-affected community to fully restore itself to pre-disaster level of functioning.

Reconstruction
Permanent measures to repair or replace damaged dwellings and infrastructure and to set the economy back on course.

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Approach to Disaster Risk Management

Disaster risk management means the systematic process of using administrative decisions, organization, operational skills and capacities to implement policies, strategies and coping capacities of the society and communities to lessen the impacts of natural hazards and related environmental and technological disasters. This comprises all forms of activities, including structural and non-structural measures to avoid (prevention) or to limit (mitigation and preparedness) adverse effects of hazards (cf. UN/ISDR 2004 and http://www.unisdr.org/). or

Disaster risk management refers to a collective and integrated approach of the people in a systematic way to understand natural and human induced hazards, their characteristics and anticipated potential threats.

Disaster Risk Management involves activities and measure including structural and non-structural to avoid or reduce adverse effects of hazards.
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Concept & Terminologies of Hazards

WHAT IS HAZARD?
Hazard is an event or occurrence that has the potential for causing injuries to life and damaging property and the environment.

WHAT IS RISK?
The probability that a community’s structure or geographic area is to be damaged or disrupted by the impact of a particular hazard, on account of their nature, construction, and proximity to a hazardous area.

WHAT IS DISASTER?
A serious disruption of the functioning of a community causing widespread human, material or environmental losses which exceed the ability of the affected community to cope using its own resources.

WHAT IS VULNERABILITY?
Vulnerability is a condition or sets of conditions that reduces people’s ability to prepare for, withstand or respond to a hazard

WHAT IS CAPACITY?

Capacities are those positive condition or abilities which increase a community’s ability to deal with hazards.

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