{"id":829,"date":"2010-12-02T17:58:16","date_gmt":"2010-12-02T17:58:16","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/treatment-of-blunt-injuries\/"},"modified":"2024-05-15T17:44:35","modified_gmt":"2024-05-15T16:44:35","slug":"treatment-of-blunt-injuries","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/bandages-and-bandaging-techniques\/controlling-bleeding-and-wound-care\/treatment-of-blunt-injuries\/","title":{"rendered":"Treatment Of Blunt Injuries"},"content":{"rendered":"<hr \/>\n<h3><span style=\"color: #003366;\"><strong>Blunt Injuries<\/strong><\/span><\/h3>\n<p><span style=\"color: #003366;\">The term <span style=\"color: #33cccc;\"><strong>blunt injury<\/strong><\/span> is used to describe a <span style=\"color: #33cccc;\"><strong>rupture<\/strong><\/span> in soft tissue caused by <span style=\"color: #33cccc;\"><strong>external violence<\/strong><\/span>, where the skin remains intact. The bleeding causes <span style=\"color: #33cccc;\"><strong>swelling<\/strong><\/span> to occur. The extent of the swelling is determined by:<\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">The severity of the injury.<\/span><\/li>\n<li><span style=\"color: #003366;\">The speed with which blood clotting takes place.<\/span><\/li>\n<li><span style=\"color: #003366;\">The elasticity of the surrounding tissue.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\">Once the <span style=\"color: #33cccc;\"><strong>vessel wall<\/strong><\/span> is <span style=\"text-decoration: underline;\">damaged<\/span>, the blood vessels constrict and the <span style=\"color: #33cccc;\"><strong>clotting mechanism<\/strong><\/span> is activated. As long as the clotting process has not been completed and the pressure of the tissue on the ruptured capillary vessels is lower than that in the blood vessel, blood will fill the available space in the tissue and, if possible, push the tissue aside. <\/span><\/p>\n<p><span style=\"color: #003366;\">As the elasticity of the tissue is <span style=\"text-decoration: underline;\">limited<\/span>, or because the site of the bleeding is <span style=\"text-decoration: underline;\">surrounded by bone<\/span>, the pressure will rise. Once this pressure is equal to or higher than that in the blood vessels, the bleeding will decrease and conditions will become more favourable for <span style=\"color: #33cccc;\"><strong>blood clotting<\/strong><\/span>. <\/span><span style=\"color: #003366;\">This <span style=\"color: #33cccc;\"><strong>counter-pressure<\/strong><\/span> acts as a <span style=\"text-decoration: underline;\">natural compression bandage<\/span>.<\/span><\/p>\n<hr \/>\n<p><span style=\"color: #003366;\">This chapter will only describe treatment of blunt injuries involving limbs. Blunt injuries to the skull, abdominal and chest cavities are less common but generally more serious and rapidly lead to disturbances in vital functions. These injuries require specialist treatment.<\/span><\/p>\n<hr \/>\n<p><span style=\"color: #003366;\">A blunt injury can arise in two ways:<\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">The tissue can be <span style=\"color: #33cccc;\"><strong>compressed<\/strong><\/span> between an <span style=\"color: #33cccc;\"><strong>external force<\/strong><\/span> exerted on the body and bone tissue.<\/span><\/li>\n<li><span style=\"color: #003366;\">As a result of <span style=\"color: #33cccc;\"><strong>abnormal movements<\/strong><\/span> which excessively stretch the tissue structure. The two points of connection for muscles or tendons are stretched further apart than permitted by the tissue\u2019s elasticity.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\">A blunt injury is usually classed according to the <span style=\"color: #33cccc;\"><strong>cause<\/strong><\/span>. If the tissue has been compressed between an external force acting on the body and the bone, the injury is known as a <span style=\"color: #33cccc;\"><strong>contusion<\/strong><\/span> or <span style=\"color: #33cccc;\"><strong>bruise<\/strong><\/span>. Tissue damage <span style=\"text-decoration: underline;\">caused by bones<\/span> involved in a fracture is also known as a contusion. In both cases, the skin remains <span style=\"text-decoration: underline;\">intact<\/span>, but the <span style=\"color: #33cccc;\"><strong>subcutaneous connective tissue<\/strong><\/span>, <span style=\"color: #33cccc;\"><strong>muscles<\/strong><\/span>, <span style=\"color: #33cccc;\"><strong>tendons<\/strong><\/span> or <span style=\"color: #33cccc;\"><strong>supportive tissue<\/strong><\/span> around the joint are bruised.<\/span><\/p>\n<p><span style=\"color: #003366;\">The signs of a contusion are as follows:<\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Pain, usually short-lasting.<\/span><\/li>\n<li><span style=\"color: #003366;\">Swelling, with bluish discolouration after some time.<\/span><\/li>\n<li><span style=\"color: #003366;\">Impaired function &#8211; the extent depends on the site and severity of the injury.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\">The severity of a contusion is often underestimated because the skin remains <span style=\"color: #33cccc;\"><strong>intact<\/strong><\/span> and <span style=\"color: #33cccc;\"><strong>discolouration<\/strong><\/span> only develops some time later. If the skin is damaged, there may well be bruising of the underlying tissue, but it is nonetheless treated as an open wound.<\/span><\/p>\n<hr \/>\n<p><span style=\"color: #003366;\">A <span style=\"color: #33cccc;\"><strong>sprain<\/strong><\/span> involves damage to <span style=\"color: #33cccc;\"><strong>ligaments<\/strong><\/span> or to the site where the <span style=\"color: #33cccc;\"><strong>ligament attaches to the bone<\/strong><\/span>. Ligaments protect a joint against <span style=\"text-decoration: underline;\">abnormal movements<\/span>. If a sudden extreme movement or constant overload causes a ligament to overstretch, damage will occur. The ligament can <span style=\"color: #33cccc;\"><strong>tear<\/strong><\/span> or <span style=\"color: #33cccc;\"><strong>rupture<\/strong><\/span> fully. <\/span><\/p>\n<p><span style=\"color: #003366;\">The damage will generally not be restricted to the ligament, but instead the surrounding tissue will also be bruised. <\/span><\/p>\n<p><span style=\"color: #003366;\">The signs of a sprain are:<\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Severe pain in and around the joint immediately after the injury occurs. <\/span><\/li>\n<li><span style=\"color: #003366;\">Pain upon palpation at the site of the ligament. The pain will only be felt in the area around the ligament upon movements which involve active and passive movement of the damaged ligament.<\/span><\/li>\n<li><span style=\"color: #003366;\">Swelling, later accompanied by bluish discolouration.<\/span><\/li>\n<li><span style=\"color: #003366;\">Loss of function.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\">In the case of <span style=\"color: #33cccc;\"><strong>luxation<\/strong><\/span> (<em>dislocation<\/em>), the sprain is so severe that the head of the joint remains fully or partially displaced. Partial dislocation is called <span style=\"color: #33cccc;\"><strong>subluxation<\/strong><\/span>. The ligaments may remain fully extended and, due to this extension, damage the nerves and blood vessels.<\/span><\/p>\n<p><span style=\"color: #003366;\">The signs of luxation are:<\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Severe pain.<\/span><\/li>\n<li><span style=\"color: #003366;\">Complete immobility in the joint.<\/span><\/li>\n<li><span style=\"color: #003366;\">Abnormal shape of the joint due to shift in joint parts.<\/span><\/li>\n<li><span style=\"color: #003366;\">Swelling due to vascular congestion and bleeding.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong>First Aid<\/strong><\/span><\/p>\n<p><span style=\"color: #003366;\">First aid for all forms of blunt injuries generally aims to <span style=\"color: #33cccc;\"><strong>prevent<\/strong><\/span> or <span style=\"color: #33cccc;\"><strong>limit bleeding<\/strong><\/span>. <\/span><span style=\"color: #003366;\">Bleeding causes <span style=\"color: #33cccc;\"><strong>circulatory problems<\/strong><\/span> due to pressure on the surrounding tissue, delaying the tissue repair process. The use of muscles and joints is difficult or avoided due to the pain.<\/span><\/p>\n<p><span style=\"color: #003366;\">By cooling the affected body part immediately after the accident, the local blood vessels will constrict. The blood supply to the affected area will be reduced, pressure on the opening in the blood vessel will decrease and the blood clotting process will be promoted. <\/span><\/p>\n<p><span style=\"color: #003366;\">Cooling can be carried out using:<\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Cold, flowing water.<\/span><\/li>\n<li><span style=\"color: #003366;\">Ice.<\/span><\/li>\n<li><span style=\"color: #003366;\">Wet cloths (<em>heat is removed from the body through evaporation<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Cold-packs.<\/span><\/li>\n<li><span style=\"color: #003366;\">Ethyl chloride.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\">The site of injury should be cooled for at least <span style=\"color: #33cccc;\"><strong>20 minutes<\/strong><\/span>. The acronym <span style=\"color: #33cccc;\"><strong>RICE<\/strong><\/span> is a useful mnemonic when providing first aid:<\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\"><strong>R<\/strong>\u00a0for <span style=\"color: #33cccc;\"><strong>rest<\/strong><\/span> (<em>immobilisation<\/em>). By avoiding any muscle activity, the tissue\u2019s oxygen requirement is reduced, and thus the blood supply remains limited.<\/span><\/li>\n<li><span style=\"color: #003366;\"><strong>I<\/strong>\u00a0for <span style=\"color: #33cccc;\"><strong>ice<\/strong><\/span> (<em>cooling<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\"><strong>C<\/strong> for <span style=\"color: #33cccc;\"><strong>compression<\/strong><\/span> in the form of a compression bandage.<\/span><\/li>\n<li><span style=\"color: #003366;\"><strong>E<\/strong>\u00a0for <span style=\"color: #33cccc;\"><strong>elevation<\/strong><\/span>, or raising the wounded part of the body. Gravity causes a relative <span style=\"text-decoration: underline;\">reduction<\/span> in the blood volume. The supply of arterial blood is reduced, while return of venous blood is stimulated.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\">In the case of a sprain, no load should be put on the joint for at least <span style=\"color: #33cccc;\"><strong>48 hours<\/strong><\/span>, and thereafter the pain threshold should not be exceeded.<\/span><\/p>\n<p><span style=\"color: #003366;\">Depending on the severity of the injury, the treatment can be continued with one of the following measures:<\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Keep the compression bandage applied.<\/span><\/li>\n<li><span style=\"color: #003366;\">Apply a support bandage using bandaging or tape.<\/span><\/li>\n<li><span style=\"color: #003366;\">Immobilise the joint using a plaster cast.<\/span><\/li>\n<li><span style=\"color: #003366;\">In severe cases where the ligaments or muscles are completely ruptured, surgery may be necessary.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\">In the case of a luxation, there is little benefit in treating the consequences of the injury if the cause itself has not been resolved. First aid should involve repositioning the joint. If this has to happen in the clinic, cooling and rest can be used to control any bleeding and pain during the journey. After repositioning, treatment should be the same as for sprains.<\/span><\/p>\n<hr \/>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Blunt Injuries The term blunt injury is used to describe a rupture in soft tissue caused by external violence, where the skin remains intact. The bleeding causes swelling to occur. The extent of the swelling is determined by: The severity of the injury. The speed with which blood clotting takes place. The elasticity of the [&hellip;]<\/p>\n","protected":false},"author":83,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[80],"tags":[149],"class_list":["post-829","post","type-post","status-publish","format-standard","hentry","category-controlling-bleeding-and-wound-care","tag-bandages-bandaging-techniques"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Treatment Of Blunt Injuries - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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