5. Bone and Joint Injury Fractures

Open (Compound) Bone protrudes through the skin Complicates fracture with an open wound

Closed No open wounds Follow guidelines for immobilization Set and splint the fracture

Signs and symptoms of a fracture Pain Tenderness Discoloration Swelling deformity Loss of function Grating

5. Bone and Joint Injury Sprains

Accidental over stretching of a tendon or ligament causes sprains Signs and symptoms:

Pain Swelling Tenderness Discoloration (black and blue)

When treating sprains, think RICE: R - Rest injured area I - Ice for 24 hours, then heat after that C - Compression E - Elevation of the affected area

6. Wounds Wound = > Any physical injury causing a break in the skin

Examples: open wounds, skin diseases, frostbite, trench foot, burns Any delay in treatment could cause infection, a serious threat Do not touch a wound with dirty hands or objects

One exception is when it's necessary to control arterial bleeding Promptly clean all wounds

Antibiotics, when available, should be taken for the control of infection. Treating open wounds:

Dressing and Bandages Cover wound with clean dressing after cleansing

A proper bandage will anchor the dressing to the wound and afford further protection

Bandages should be snug to prevent slippage, but not too tight Lacerations (cuts) are best left open due to the probability of infection from the

source that caused the laceration Clean thoroughly, remove foreign material, apply dressing

6. Wounds Skin Diseases and Ailments

Boils Apply warm compresses to bring the boil to a head Open the boil using a sterile knife, wire, needle, or similar item

Fungal Infections Keep skin clean and dry Expose the infected area to as much sunlight as possible Do not scratch the affected area

Rashes First determine what is causing the rash Rules to follow:

If it is moist, keep it dry If it is dry, keep it moist Do not scratch it Treat rashes as open wounds => clean and dress them daily

6. Wounds Frostbite => Results from frozen tissues

Light frostbite involves only the skin that takes on a dull, whitish look Deep frostbite extends to a depth below the skin Feet, hands, and exposed facial areas are vulnerable to frostbite Treating Frostbite:

Do not thaw the affected areas using an open flame Gently rub affected areas in lukewarm water Dry affected area and place it next to your skin to warm it at body temperature

6. Wounds Trench Foot

Results from many hours or days of exposure to wet or damp conditions at a temperature just above freezing

Nerves and muscles sustain the main damage, but gangrene can occur In extreme cases, flesh dies and may result in amputating the foot or leg Best prevention is to keep your feet dry.

Burns Cause severe pain Increase probability of shock and infection Can lead to loss of considerable body fluids and salts Treatment:

Covering burn with clean dressing of any type reduces pain and chance for infection Maintenance of body fluids and salts is necessary

Only way to administer fluids in burn situations is by mouth

7. Bites and Stings Insect Bites

Mostly just an irritant Can cause severe allergic reactions in some individuals Can be carriers of diseases

In other countries, you may be exposed to serious, even fatal, diseases not encountered in the United States

Ticks => Rocky Mountain spotted fever, Lyme disease Mosquitoes => Malaria, dengue, and many other diseases Flies => Can spread disease from contact with infectious sources

Sleeping sickness, typhoid, cholera, and dysentery Fleas => Plaque Lice => Typhus, Relapsing fever

7. Bites and Stings Insect Bites (continued)

Treatment: Immunizations can prevent most diseases from mosquitoes and flies If antibiotics are available, obtain and use them

Common fly-borne diseases usually treatable with penicillin or erythromycin Most tick-, flea-, louse-, and mite-borne diseases are treatable with tetracycline Most antibiotics come in 250 milligram (mg) or 500 mg tablets

2 tabs, 4 times a day, for 10 to 14 days will usually do the job

7. Bites and Stings Bee and Wasp Stings

If stung by a bee, immediately remove the stinger and venom sac, if attached, by scraping with a fingernail or a knife blade.

Wash sting site thoroughly with soap and water to lessen chance of infection

7. Bites and Stings Spider Bites

Black widow spider is identified by a red hourglass on its abdomen Only the female bites, and it has a neurotoxic venom Initial pain is not severe, but severe local pain rapidly develops

Pain gradually spreads over entire body, more intense in abdomen and legs Some symptoms include:

Abdominal cramps and progressive nausea Vomiting Rash may occur Weakness, tremors, sweating and salivation

Symptoms begin to regress after several hours; usually gone in a few days Funnel web spider is a large brown or gray spider found in Australia

Symptoms and treatment are same as for black widow Brown house or recluse spider is a small, light brown spider identified by a dark

brown violin on its back

7. Bites and Stings Spider Bites (continued)

Brown house or recluse spider is a small, light brown spider identified by a dark brown violin on its back

There is no, or so little pain, that usually a victim is not aware of the bite Within a few hours a painful red area with a blotch blue center appears The outstanding characteristic of the brown recluse bite is an ulcer that does

not heal but persists for weeks or months Victim will experience fever, chills, joint pain, vomiting, and a generalized

rash. This occurs in children or weak and tired persons Tarantulas are large, hairy spiders found mainly in the tropics

Pain and bleeding are certain, and infection is likely Treat tarantula bite as for any open wound => Try to prevent infection If symptoms of poisoning appear, treat as you would a black widow

7. Bites and Stings Scorpion Stings

Scorpions are all poisonous, some more than others Death is rare, occurring mainly in children and adults with high blood pressure

or illnesses Treat sting same as a black widow Two different reactions, depending on the species

Severe local reactions only, with pain/swelling around sting area Possible prickly sensation around mouth and a thick-tongue feeling

Severe systematic (whole body) reaction Little or no visible local reaction around the sting area Possible reactions:

Breathing difficulties Thick-tongue feeling Body spasms Drooling Gastric distention Double vision, blindness, involuntary rapid movement of eyeballs

7. Bites and Stings Snakebites

Death from snakebites is rare 50% of the snakebite victims have little or no poisoning 25% develop serious systemic poisoning

Before treating a snakebite, determine if snake was poisonous Bites from poisonous snake may have rows of teeth showing, but will have one or

more distinctive puncture marks caused by the fangs Symptoms of poisonous bite may include:

Pain at bite area Swelling at bite area within a few minutes or up to 2 hours later Spontaneous bleeding from the nose and anus Blood in the urine

Symptoms of neurotoxic venoms usually appear 1.5 to 2 hours after bite: Breathing difficulty Paralysis Weakness Twitching Numbness

8. Vital Injuries Head Injuries

Pose additional problems related to brain damage Can also interfere with breathing and eating Bleeding is more heavy flowing in the face and head area Infections have more difficulty taking hold

Abdominal Wounds Particularly serious in survival situations Extremely high mortality rate Renders victim totally unable to care for themselves If intestines are not coming out through the wound, a secure bandage should be

applied to keep this from occurring If intestines are coming out:

Do not replace due to almost certain fatal peritonitis Victim should lie on back and avoid any motions that increase intra-abdominal

pressure which might cause more intestine to come out “Nature” will eventually take care of the problem, either through death, or walling-off

of damaged area

8. Vital Injuries Chest Injuries

Common, painful and disabling Severe bruises of chest or rib fractures require that the chest be immobilized to prevent

large painful movements of the chest wall Apply bandage while the patient deeply exhales

Sucking Chest Wounds Easily recognized by the sucking noise and appearance of foam or bubbles in the wound Wound must be closed immediately before serious respiratory and circulatory

complications occur Eye Injuries

Serious in survival situation due to pain and interference with other survival functions More serious eye injuries involving disruption of the contents of the orbit may require

that the lids of the affected eye be taped closed or covered to prevent infection Thorns and Splinters

Frequently encountered in survival situations Reduce their danger by wearing gloves and proper footgear

9. Environmental Injuries Heatstroke

Breakdown of body’s heat regulatory system Body temperature more than 105ºF Signs and symptoms include:

Swollen, beet-red face Reddened whites of eyes Not sweating Unnatural paleness or absence of color in the skin Bluish color to lips and nail beds Cool skin

Hypothermia Body’s failure to maintain a temperature of 97ºF Caused by exposure to cool or cold temperature over a short or long time Treatment:

Gradually warm victim Get victim into dry clothing Replace lost fluid

9. Environmental Injuries Diarrhea

Common ailment Can be caused by:

Change of water and food Drinking contaminated water Eating spoiled food Becoming fatigued Using dirty dishes

You can avoid most of these causes by practicing preventive medicine

Intestinal Parasites Usually avoided with preventive measures => Example: Never go barefoot Most effective prevention is to avoid uncooked meat and raw vegetables contaminated by

raw sewage or human waste which was used as a fertilizer