Fractures (broken bones): First aid

A fracture is a broken bone. It requires medical attention. If the broken bone is the result of a major trauma or injury, call 911 or your local emergency number. Also call for emergency help if:

• The person is unresponsive, isn't breathing or isn't moving. Begin cardiopulmonary resuscitation (CPR) if there's no respiration or heartbeat.
• There is heavy bleeding.
• Even gentle pressure or movement causes pain.
• The limb or joint appears deformed.
• The bone has pierced the skin.
• The extremity of the injured arm or leg, such as a toe or finger, is numb or bluish at the tip.
• You suspect a bone is broken in the neck, head or back.
• You suspect a bone is broken in the hip, pelvis or upper leg (for example, the leg and foot turn outward abnormally, compared with the uninjured leg).
Take these actions immediately while waiting for medical help:

• Stop any bleeding. Apply pressure to the wound with a sterile bandage, a clean cloth or a clean piece of clothing.
• Immobilize the injured area. Don't try to realign the bone, but if you've been trained in how to splint and professional help isn't readily available, apply a splint to the area.
• Apply ice packs to limit swelling and help relieve pain until emergency personnel arrive. Don't apply ice directly to the skin — wrap the ice in a towel, piece of cloth or some other material.
• Treat for shock. If the person feels faint or is breathing in short, rapid breaths, lay the person down with the head slightly lower than the trunk and, if possible, elevate the legs.

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MORE ON THIS TOPIC
• Shock: First aid
• Cardiopulmonary resuscitation (CPR): First aid
• Severe bleeding: First aid

Source: http://www.mayoclinic.com/health/first-aid-fractures/FA00058

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Rib Fracture

WHAT YOU SHOULD KNOW
Broken ribs are more common in older adults than younger people. The ribs may be fractured in more than one place. They generally take from 3 to 8 weeks to heal.

Causes
Causes range from a fall or a blow to the chest to hard coughing or sneezing.

Signs/Symptoms
You'll suffer pain, especially when taking a breath. Other symptoms are tenderness and shallow breathing. You may feel as though you have to hold your chest to relieve the pain. There may be bruising at the place of injury.

Care
The break will need to heal naturally. To speed healing, follow the guidelines listed below.

WHAT YOU SHOULD DO
• Avoid strenuous activity. Be careful not to bump the injured rib.
• Eat a normal, well-balanced diet. Drink plenty of fluids to avoid constipation.
• Take deep breaths several times a day to keep the lungs free of infection.
• Do not wear a rib belt or binder.
• You may apply heat to the injury to help relieve pain. Use a warm heating pad, whirlpool bath, or warm, moist towels.
• You may use over-the-counter pain-killers such as aspirin, acetaminophen, or ibuprofen.

Call Your Doctor If...
• You develop a high temperature.
• You develop a cough.
• You cough up thick or bloody sputum.

Seek Care Immediately If...
• You have trouble breathing.
• You develop nausea, vomiting, or abdominal pain.
• Your pain gets worse.

Source: http://www.healthsquare.com/mc/fgmc2180.htm

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How to tell a broken bone from a hole in the snow

Winter is definitely here, with snow and ice in the morning, followed by sun and puddles in the afternoon. This can often cause a fall. Falling forward is a very common injury from many outside activities -- including skiing, snowboarding or running on icy trails -- and usually results in nothing more than a bruise or a bump.

Most commonly, falls mean a fracture of the wrist or hand, but sometimes the force of the blow can be transferred up the arm to the elbow. In this case, there could be a fracture or dislocation of the bones of the elbow, and the radial head is often where this occurs.

There are two bones in the forearm that connect to one in the upper arm. The humerus is the bone that goes from the shoulder to the elbow. At the elbow, it widens out so that it can connect to the bones of the forearm (the radius and the ulna). The construction of the forearm is complex in that it must allow rotation of the forearm so the wrist can go from facing down to facing up while still providing stability. This is achieved by having each bone swap functions at each end of the forearm. In the elbow, the radius is the bone that rotates. In the wrist, the ulna is the one that allows rotation. It is a pretty neat construct.

If there are excess loads to the forearm or wrist, these stresses can literally be sent up the arm to the elbow. This can result in so much force on the elbow and the forearm bones that something has to give. What gives depends upon many things, but one of the most important is that age of the person.

Young children tend to dislocate the elbow or fracture the end of the humerus or upper arm bone. Older people tend to fracture the wrist since they tend to have less calcium and weaker bones. Between the ages of 30 and 40, more commonly in women, the part of the radius bone that connects with the elbow is where the fracture occurs.

If you are unlucky enough to have an injury like this, here are some of the signs that you should look for:

Pain in and around the elbow, especially on the outside of the elbow.

Swelling around the elbow, especially on the outside.

Pain with bending or straightening the elbow.

Pain with trying to turn the forearm, such as with turning the palm up and down.

Pain in the elbow, especially on the outside, when gripping.

If any of these symptoms are present, you should get the arm in a sling or a splint to protect it and get it checked out. In most cases, the diagnosis is made from a routine X-ray, and we can classify the break as either a type I, II or III fracture depending on the severity.

If the initial X-rays are negative and the pain and especially loss of motion persist, you might need an MRI. This will allow proper treatment and hopefully a rapid return to full activity.

Paul Collins, M.D., is an orthopedic surgeon specializing in sports medicine at Orthopedic Health Care in Boise, Idaho. Collins is an avid participant in many outdoor activities.

Source: http://dailycamera.com/news/2007/dec/20/the-elbow-fractures-connected-to-the/

New MRI scanner aids WARMC docs

BULLHEAD CITY - A head-on accident sent a victim to the ER and left them unable to walk. But the X-rays showed the victim's legs were normal. It was only after the patient got an MRI scan that the bruises appeared that will eventually lead to broken bones.

“I couldn't believe my eyes. I practically flipped out of my chair,” said Dr. Jim Lash, medical director of diagnostic imaging at Western Arizona Regional Medical Center.

“It's dramatically changing our approach to trauma.”

With an early diagnosis of a stress fracture, bruised bones are treated like fractures and are wrapped up or put in a cast so they're allowed to heal. Magnetic resonance imaging technology is capable of showing trauma within minutes of the actual injury by using a STIR Imaging scan, Lash said, with a detail that shows bones, tissues and even individual muscle groups.

It's a big advance from X-ray technology, where bones, muscles and tissues all looked alike. But an MRI scan often involves a cylinder-shaped scanner that is uncomfortable for larger patients and leaves others claustrophobic.

When Open MRIs came on the market, some patients were concerned that the machine would yield lower quality images and Lash himself was dubious. Then a year and a half ago Open MRI began catching up with its closed version and began offering all the features of a closed MRI.

WARMC recently added the Hitachi AIRIS Elite Open to complement its three other computer tomography (CT) scanners, including two hospital-based scanners, another at the hospital's Imaging Center and an MRI at the hospital.

For many patients the open machine minimizes anxiety and claustrophobia by offering a spacious environment and is good for children because they can have their family close to hold their hand.

The AIRIS Elite features technology that can diagnose spinal problems, brain diseases, strokes and multiple sclerosis. It can produce images of the liver without the traditional injections of dye that in the past allowed doctors to view the organ. A magnet allows operators to image any part of the body in any plane, Lash said, and lets medical staff change the parameters of view to see blood or tumors.

“I was relegated to thinking we weren't going to have that capability. When (AIRIS Elite) came out, I practically came flying out of my chair,” Lash said. “I was like, where do I sign?”

Source: http://www.mohavedailynews.com/articles/2007/09/02/news/local/local6.txt

Fractures (broken bones): First aid

A fracture is a broken bone. It requires medical attention. If the broken bone is the result of a major trauma or injury, call 911 or your local emergency number. Also call for emergency help if:

• The person is unresponsive, isn't breathing or isn't moving. Begin cardiopulmonary resuscitation (CPR) if there's no respiration or heartbeat.
• There is heavy bleeding.
• Even gentle pressure or movement causes pain.
• The limb or joint appears deformed.
• The bone has pierced the skin.
• The extremity of the injured arm or leg, such as a toe or finger, is numb or bluish at the tip.
• You suspect a bone is broken in the neck, head or back.
• You suspect a bone is broken in the hip, pelvis or upper leg (for example, the leg and foot turn outward abnormally, compared with the uninjured leg).
Take these actions immediately while waiting for medical help:

• Stop any bleeding. Apply pressure to the wound with a sterile bandage, a clean cloth or a clean piece of clothing.
• Immobilize the injured area. Don't try to realign the bone, but if you've been trained in how to splint and professional help isn't readily available, apply a splint to the area.
• Apply ice packs to limit swelling and help relieve pain until emergency personnel arrive. Don't apply ice directly to the skin — wrap the ice in a towel, piece of cloth or some other material.
• Treat for shock. If the person feels faint or is breathing in short, rapid breaths, lay the person down with the head slightly lower than the trunk and, if possible, elevate the legs.

Source: http://www.mayoclinic.com/health/first-aid-fractures/FA00058