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Accidents and their Prevention

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Author - Dr. C. S. Ranaweera
Institution - Health Education Bureau

 

Accidents are the most common cause of death in those under 45. Accidents can take place any where – at home, workplace, school or on the road.

Do s and don’t s to follow after receiving an injury are described below. But, our main concern should be on prevention of accidents. Though Accidents happen unintentionally we can minimize the impact of it. It is called” prevention”. Where ever you are  , what ever you do, or hoe much ever you are in a hurry, simple safety measures will prevent you from unnecessary suffering and will keep your life happy.

Accident Prevention

Road Traffic Accidents

  1. Wear seat belts, should have air bags, advanced breaking systems
  2. Children should be in rear seats
  3. Speed – Driving at a speed of 45 kilometres per hour will reduce 10% of accidents.
  4. Avoid alcohol.
  5. Use hand free sets if you use a hand phone while driving.
  6. Obey traffic rules always.

Accidents in the Home

01. Fire and electrical safety – always.

  • Do not overload circuits, including using multiple adapters in sockets.
  • Have your wiring checked regularly.
  • Always ensure electrical equipment that you buy has been safety tested.

02. Medicines and Chemicals

labelled and lock in a cupboard. Keep out of reach of children.

03. Other Measures

  • Stairs should have banisters or rails.
  • Only climb up on something firm and strong.
  • Cover garden ponds/swimming pools if small children are about.
  • When using power tools use adequate protection including sturdy shoes, gloves and
    goggles. Always wear proper shoes when mowing the lawn.
  • Improve lighting in halls and stairways.

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Drowning

Learning to swim may well save your life. There are a few basic rules about swimming:

  • Never swim alone. Even a strong swimmer can get cramp and drown.
  • Never dive into shallow water.
  • Always wear a life jacket for sports like yachting and water skiing.
  • Never go swimming under the influence of alcohol.

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Sports-Related Acciden

Protective equipment is important and far more protection is worn when practicing sports e.g. helmet wearing in cricket. biking, wearing Protective equipment for sport must be worn and the rules must be enforced.

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Accidents in the work Place

Safety equipment must be worn. Risks must be appreciated. Every workplace should have a safety officer who is responsible for identifying danger and advocating action.

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When Managing Accidents and Injuries

  • Maintain your own safety - you will not be helpful to the injured person (s)
  • If possible precautions to ensure that the injury is not made worse
  • Deal with accidents in order of priority:
    Life-threatening situations first (e.g. arrested breathing, heavy bleeding or fractures)
    Followed by the less serious injuries.
  • If several people are injured, deal with those who will benefit most from immediate treatment.
  • Watch out for shock.
  • If hospital treatment may be needed, do not give the casualty food or drinks.
  • If in any doubt, call for appropriately qualified assistance giving clear and accurate information about the incident. (as outlined in your emergency strategy)
  • Though not visible to outside, the victim may have received injuries  to neck and spine. It may cause paralysis depending on the site of injury to the spine.

Therefore handling and transportation of a victim should be done very carefully. Stabilization of the back with a hard plank and  wearing a cervical collar are needed.

Injuries to bones like thigh bone (femur) or pelvis is suspected, as the bleeding is so severe, it may lead to death. The victim should be taken to a hospital immediately.

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Head Injuries

Head injuries fall into two categories:

  1. External  (usually scalp) injuries.
  2. Internal  head injuries, which may involve the skull, the blood vessels within the skull, or the brain.

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External (Scalp) Injury

The scalp is rich with blood vessels, so even a minor cut there can bleed profusely. The "goose egg" or swelling that may appear after a head blow is the result of the scalp's veins leaking fluid or blood into (and under) the scalp. It may take days or even weeks to disappear.

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Suspected Internal Injury

What are the Symptoms of a Head Injury?

Signs and symptoms of head injuries vary with the type and severity of the injury. The symptoms of head injury can vary from almost none to loss of consciousness and coma. symptoms may not necessarily occur immediately at the time of injury. Initial symptoms may include a change in mental status, meaning an alteration in the wakefulness of the patient. Minor blunt head injuries may involve only symptoms of being "dazed" or brief loss of consciousness. They may result in headaches or blurring of vision or nausea and vomiting. There may be longer lasting subtle symptoms including, irritability, difficulty concentrating, insomnia, and difficulty tolerating bright light and loud sounds. These post concussion symptoms may last for a prolonged period of time.

Severe blunt head trauma involves a loss of consciousness lasting from several minutes to many days or longer. Seizures may result. The person may suffer from severe and sometimes permanent neurological deficits or may die. Neurological deficits from head trauma resemble those seen in stroke and include paralysis, seizures, or difficulty with speaking, seeing, hearing, walking, or understanding.

  • Confusion
  • Difficulty in tolerating bright lights,
  • Abnormal breathing
  • Obvious serious wound or fracture
  • Bleeding or clear fluid from the nose, ear, or mouth
  • Disturbance of speech or vision
  • Pupils of unequal size
  • Weakness or paralysis
  • Dizziness
  • Neck pain or stiffness
  • Seizure
  • Vomiting more than two to three times
  • Loss of bladder or bowel control

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Causes for these Symptoms May be-

  • Skull fracture: A skull fracture is a break in the bone surrounding the brain and other structures within the skull.
  • Closed head injuries: This broad term describes any injury to the brain or structures within the skull that is not caused by a penetrating injury (such as a gunshot wound or stab wound). They range from very minor to potentially fatal injuries
  • Intracranial (inside the skull) hemorrhage (bleeding): Late signs of significant head injury and raised pressure within the brain and skull include a dilated pupil, high blood pressure, low pulse rate, and abnormal breathing pattern

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When to Seek Medical Care

A doctor should immediately attend to all potentially serious head injuries.

  • Weakness or inability to walk
  • Severe headache
  • Severe head trauma or a fall from more than the height of the person or a hard fall onto a hard surface or object
  • Loss of consciousness for more than 1 minute, vomiting more than once, confusion, drowsiness, weakness or inability to walk, or severe headache
  • Prevent movement of the neck in severe head injury or if the injured person has any neck pain. If the person needs to vomit, carefully roll them onto their side without turning the head.
  • If a person who was initially normal after a head injury cannot be awakened or is extremely difficult to awaken, he or she may have a more serious head injury and should be evaluated by a doctor.

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Preventing Head Injuries

Make sure that:

  • Always to wear appropriate headgear and safety equipment when biking and playing contact sports. Wearing a bike helmet, for instance, reduces the risk of concussion by about 85%.
  • Kids always use a seat belt or child safety seat
  • Follow safety precautions at work place

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Minor Head Injury Treatment at Home

Minor head injuries may be cared for at home. If you have any worrisome symptoms, such as loss of consciousness, vomiting, weakness, visual changes, confusion, or severe headache, you should see immediate medical treatment.

  • Bleeding under the scalp, but outside the skull, creates "goose eggs" or large bruises at the site of a head injury. Using ice immediately after the trauma may help decrease their size.
  • Do not apply ice directly to the skin. Ice should be applied for 20-30 minutes at a time and can be repeated about every 2-4 hours as needed.
  • Use a cloth as a barrier and wrap the ice in it.
  • When a minor head injury results from a fall onto carpet or other soft surface and the height of the fall is less than the height of the person who fell and there is no loss of consciousness (in other words, the person was not "knocked out"), a doctor's visit is not usually needed. Apply ice to lessen swelling.
  • The person should not be alone and driving or operating machinery should be restricted for 24 hours.

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Neck and Spinal Cord Injuries

Neck and Back Injuries

Trauma to the neck and back can lead to spinal cord injury and permanent disability. If trauma occurs, the neck and back should be splinted and movement should be avoided. Accurately determining the cause and extent of the injury is important. The vertebral column has many ligaments and muscles that protect the spinal cord and assist in movement. Injury to any of these structures may cause significant and debilitating pain, even if a neck or back injury does not involve the nerves.

Neck and Back Injuries Symptoms

  • Someone with a neck or back injury may have localized pain, tenderness and stiffness. Muscles on either side of the spinal column may spasm immediately after an injury or up to 24 hours later.
  • Numbness, tingling, or paralysis of an extremity indicates that a more serious injury may have occurred.
  • Any penetrating injury to the neck requires immediate treatment. Leave the object in place until medical personnel can remove it.

Neck Strain

Strain is an injury to muscles that move the spine. Normally caused  by bending over at the waist to lift a heavy object

Symptoms - Pain inability to perform daily activities

Neck Sprain

Sprains are injuries to ligaments, caused by falls or sudden twists

Symptoms - swelling, reduced flexibility and pain.

If a severe neck injury is suspected ,you should immobilize spine.

For minor sprains, rest and ice the area and get it checked by a doctor.

Neck Injuries Affecting Nerves

Certain neck injuries may damage to the nerves coming out from the spinal cord. resulting  life long disability, paralysis or even death.

Whiplash Injury

Whiplash is the head is thrown first into hyperextension and  then quickly forward. It is most often due to car accidents, but may be caused by sports injuries, falls or trauma. It may damage joints or discs, which in turn may irritate nerve roots or possibly the spinal cord. Depending on the injury, symptoms can include pain, weakness/numbness/tingling down the arm, stiffness, dizziness or disturbed sleep. Symptoms may delayed a day or two following the injury. Treatments are medication and wearing a collar.

First Aid -

Stabilize the neck/back and immediately transfer to a hospital.

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10 ways to Prevent Broken Neck

  1. Wear a helmat.
  2. Prevent falls.
  3. Have a head rest, seat belts.
  4. Develop your bone density. Prevent osteoporosis.
  5. Eat food enriched with  vitamin D and calcium.
  6. Strengthen your neck muscles.
  7. Drive slowly.
  8. Do not dive head first in shallow water.
  9. Do not hit or block with head.
  10. Avoid violence.

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Limb Injuries

Limb injuries can cause damage to bones, joints, ligament, muscles, the major blood vessels and nerves of the limb. Severe limb injuries may cause  blood loss, shock and may be life-threatening.

Commonly Occurring Injuries Are-

  1. Injuries to tough, rope like fibers (ligaments) that connect bone to bone and help to stabilize a joints ( Sprains)
  2. Injuries to tough, rope like fibers, that connect muscle to bone (tendons)
  3. Pulled muscles – strains
  4. Muscle ruptures
  5. Broken bones – fractures.
  6. Pulling or pushing bones out of their normal relationship to the other bones that make up a joint.
  7. Superficial injuries – scrapes (abrasions), cuts (lacerations), Bruise (contutions), burns

Types of Arm or Leg Injuries

  • Fractures (broken bones)
  • Dislocations (bone out of joint)
  • Sprains - stretches and tears of ligaments
  • Strains - stretches and tears of muscles (e.g., pulled muscle)
  • Muscle overuse injuries from sports or exercise (e.g., shin splints of lower leg)
  • Muscle bruise from a direct blow (e.g., thigh muscles)
  • Bone bruise from a direct blow (e.g., hip or elbow)

Bruises

These may be caused by falls, blows or crushing. Bleeding into the deep tissues occurs, causing bruising.

Symptoms and Signs

  • Pain
  • Swelling
  • Bruising
  • Tenderness

Management
RICE

RICE Management

R - Rest the casualty and the injured part.
I - Ice packs wrapped in cloth
C - Compression.
E - Elevate the injured part.

Strains

A strain is the result of overstretching of a muscle or tendon.

Symptoms and Signs

  • Pain in the region.
  • Loss of power.
  • Tenderness over the muscle.
  • Sometimes a gap in the muscle.

Management

  1. Apply a cold pack over the injured area
  2. Advise the casualty not to further overstretch the muscle
  3. Support the injured muscle with a compression bandage
  4. Encourage gently exercise to reduce painful spasm and/ or shortening of the muscle
  5. Avoid rubbing or massage

Dislocations

A dislocations occurs when force stretches the ligaments so far that the bones in the joint are pushed out of normal contact with each other.

Symptoms and Signs

  • Pain
  • Inability to move the joint
  • Deformity
  • Tenderness over the joint
  • Rapidly developing swelling and discoloration about the jopint.

Management

If in doubt, manage as a fracture.

  1. Do not attempt to reduce the dislocation
  2. If a limb:

- check the pulse and if absent, gently move the limb to try to restore circulation. Seek medical aid urgently
- rest the joint in the most comfortable position
- elevate if possible
- expose the joint and apply cold packs
- use soft padding and bandages to support the joint in the positon in which it was found

  • For shoulder dislocations, support the shoulder and arm in the position of least discomfort and apply ice packs.

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Symptoms of Arm and Hand Injuries

Ligament sprains can occur in the wrist joint or elbow regions when the ligament attaching bone is pulled or torn beyond capacity

Severe pain, swollen bone protrusion, fast bruising, and inability to use the arm or hand is an indication of bone fracture.

Arm or hand numbness with tingling could be nerve damage, such as with carpal tunnel syndrome where pain radiates through the wrist and fingers, sometimes forearm.

Medical Treatment of Arm and Hand Injuries

For all hand and arm injuries, the PRICE method should be applied immediately

Stop doing the exercise activity, rest the arm and hand, wrap the injured site with ice or cold wet cloth, support the arm or hand with a bandage, wrap or tape, and try to elevate the arm to reduce swelling. An anti-inflammatory can be used to treat pain, but a medical professional should be seen to examine the injury.

Preventing Arm and Hand Injuries

A hand wrap can be used to support and protect the wrist joint and thumb from sprains and fractures,

WHEN TO GO TO A DOCTOR FOR FINGER AND TOE INJURY

  • You think your child has a serious injury.
  • Bleeding won't stop after 10 minutes of direct pressure.
  • Looks like a broken bone or dislocated joint.
  • Skin is split open or gaping and may need stitches.
  • Large swelling is present.
  • Blood that's present under a nail is quite painful.
  • Finger joint can't be opened (straightened) and closed (bent) completely.
  • Toe injury that causes bad limp or can't wear shoes.
  • Severe pain.
  • Age less than 1 year old.

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Finger Injuries

Why Finger Injuries are Important?

Unlike most of the other parts in the body; blood supply, nerve supply and the anatomy of fingers are unique. The movements and actions of fingers  too are of very much important to man.
Therefore, attending to injuries of fingers quickly and correctly is extremely important.

Types of Finger / Toe Injuries

01. Cuts, scrapes (skinned knuckles) and bruises:  the most common injuries.
02. Jammed finger or toe.
  • The end of a straightened finger or thumb receives a blow (usually from a ball).
  • The energy is absorbed by the joints' surfaces and the injury occurs there.
  • For jammed fingers, always check carefully that the end of the finger can be fully straightened.
03. Crushed or smashed fingertip or toe (e.g., from car door or screen door).

  • Usually the end of the finger receives a few cuts or a blood blister.
  • Occasionally the nail is damaged, but fractures are unusual.
04. Fingernail injury:  if the nailbed is cut, it needs sutures to prevent a permanently deformed fingernail. This is less important for toenails.
05. Blood clot under the nail.

  • Usually caused by a crush injury from a door or a heavy object falling on the finger while it is on a firm surface.
  • Many are only mildly painful.
  • Some are severely painful and throbbing.  These need the pressure released to prevent loss of the fingernail and to relieve the pain.
06. Fractures or dislocations.

What Caused It?

  • Usually  a cut or crush, caught in a door, window, gear, belt, saw, etc.

What can you do to Help?

  • Ice, elevation,applying pressure over the injury and have it checked out by a doctor.
  • Injury involved a cut, medical evaluation is particularly important - to check whether or not a tetanus shot, antibiotics or other treatment is required, even if stitches aren't needed.

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Home Care Advice for Mild Finger/ Toe Injuries

01. Bruised/Swollen Finger or Toe:

  • Soak in cold water for 20 minutes.
  • Give acetaminophen (e.g. Tylenol) or ibuprofen as necessary for pain relief.

02. Superficial Cuts:

  • Apply direct pressure for 10 minutes with a sterile gauze to stop any bleeding.
  • Wash the wound with soap and water for 5 minutes.
  • For any dirt in the wound, scrub gently.

03. Jammed Finger or Toe:

  • Caution: be certain range of motion is normal (can bend and straighten each finger).
  • Soak the hand or foot in cold water for 20 minutes.
  • Give acetaminophen (e.g. Tylenol) or ibuprofen as necessary for pain relief.
  • If the pain is more than mild, protect it by "buddy-taping" it to the next finger.

04. Smashed or Crushed Fingertip or Toe:

  • Wash the finger (or toe) with soap and water for 5 minutes.
  • Trim any small pieces of torn skin with a scissors cleaned with rubbing alcohol.
  • Cover any cuts with an antibiotic ointment and Band-Aid. Change daily.
  • Give acetaminophen (e.g. Tylenol) or ibuprofen as necessary for pain relief.
  • Foot and Ankle Injuries

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Ankle Sprain

A sprained ankle is one of the most common orthopedic injuries and they can occur during sports or when walking to carry out daily activities.

  • A sprain is actually an injury to the ligaments of the ankle joint Ligaments provide connection between bones. Sprains are injuries to the ligaments when the ligaments of the ankle have been stretched beyond their limits. In severe sprains, the ligaments may be partially or completely torn.
  • Tendons connect muscles to bones.
  • Tendons can be stretched or torn when the joint is subjected to greater than normal stress.

Ankle injuries can be painful and can make it difficult to carry out daily activities.

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Ankle Sprain Symptoms

  • Swelling because of increased fluid in the tissue is sometimes severe.
  • Pain because the nerves are more sensitive:
  • Redness and warmth caused by increased blood flow to the area.

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Ankle Sprain Treatment

at Home

Care at home is directed toward lessening pain and helping healing.

  • Ice is the best treatment.
  • Applying ice to the injury will do more for most people than medications.
  • Ice counteracts the increased blood flow to the injured area.
  • It reduces the swelling, redness, and warmth.
  • Applied soon after the injury, ice prevents much of the inflammation from developing.
  • Do not apply ice directly to the skin.
  • Rest prevents further injury and avoids stress on already inflamed tissue.
  • Put the ankle joint at rest by wearing a brace or splint.
  • Compression wraps such as bandages  but should not,apply them too tightly.
  • Elevation (keeping the injured area up as high as possible) will help the body absorb fluid that has leaked into the tissue.
  • Anti-inflammatory pain medications will reduce the pain and combat the swelling.

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When to Seek Medical Care

Usually, no need to go to the hospital for an an ankle sprain.
The problem is a more serious injury when there is a  fracture.
Pain is uncontrolled, despite of over-the-counter medications, elevation, and ice.

  • Unable to walk or cannot walk without severe pain.
  • The ankle fails to improve within five to seven days.
  • Severe or uncontrolled pain
  • The foot or ankle is misshapen beyond normal swelling.
  • Cannot walk four steps, even with a limp
  • Severe pain when pressing over the medial or lateral malleolus, the bumps on
  • Each side of the ankle
  • Loss of feeling in the foot or toes

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Ice Treatment

With any sprain, strain or bruise there is some bleeding into the underlying tissues. This may cause swelling, pain and delay healing. Ice treatment may be used in both the immediate treatment of soft tissue injuries and in later rehabilitation.

During immediate treatment, the aim is to limit the body's response to injury. Ice will:

  • Reduce bleeding into the tissues.
  • Prevent or reduce swelling.
  • Reduce muscle spasm and pain.

These effects all help to prevent the area from becoming stiff by reducing excess tissue fluid that gathers as a result of injury and inflammation.

How do you Make Ice Packs?
Ice packs can be made from ice cubes in a plastic bag or wet tea towel.

How are Ice Packs Used?

  • Ideally, rub a small amount of oil over the area where the ice pack is to go (any oil can be used). If the skin is broken, do not cover in oil but protect the area with a plastic bag to  stop the wound getting wet.
  • Place a cold wet flannel over the oil (do not need if using plastic bag).
  • Place the ice pack over the flannel.
  • Check the color of the skin after 5 minutes. If it is bright pink/red remove the pack. If it is not pink replace the bag for a further 5-10 minutes.
  • Ice can be left on for 20 to 30 minutes but there is little benefit to be gained by leaving it on for longer. You run the risk of damaging the skin if ice is left on the skin for more than 20-30 minutes at a time.
  • The effect of the ice pack is thought to be improved if it is pressed gently onto the injured area.

Ice can burn or cause frostbite if the skin is not protected with oil and/or other protection such as a wet flannel.

How Long Should Ice be Applied?

Ideally, ice should be applied within 5-10 minutes of injury for 20-30 minutes. This can be repeated every 2-3 hours.

Do not use ice packs on the left shoulder if you have a heart condition.

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Last update on : 2010-11-22 16:00:29