Safety & First Aid
FRACTURED BONES
Problem. How does the body heal fracitured bones ? How well do broken bones heal themselves?
Background. Did you know that your bones are as alive as your skin or any other tissue in your body? Most people think that the bones in the skeleton are made of dead material. A close look would reveal some different information, however. Your bones grow rapidly during your first sixteen to eighteen years. Then they harden to form your adult skeleton. The marrow within some bones forms essential parts of your blood. Broken bones heal so completely that it is difficult to find the healed fracture. This evidence certainly points to the conclusion that bones are alive, in spite of their hardness.
Late in the seventeenth century an English physician, Dr. Clopton Havers, discovered that there are thousands of tiny canals lacing the bones. These canals, called Haversian canals after their discoverer, carry the blood vessels and nerves to the interior of the bones.
Around each canal is a group of cells called osteocytes. These cells form much of the living matter in the bones. One kind of osteocyte, an osteoblast, deposits the minerals that make up bones. This hard mineral content forms about 45 per cent of the weight of the skeleton. The other kind of osteocyte, the osteoclast, dissolves the hard calcium and other minerals in the bones. This dissolving
Explanation. When a bone breaks, whether it has split, broken into many pieces, or only cracked, there is apt to be damage to the blood vessels and nerves in the bone as well as to the bony substance itself. The repair of the break necessitates a repair of these vessels and nerves as well as a new deposit of calcium mixture at the site of the break.
As soon as the bone fragments are set so that they are close to each other, the osteocytes in the area begin to repair the break. The blood vessels grow back and help to carry away the debris dissolved by the osteoclasts. The osteoblasts deposit new calcium between the bones to cement them together. The osteoclasts dissolve away the rough edges and "polish up" the job. Finally, the break is so completely healed that it is not easily distinguished from the original bone.
Safety & First Aid - Activity for Health and Fitness
Do you realize that you can exercise many muscles in your body without moving them? You can if you use a system of exercises called isometrics. Isometrics is a method of exercising the muscles by pushing or pulling hard against a stationary object or against another part of the body. The exercises you will learn from this book will help you strengthen the muscles of your legs, neck, chest, and shoulders. You will find that daily practice is very helpful. From time to time you will be able to review these exercises so that you will continue to perform them properly.
Front and side neck muscles. This exercise will help you to strengthen the front and side neck muscles that rotate and nod your head.
Position. Turn your head to the right. Place the palm of your left hand on the left side of your head.
Action. Press your hand against your head as you press your head against your hand. Hold it for ten counts. Repeat the action on the right side. Repeat the exercise.
The chest. These exercises help to develop various muscles in your chest.
Position. Sit on the floor in the middle of a doorway. Extend your legs and keep your back straight.
Action.
1. Place your hands on the sides of the door frame at hip level, palms outward. Press hard against the frame with both hands. Hold this pressure for ten counts. Repeat the exercise five times.
2. Place the palms of your hands on the sides of the door frame at shoulder height. Press hard for ten counts. Repeat this five times.
3. With arms fully extended above your head, place the palms of your hands against the door frame and press hard for ten counts. Repeat this five times.
Elbow and shoulder muscles. The purpose of this exercise is to increase the strength of the muscles that help to bend and flex the elbows and shoulders.
Position. Lie face down with your legs fully extended. Place your hands at the hip-waist level with your palms against the floor. Your elbows will be bent and your fingertips placed at about your hips, fingers pointing towards your feet.
Action. Press your hands hard against the floor. Hold this position for ten counts. Repeat the exercise.
Inner and outer thigh muscles.
Position. Sit on the floor in front of a straight chair. Extend your legs toward the chair and place the inside of your ankles against the outside of the chair legs.
Action. Keep your legs straight and attempt to close them against the chair leg. For your outer thigh muscles, place your ankles inside the chair legs and push outward. Do each exercise for ten counts. Repeat this exercise five times.
First-Aid Kits
Making a kit. From your reading of this chapter, you know that many first-aid measures do not require any equipment. However, the cuts, scrapes, and scratches that occur in a large proportion of all accidents do need some treatment. You should remember that poisonings, sprains. wounds, and shock also require some equipment. You may need to have it handy.
A first-aid kit should be large enough to contain all of the supplies necessary to treat an emergency situation. It should be small enough to be portable, and inexpensive enough to be practical.
If you like, you can purchase a pre-packaged first-aid kit. You will probably need two kits, one for the home and one for the car. The following list of contents is intended as a basic guide and may be lengthened at the desire of any first-aider, provided that no items are dangerous.
First Aid for Broken Bones
Preventing broken bones. Many accidents that cause broken bones occur in the home, on the playing field, and on the highway. Falls account for many accidental fractures in the home and on the playing field. Walking, automobile, and bicycle accidents account for many fractures on the highway.
You can prevent those kinds of accidents if you observe some safety rules for the home, the highway, and the playing field. When you are walking or riding along a roadway, you should observe the rules of the road. Walkers should walk on the left side of the highway. Bicycle riders should ride on the right side of the road.
Automobile drivers are never sure whether a bicycle rider will swerve out into traffic. For this reason you should be careful to ride close to the edge of the road. You should never swerve out into the roadway without giving the proper hand signal and looking both ways. Observing these highway rules can prevent an accident that could break your arm or leg and possibly cause even more severe injuries.
When you play sports such as hockey, basketball, baseball, and football, you should be careful to wear the proper clothing and use the proper equipment. If you wear the wrong kind of shoes or forget essential protective equipment, you could receive painful cuts or broken bones. It is also important that you play these rough sports in a supervised area. In that way, there will always be an adult nearby if an accident should occur.
The home may be the greatest "bone breaker" of all. Because everyone spends so much time at home, everyone has a great opportunity for severe falls. Older people in particular are likely to receive broken bones from falls in the home. An older person’s bones are brittle and break easily. He has to be particularly careful of the high hazard areas of the home.
The danger of falls may be greatly increased by loose stair treads, small rugs that are not fastened down, objects left on stairs, upturned carpet edges, and highly polished wood or tile floors. You can see that the cellar stairs, the kitchen, and hallways with small rugs would be high hazard areas for falls. If you can eliminate these hazards, you will be helping to prevent accidents that can cause broken bones.
Finding a fracture. More serious than a strain or a sprain is a fractured bone. It is not always easy to see whether an accident victim has a fracture. Sometimes a person may mistake a sprain for a break, and at other times he may not be able to feel any break at all. If he is unconscious, it may be very hard to find a fractured bone even though it might be a serious fracture.
Sometimes a victim will feel a bone break or recognize a fracture because he is unable to move a limb properly. In other cases, you must check for swelling, tenderness, an unnatural shape or position of a body part, or pain on motion. If the results of your investigation indicate that a bone may be broken, you should apply first-aid measures. No harm can be done by treating the victim if there is no break, and great harm may occur if you leave a fracture untreated.
Treatment of a fracture. Whether the break is a simple fracture or a compound fracture, the first-aid treatment is the same: keep the injured part of the body immobile. It is best to accomplish this without moving the victim., He should be made comfortable and warm, and kept cheerful until a doctor can be summoned.
If the victim is in immediate danger, or must be moved to a place where he can be given medical attention, other steps may be necessary. In this event, the broken part should be splinted with some stiffening device such as boards, rolled newspaper, cardboard, or sticks. These should be padded to prevent injury and additional pain. The illustrations on page 47 show some methods of applying splints.
In any case of a broken bone, you should not attempt to set the bone yourself. Only a doctor has the skill necessary to give proper treatment. In the case of a compound fracture, do not attempt to push the exposed bones back into the flesh. Cover the break with a sterile bandage or pad and let the doctor give the proper treatment.
Complications. In any case involving broken bones, there may be complications. You will remember from your study of general first-aid rules that shock is usually present in an accident of this sort. Severe bleeding, internal injuries, and sprains may be other complications. If you remember to keep calm and look for all injuries that require treatment, you will be able to give excellent first aid.
First Aid for Sprains and Strains
Sprains. Do you know what a sprain is? Do you know the difference between a sprain and a strain? Both are common injuries resulting from running and walking accidents. A sprain occurs when a ligament, or tissue surrounding a joint, is damaged.
Many times a sprain is so severe that the blood vessels are also damaged. Blood and other fluids seep into the area to cause swelling and pain. For this reason the injured part should be elevated to help the fluids drain away. Applications of cold cloths will also help to reduce swelling and pain.
In all severe sprains there is the possibility that a bone may be broken or a ligament severely damaged. For this reason, it is wise to take the injured person to a doctor for professional treatment.
Strains. A strain is an injury to a muscle or to the tendons. These are cords that are attached to muscles and help move parts of the body. A strain is not as severe as a sprain. Often rest is the only first aid needed. If there is any doubt about the seriousness of a strain, put a cold compress on the affected area and consult a doctor.
Walking safely. It is often possible for you to prevent strains and sprains by observing a few simple rules and habits. You should clear all walkways of toys and other hazards. Make sure that snow and ice are cleared from walks and that all handrails are safe. Care should be taken to lift heavy loads properly so that the danger of strains is reduced. Observance of these rules in your home can mean the difference between safety and a painful sprain or strain.
Think for Yourself
What parts of the body do you think are most liable to sprains? What parts to strains?
First Aid for Fainting
Causes of fainting. Cartoons often show women shrieking and fainting at the approach of a mouse, or a snake, or a singing star. It is not very often that you will have to give first aid for this sort of a condition. However, fainting can be caused by great fear or any other condition which causes blood to drain away from the brain.
Perhaps you have heard of someone who has fainted after sitting for a long time in a stuffy room. The stuffy air was probably only one of the causes. Lack of sleep, tension, fatigue, and poor diet might have been other causes.
Helping a victim. You can treat a fainting victim by laying him down and elevating his feet slightly. This will help the flow of blood to the brain. If the person is sitting and feels faint, he should place his head between his knees to help revive circulation to the brain.
Women are not the only ones who faint. Soldiers who are forced to stand at attention in the heat of the sun for long periods often faint. The heat causes the blood vessels to expand. Because of the soldier’s inactivity and the tension he is under, the blood collects in the lower parts of the body.
If a person faints from any of the
previously mentioned causes, the first-aid measures already described should revive him within a few minutes. If the person does not respond quickly, there is probably something else wrong. The alert first-aider should then check for an injury suffered during a fall or some other complication. If simple first aid does not produce a quick recovery, a doctor should be consulted at once.
First Aid for Shock and Burns
Shock. Most people suffer shock after an accident. Consequently, it is a good idea to treat all accident victims for shock.
Doctors know that one of the causes of shock is a partial collapse of the circulatory system. Therefore, the treatment for shock is to get the patient to a doctor or hospital where he may be given plasma or a blood transfusion. For this reason you should call an ambulance or a doctor immediately.
Quite often a person in shock has suffered a loss of blood, either through a wound or internal injuries. However, this is not always the case. A person in shock is usually pale and listless. His body processes are slow. Perspiration may appear on his face. He may vomit or feel nauseous.
If the shock is severe, the patient may be unconscious. In this case, give no fluids, but lay the patient down and elevate his feet slightly. Call a doctor at once.
Electric current injury. Do not confuse shock with electric shock (electrocution ). The two conditions are not similar and are treated differently. The treatment for electric shock is artificial respiration because a shock may stop breathing. Treatment for burns is also given, because electric current accidents often involve severe burns.
Burns. One of the most common and most painful injuries is a burn. Burns may be caused by heat, chemicals, sunlight, or electricity. They may be mild (first degree), severe (second degree), or very severe (third degree). In any of them, good first aid may relieve considerable pain and may save a life.
First aid for burns. The best first aid for any burn is simple and easy to remember. If possible, plunge the burned area in ice water immediately. If you cannot plunge the burned part into water, you can apply ice or very cold water to the burned area. Wet sterile cloths or ice packs are good for this. Keep the burn chilled until the victim can be taken to a doctor.
Placing ice water or cold water on the burn relieves pain very well. It also helps prevent further tissue damage within the burned area.
This treatment is very effective and may be used for all burns, whether slight first-degree burns or very severe third-degree burns.
If the skin of the burned area is not broken, you may cover the burn with a sterile pad and bandage it loosely.
Burns of the eye. In the case of a chemical burn to the eye, immediate first aid is necessary. Wash the eye with great quantities of water. It is extremely important to remove every trace of the chemical, especially if a strong alkali is the harmful substance. This first aid is so important that the first-aider should continue pouring water over the open eye even while the victim is being transported to a doctor or hospital.
First Aid for Poisoning - Part 2
Universal antidote. Another method of treating many poisonings is to give the universal antidote. This substance counteracts poisons by inducing vomiting and by slowing absorption of the poison by the system. The antidote can be made by combining two parts burned toast, one part strong tea, and one part milk of magnesia. If prepared beforehand, it may be administered immediately with the water or milk. Most drugstores now carry it, and it is a valuable addition to any first-aid kit.
Strong acids and alkalis. The most common victims of poisoning are children too young to read. Sometimes they swallow cleaning preparations such as toilet bowl cleaner (a strong acid), or lye or ammonia (strong alkalis).
In the case of a strong acid, give plenty of milk or egg whites to dilute the acid and protect the lining of the stomach. Do not induce vomiting. Call a doctor or an ambulance immediately.
In the case of strong alkalis, give plenty of water and some vinegar, with egg whites or milk. Do not try to induce vomiting. As in all poisonings, call a doctor or an ambulance as soon as possible.
Try This
Dissolve a teaspoonful of ammonia in a half cup of water. Test the solution with both red and blue litmus paper. Which paper changes color? If the solution is an acid, the blue litmus paper will turn pink. If the solution is an alkali, the red litmus paper will turn blue. Make the same test on some household chemicals such as toilet cleaning powders, chlorine bleach, and aspirin dissolved in water.
Gasoline and petroleum products. These substances are dangerous because they can cause pneumonia or death if their fumes are inhaled. If you suspect a person has been poisoned from swallowing kerosene, gasoline, oil, or some other petroleum product, lay him down and keep him warm. Do not try to induce vomiting since damage to the lungs may result from the victim’s inhaling the fumes of the poison. Call a doctor or an ambulance right away. Make it clear that the poison is a petroleum product.
Poisoning by gas. Asphyxiation may occur if a person has been exposed to high concentrations of certain gases such as carbon monoxide. Leaky heaters and stoves and gasoline engines are the major culprits in this kind of poisoning. Once a victim has been safely rescued from the contaminated area, give him artificial respiration and call a doctor and the fire department rescue unit. Give artificial respiration even if the person is breathing a little by himself. Keep the person lying down and quiet until he is under medical care.
First Aid for Poisoning - Part 1
Poisons in the home. Poisons account for thousands of accidental deaths each year. Most of the victims are children who have swallowed substances that were never intended for their consumption. Household preparations such as ammonia and cleaning fluids account for many poisonings. But pesticides and overdoses of medicines such as aspirin account for the largest proportion.
Preventing poisonings. There are a number of things you should do to "poisonproof" your home. First, obtain your parents’ cooperation and aid in your attempt to reduce the hazards of poisonings. Second, place everything poisonous in cabinets and on shelves that cannot be reached by young children. Third, throw away all unlabeled medicines, out-of-date prescriptions, old bottles of iodine and other antiseptics, and old cough medicines. Finally, label all medicines and place them in a locked cabinet.
Detecting poisonings. If you saw an unconscious person being pulled out of the water by two lifeguards, you would assume that the person had had a drowning accident. It would be easy to decide on the proper first-aid treatment.
If the unconscious person were a little girl in your back yard, you would not be so sure of the cause. You might think she had fainted, had fallen from a tree, had been shocked, or had been poisoned. In this case, the only first aid you could give would be to send for a doctor. You would not be sure what had happened to her.
If the accident victim were conscious, or some sign of a poisoning were present, you would be able to do more. In this case you could proceed with the five first-aid measures that follow.
Treating poisonings. When you arrive on the scene and a victim is still conscious, there are several things you can do.
1. Give the person as many glasses of water or milk as he can drink, even if it promotes vomiting. This step should be taken immediately. The water will dilute the poison and reduce its action. The water may produce vomiting, which is a helpful reaction.
2. Find out what poison he has taken and the antidote that will counteract the poison. The antidote is often listed on the container. Give the antidote if it is readily available.
3. Call a doctor and give him as much information as possible.
4. Induce vomiting right away unless the poison is a corrosive acid, an alkali, or a petroleum product. This can be done by giving milk of magnesia or a solution of baking soda.
5. Keep the person lying down and warm.
These first-aid measures will be of great value if performed soon after the poisoning has occurred. The water or milk helps slow the absorption of the poison and dilutes it. The vomiting gets rid of at least part of the poison in the stomach. Getting rid of the poison is extremely important.
Many times the victim of a poisoning can tell you what poison he has swallowed. In other cases, a telltale container or an acid or alkali burn on the victim’s mouth may indicate that he was poisoned.
When you have evidence of a poisoning, you can proceed to administer first aid without delay. Any delay increases the chance of injury.
First Aid for Asphyxiation - Part 2
Back-pressure arm-lift method. (Holger-Nielsen method) Another method of artificial respiration is the back-pressure arm-lift method. When using this method, lay the victim on his stomach. Than bend his elbows and place one of his hands on the other so that both are lying under his head. Turn the victim’s head to one side and quickly wipe out any foreign matter that might be in his mouth. Make sure that his throat is clear.
Rescuer’s position. Kneel on one or both knees at the victim’s head, facing him. Open your hands and spread them across the victim’s back so that your thumbs are almost touching and the palms are just below an imaginary line connecting the armpits.
Compression. Rock forward slowly, so that the weight of your upper body presses on your hands. Increase the pressure until your arms are vertical. The pressure of your weight forees the air out of the victim’s lungs.
Expansion. Release the pressure on the victim’s back. Then slide your hands to his arms, just above the elbows. Grasp the upper arms and rock backward slowly, forcing the victim’s arms up and out. Continue until you feel the strain in his shoulders; then lower his arms.
This procedure forces air into a victim’s lungs by expanding his chest and arching his back. The steps in this method are repeated twelve times a minute for an adult victim and twenty times a minute for a child.
Think for Yourself
Can you think of a situation in which the back-pressure arm-lift method would be harmful to a patient?
Alternating rescuers. Because either method of artificial respiration may take a long time to help the victim to breathe by himself once again, one person may not be able to maintain the resuscitation by himself. In that case, it may be necessary to alternate rescuers. The move should be completely planned. It should be executed only when the two rescuers are certain they can complete the shift without missing any breaths.
If you have a chance to enroll in a Junior Red Cross course or one like it, you can learn about and practice many
methods of artificial respiration.
Try This
From your local fire department find out what equipment is used for victims of asphyxiation. It may also be possible to arrange for a demonstration of these kinds of equipment.
