Nursing care for fracture patients

2-  Severe muscle contraction as in electrical injuries

3-  Chronic diseases such as  bone cancer or osteoporosis))

4-  penetrating gunshot

-   Inability to use the affected part

-   Blue or discoloration of the skin

-   Swelling at the site of injury

-   Deformity in the affected part

-   Crackle at the fracture site

-   Shortening of the affected limb

•  Do not move the injured person if there is even the slightest suspicion of a fracture

•  injured person should be relaxed in an appropriate position

•  Do not give the injured person anything by mouth if there is an open fracture .

•  Do not try to put the broken bone back into its normal position

•  Do not try to push the protruding bone into the body in case of an open fracture

•  Ice is used to reduce internal bleeding , swelling and pain

•  The bleeding from wounds associated with the fracture is controlled by covering it with a sterile dressing and elevating it if possible after applying a splint.

•  Immobilize the affected limb by splinting it to prevent further damage

A piece of wood, or something similar, that is fixed to an injured part of the body to prevent its movement. If necessary, a splint can be made from anything solid to relieve pain, bleeding, and swelling and prevent complications such as cuts to the skin, nerves, or blood vessels

Types of splints:

•   We sit the injured person and support his injured arm on his chest

•  We support the limb with an arm hanger

•   We secure the end to his chest with straps or a belt

Finger fractures:

•   Place a layer of cotton between the broken fingers to protect them

•   We fix the injured person's fingers together with plaster

•   We place soft padding between the injured person's legs to cover the big bumps in the knees and ankles

•   Bring the healthy end closer to the broken one

•   Tie a band around the injured person's leg to secure the splint

•   We expose the leg to determine the type of fracture (closed or open)

•   Place bandages under the injured person's legs at knee level. Bring the healthy limb closer to the injured limb

•   We place soft pads between the injured person's legs

•   We tie the bandages around the ankles and feet

•   Do not allow the injured person to walk if he is standing and make him lie on his back

•   Place a splint under the injured leg and a small pillow under the knee to support it and tie it around the knee

The pelvic bones protect the lower internal organs. Fractures often occur as a result of indirect injury. In car accidents, the trauma is transmitted from the knee to the pelvis via the femur

Complications of pelvic fracture include injury to tissues and internal organs. Internal bleeding is severe, and shock often occurs

First aid for pelvic fracture:

•   Help the injured person lie on his back

•   Fix the legs and feet

•   Call for medical help quickly

•   If symptoms of shock appear, seek first aid

•   Monitor breathing, pulse and consciousness until medical help arrives

Nasal fractures:

•   The injured person is reassured and an attempt is made to make him calm

•   Encourage the victim to breathe through his mouth

•   The patient is tilted forward in a sitting position to prevent blood from entering the back of the throat

•   Apply cold compresses to reduce swelling without putting pressure on the fracture

•   Do not try to correct a broken nose

Mandibular fractures:

•   A free airway is provided inside the patient's mouth

•   If the injured person's jaw is hanging forward, it is supported by a strap that we place under the chin and tie over the head

Broken collarbone:

•   The shoulders are pulled back using a strap or band in the shape of the number 8 by wrapping it around both shoulders and tying it at the back.

•   Or the arm is carried in a triangular sling with the lower base at the edge of the elbow, then the two ends are wrapped around the neck and tied after placing a soft pad under the armpit on the injured side to tighten the broken bone

•   These fractures often heal on their own

•   It is best not to bandage or tie the chest

•   Rest is the best medicine

•   The arm is suspended on the fracture side in a neck sling

•   The patient is asked to take 4-5 deep breaths every two hours to maintain lung health

•   If a rib punctures the skin and is accompanied by a crackling sound, cover the wound with a clean, tightly secured dressing to prevent air from entering the chest, which could compress the lung externally.

•   If the injured person spits blood while coughing or experiences difficulty breathing (aside from pain), seek medical assistance.

Head, neck and back injuries:

Head, neck and back  (spine)  injuries are serious and difficult to care for

A spinal injury can cause a spinal cord injury

Symptoms of a spinal fracture:

-   Severe pain in the neck or back , with intolerance to touch that area.

Signs of spinal cord injury:

-    Weakness or lack of movement in the limbs below the level of injury

-     Loss of sensation below the level of injury

-     Feeling of numbness or stinging in the skin

-     Stiffness and heaviness in the extremities

-     difficulty breathing

·  Reassure the injured person and ask them not to move.

·  Movement or transportation of the injured person is cautioned against to prevent damage to or severing of nerves or the spinal cord.

·  Request an ambulance.

·  In case of suspected spinal injury, a "medical collar" should be applied before transportation, if available.

·  Place your hands on both sides of the injured person's head to stabilize it and keep the head aligned with the spinal column, preventing movement.

·  Seek the help of at least four people to move the injured person as a unit onto a stretcher or a large wooden board, such as a door.

·  Ensure the head, neck, and torso remain in a straight line at all times.

·  Use blankets or clothing to provide additional protection for the neck and torso.

Sprain :​

A sprain occurs in a joint as a result of excessive tension on the tissues surrounding the joint or the ligaments that connect the bones to each other

It occurs as a result of twisting the foot during a fall, running, playing football, or  things like that

Strain :​

It is the occurrence of a strain or partial tear in the ligaments surrounding a joint due to excessive tension on the muscle or tendons. The most susceptible joints to this are the ankle and knee joints.

The symptoms of sprains and tears are similar to those of fractures in the following:

-    pain during movement

-    swelling

-    Blue

-    Inability to move the joint.

First aid for sprains and strains:

• Rest should be taken, and the joint should not be moved to protect it from further injury.

• Apply ice packs to the joint for 10 to 15 minutes, four times a day, to reduce swelling immediately after the injury, followed by warm water compresses.
• The injured joint should be wrapped with a compression bandage.
• Elevate the injured area to reduce swelling.

Dislocation:

It is the displacement of one of the bones forming the joint from its natural position, meaning the end of the bone moves from inside the joint to outside it. This usually occurs in the shoulder and elbow.

•   If the injury is serious, check the victim's breathing to resuscitate him if necessary

•   Do not move the injured person if there is any suspicion of a head, neck or leg injury

•   Do not try to reduce the dislocation in any joint

•   If there is a cut in the skin, clean the wound gently and cover it with a sterile bandage

•   Reassure the injured person

•   Hang or splint the injured part in place so that it does not move up and down

•   Apply indirect ice packs  (wrapped in a clean cloth)  to the dislocation site to relieve pain and swelling

•   The injured person is placed on his back, his feet are raised about 30 cm and he is covered with a blanket to keep him warm and prevent shock, unless there is an injury to the head, leg or back.