Fractures, dislocations and spinal injuries

1. Causes and characteristics of fractures, dislocations and spinal injuries

Fractures:

• The normal structure of the skeleton is disrupted
• The bone is fully or partially broken
• Causesd by a fall, blow or sudden movement
• Open fracture: 
  • If there is a wound at the site of a fracture
  • Carries a risk of infection

Dislocation:

• The ends of two bones that meet at a joint are displaced
• Caused by a blow, impact, fall or by twisting of the limb

Spinal injuries:

• Broken vertebrae can damage the spinal cord, resulting in paralysis of the limbs
• Caused by falling form a height, a blow to the neck or throat, excessive force on the spine, as in a collision, or diving into shallow water, or a heavy object falling on the head

2. Assessing the victim

A victim with a broken bone (fracture) will show the following symptoms:

• Pain
• Swelling 
• Limited us of the affected limb
• The affected limb may be in an abnormal position
• External bleeding in the event of an open fracture
• Internal bleeding in the even of a closed fracture (swelling will be visible on the outside)

It is not always easy to distinguish a fraction from a bruise or a sprain. 

A victim with a broken collarbone will show the following symptoms:

• Shoulder will hang limp and little forward
• Victim will hold his arm against his body and feel a lot of pain when he moves his shoulder

A victim with a dislocation will show the following symptoms:

• The joint is often in an abnormal position
• The victim will not be able to move the affected join fully, or not at all
• There may be a swelling

A victim with a spinal injury will show the following symptoms:

• Pain in his neck or back
• Mostly will not move or raise his head
• If his spinal cord is damaged, his legs and feet may tingle, feel numb, or be paralysed

If you suspect a victim has a spinal injury, it is crucial not to move him at all!

3. What the ERO should do

An ERO can provide first aid only for fractures or dislocations in the arms or legs. First aid for other fractures must be left to the professionals.

Treat closed fractures and dislocations as follows:

• Assess whether you need to call the internal emergency number or 112
• Immobilise the affected part
• Support the affected limb
• You can immobilise a fractured leg (step 1 | step 2) or pelvis by carefully placing a blanker, jacket, first aid bag o something similar against it. Make sure the foot cannot fall sideways
• A victim with a broken arm (step 1 | step 2) can support it with his other arm
• In the case of a fracture, wait for the ambulance or take the victim to a doctor

Treat open fractures (step 1 | step 2 | step 3 | step 4) as follows:

• Immobilise the affected limb
• Stop the bleeding
• Cover the wound with a sterile gauze

What to do in the event of a spinal injury: the only thing you can do as an ERO if a victim is suspected of having sustained a spinal injury is to alert the emergency services as quickly as possible and leave the victim where he is. Make sure that the victim does not move and that bystanders leave him in peace. If necessary, protect the victim against the cold by covering him with a blanket.