Specific Injuries

Eye injuries

Foreign bodies in the eye

Foreign objects are often blown or rubbed into the eyes. Such objects are harmful not only because of the irritating effect but also because of the danger of their scratching the surface or becoming embedded in the eye.

Signs and symptoms

• Redness of the eye.
• Burning sensation.
• Pain.
• Headache.
• Over production of tears.
• Swelling.
• Wound.
• Presence of foreign body.

Precautions

• Keep the victim from rubbing his eye.
• Wash your hands thoroughly before examining the victim’s eye.
• Do not attempt to remove a foreign object by inserting a matchstick, toothpick, or any other instrument.
• Refer the victim if something is embedded in the eye, or if something is thought to be embedded but cannot be located.

Removal of a foreign body from the surface of the eyeball or from the inner surface of the eyelid

• Pull down the lower lid to determine whether or not the object lies on the inner surface.
• If the object lies on the inner surface, lift it gently with the corner of clean handkerchief or paper tissue.
• If the object has not been located, it may be lodged beneath the upper lid.
• While the victim looks down, grasp the lashes of the upper lid gently.
• Pull the upper lid foreword and down over the lower lid. Tears may dislodge the foreign object.
• If foreign object has not been dislodged, depress the victim’s upper lid with a matchstick or similar object placed horizontally on the top of the cartilage and evert the lid to its place by pulling down gently.
• Flash the eye with water.
• If the object is not removed, apply a dry dressing and refer to hospital.

Injury of the eyelid

• Stop hemorrhage by gently applying direct pressure.
• Clean the wound and apply a sterile or clean dressing. Seek medical help without delay.
• Bruises above and below the eye should be treated by immediate cold application to lessen bleeding and swelling.

Blunt Injury of the eye

• A contusion occurs from direct blow, such as fist, a vehicle accident or explosions and results in black eye.
• In serious case, the structure of the eye may be torn or ruptured.
• Secondary damage may occur by the effect of hemorrhage and later by infection.
• Vision may be lost.
• Bleeding may occur after several days.
• The victim should be seen by a physician, preferably by eye specialist.
• A dry sterile or clean dressing should be applied, and the victim should be transported lying flat.

Penetrating injuries of the eye

Such injuries of the eye are extremely serious and can result in blindness. Therefore, urgent referral must be arranged.

First aid measures

• Do not try to remove the object or to wash the eye.
• Cover both eyes loosely with a sterile or clean dressing. Secure with tape or bandage and cover both eyes to eliminate movement of the affected eye.
• Keep and transport the victim by stretcher.
• Take the victim to emergency room of hospital to get quick medical attention.

Head injuries

Scalp injuries

Wounds of the scalp even if small tend to profusely bleed. Deep scalp wounds may be complicated by fragment from skull fractures or they may contain hair, glass or other foreign material.

First aid measures

• Do not try to clean scalp wounds.
• Control bleeding by raising the victim’s head and shoulder; do not bend the neck (fracture may be present).
• Place a sterile dressing on the wound.
• Apply a bandage to hold the dressing in place and to provide pressure.

Brain injury

May occur not only from wounds of the scalp and open or closed fracture of the skull, but also in the case of an illness such as a stroke or tumor.

Signs and symptoms

Clear or blood-tinged cerebrospinal fluid draining from the nose or ears following skull fracture.

• Temporary loss of consciousness.
• Other manifestations of brain injury includes:

• • Partial or complete paralysis of muscle of extremities of the opposite side and facial paralysis on the same side of brain injury.
  • Disturbance of speech.
  • Local or generalized convulsions.

Bleeding from the nose, ear canal or mouth which is indicative of skull fracture

• Pale or flushed face.
• Fast and weak pulse.
• Headache and dizziness.
• Vomiting.
• Unequal size of pupils.
• Loss of bowel and bladder control.

First aid for suspected brain injury

•  Call for ambulance and obtain medical assistance as quickly as possible.
• Keep the victim lying down and treat for shock.
• Give particular attention to insuring an open air way.
• Control hemorrhage.
• Do not give fluid by mouth to the victim.
• Apply dressing and bandage over the skull if wound is present.
• Record the level of consciousness.

Face and jaw injury

It often occurs as a result of automobile accidents or other type of violent injuries. The immediate problems are obstruction of the air passage by blood, saliva, and other secretions; swelling and severe hemorrhage.

First aid measures

• Call for ambulance and seek immediate medical assistance.
• Maintain an open air way.
• Provide continuous support to the head to prevent air way obstruction.
• If the victim is conscious help to lean foreword to drain secretion from mouth and cough up.
• Give artificial respiration if necessary.
• Treat for shock.
• Apply protective dressing as necessary.

Ear injuries

Cuts and lacerations

Any torn and detached part of the ear should be saved and accompany the victim to medical facility.

First aid measures

• Apply dressing with light, even pressure:
• Raise the victim’s head.

Perforation of the eardrum

It may result from blast, blow on the head, diving, sudden change in atmospheric pressure or disease of the middle ear.

First aid measures

• Put a small gauze or cotton loosely in the outer ear canal for protection.
• Obtain medical care.
• Do not insert instrument or any kind of liquid in to the ear canal.
• Don’t clean the ear.
• Don’t stop the flow of cerebrospinal fluid from the ear.
• Turn the victim on to his injured side (unless there is some reason not to do so) to allow fluid to drain away.

Note- Perforation of ear drum associated with skull fracture requires special attention.

Nose injuries and nose bleeds

Injury to the soft tissue of the nose may or may not include fracture. Nose bleeding can result from injury or disease such as hypertension. It can also occur after cold, stressful activity or exposure to high altitude.

First aid measures

• Keep the victim quiet.
• Keep the victim in sitting position head tilted foreword.
• Inform the victim to breathe through the mouth.
• Apply direct pressure to the bleeding nostril by pinching.
• Instruct the victim not to blow his mouth
• Apply cold compress to nose and face of the victim.
• If bleeding does not stop, insert a small clean pad of gauze into one or both nostrils and apply pressure externally with thumb and index finger.
• If it does not stop, obtain medical assistance.
• Make sure that nasal bone fractures, like all other fractures, have medical attention.

Neck injuries

Blunt force exerted on the face, mouth or jaw may produce tissue damage and in the process, the body fluids draining in to the air passages may block the air way. Blockage may also result due to hard blow on the front of the neck especially if the laryngeal area is affected and throat tissue are bruised, In such case the following is necessary.

• Apply mouth- to -mouth or mouth- to- nose respiration.
• Obtain immediate medical assistance in case emergency tracheostomy is needed.
• Place the victim at rest on his back (supine position) to relax the abdominal muscles.
• Control bleeding.
• Give first aid for shock.

Open wounds of the abdomen

Wounds of the abdomen are particularly dangerous because of the risk of damage of the internal organs.

First aid measures

• Don’t try to replace protruding intestines or abdominal organs but cover with sterile dressings.
• Hold the dressing in place with a firm bandage, but don’t tighten the bandage.
• Don’t give food or fluid because surgery may be necessary.
• Keep the victim’s head and shoulders elevated to avoid breathing difficulty.
• Seek medical attention as rapidly as possible and take extreme care to gently transport the victim.