Treating injuries to the musculoskeletal system

After thoroughly cooling the area (not for bone fractures), call 112 or your GP. If you do not know who to call, randomly select one of the two options.

• Support a broken leg with your hands, a rolled blanket, bags, or jackets. In any case, prevent unnecessary movement of the limb.
• Let the victim hold an injured arm themselves.
• In the event of an injury to the upper arm or shoulder, the victim often supports the arm by holding it at the wrist.
• In the event of injuries to the forearm, the victim will usually place the injured arm on the other arm. Other support, such as a triangular bandage, is therefore not necessary. 
• Cover a skin wound loosely. 
• Cover an open bone fracture to prevent dirt from getting in.
• Apply a support bandage for a sprain or bruise.
• Advise the victim to move guided by the pain.

Muscle injury

Muscle injury occurs, among other things, as a result of muscle cramps or a muscle tear, also known as a whiplash. A muscle tear can occur in any muscle, but most commonly occurs in the calf. There is a sudden, sharp pain precisely at the site where the tear occurred. Depending on the severity of the tear, swelling may develop after some time. Additionally, bruising may occur. Muscle cramps, on the other hand, are involuntary contractions of muscle fibers and also occur most frequently in the calf. With calf cramps, the muscles in the calf contract suddenly. This also causes sudden pain. The cramp can last from a few seconds to minutes.

What do you observe?

• A sudden pain.
• With a muscle tear, the muscle feels soft.
• With a muscle cramp, the muscle feels hard.

Back pain

People with lower back pain experience pain in the lower part of their back. The pain can also radiate to the buttock or leg. Standing or sitting for long periods, as well as moving, can be quite painful. Back pain can develop suddenly or more gradually.
It is often a nagging pain. The pain can also be very severe. Certain postures or movements often cause (much) more pain. Sometimes, movement is almost impossible due to the pain.

What do you observe?

• Pain in the lower back.
• The victim can move little or not at all.
• Sometimes pain radiates to the buttock or leg.
• Sometimes sudden loss of strength in the leg, a numb feeling in the groin and around the anus.

Entrapment

@marcel 

Covering an open bone fracture 

Goal: 

Covering an open bone fracture. 

• Have someone hold the affected body part still.
• Place the dressing loosely on the wound.
• Ensure that the dressing cannot shift by securing it with adhesive tape.

Weather influences and injury

Hypothermia

What do you observe? 

• Has been exposed to cold temperatures or water.
• Cold, pale, and dry skin. Sometimes blue lips, ears, fingers, etc.
• Uncontrollable shivering.
• The breathing goes from very fast to slow and shallow.
• In cases of severe hypothermia, the victim becomes drowsy and less alert.

What are you doing?

• Call or have someone call 112 if consciousness decreases.
• Move the victim to a warmer environment.
• Remove any wet clothing.
• Wrap the victim, including the head, in an insulation pack.. Wrap arms and legs separately if necessary.
• Do not give the victim anything to eat or drink if he becomes or is drowsy.

In cases of severe hypothermia, wrap the arms separately, not together with the victim's torso. The arms are the most severely chilled and will cool the torso further if wrapped together. This also gives paramedics easier access to an arm (for measuring blood pressure or inserting an IV) without the torso cooling down.

Freezing

What do you observe?

• Red skin, which can also turn white. Frozen areas can turn blue.
• Especially pain during exertion.
• A possible swelling.
• A sensation of tingling and a burning feeling that turns into stabbing pain.
• Blisters with dark fluid.
• A white, cold, and stiff skin that dies and turns black.

What are you doing?

• Is the victim becoming or is he drowsy? Call or have someone call 112.
• Is there second- or third-degree frostbite? Call or have someone call 112.
• Consult the doctor about pain relief for frostbite if necessary.
• Remove gloves, shoes, and any rings if necessary.
• Cover external wounds with a sterile dressing. Place gauze between the fingers or toes if the skin is affected.
• Never prick open frostbite blisters.
• Warm frozen body parts only (with water) when it is certain that refreezing cannot occur.

Ensure the water is not too hot. Freezing can cause impaired sensation in the limbs. There is a risk of burns if the water is too hot. Ideally, the water should be at body temperature, so no higher than 40°C. Therefore, always check the water temperature with a thermometer, the inside of your wrist, or your elbow. Adjust the water temperature if necessary.

Heat rash

What do you observe?

• Red rash with small fluid-filled blisters and itching on the legs.
• Can be deduced from the situation (walking on a hot surface) and weather conditions.

What are you doing?

• Have the victim rest and cool the legs with water or a cold pack.
• Contact the GP in case of doubt or serious symptoms.

Many skin irritations can resemble heat rash, but are actually not. Examples include clogged hair follicles, acne, eczema, an allergic reaction, or a reaction to medication.

Sunburn

What do you observe?

• The skin has been exposed to (prolonged) sunlight without protection.
• Red and painful sunburned skin.
• The skin may start to peel.
• Sometimes: (burn) blisters, edema.
• Sometimes: fever and chills.

Heat exhaustion

What do you observe?

• Flu-like picture
• Sweats a lot, looks pale or red.
• Headache, dizziness, vomiting.
• Muscle cramps.
• Severe fatigue, feeling weak, sometimes falls.
• During actions, one clearly starts making 'mistakes'.
• Can progress to heatstroke

Heatstroke

This is a life-threatening situation and 112 must always be called. If the victim's skin is warm, red, and flushed, this indicates heat exhaustion. Heatstroke is a severe form of heat exhaustion in which tissue damage occurs. Heatstroke is often accompanied by convulsions and loss of consciousness.

What do you observe?

• High body temperature (sometimes up to 41 °C or higher).
• Abnormal behavior, drowsy and confused, or balance disorders.
• No sweat, red skin, or dry red skin.
• Nausea, fatigue, feeling weak.
• Possible loss of consciousness and unconsciousness.

What are you doing?

• Call or have someone call 112.
• Continuously monitor vital signs and provide life-saving assistance if necessary.
• Measure the victim's temperature with an (ear) thermometer.
• Lay the victim down in a cool environment.
• Remove as much clothing as possible from the victim.
• Let the victim rest and avoid any exertion.
• Actively cool the victim down as quickly as possible with cold packs on the neck, armpits, and groin, or by placing cloths soaked in water with ice on the victim (replace every 2 minutes).

Sometimes, a victim of heatstroke does not cool down quickly enough and their condition deteriorates rapidly. In that case, direct a rotating fan at the wet skin or spray the victim with cold water using a shower head or watering can. Consult the dispatcher in this situation.

Heatstroke occurs during strenuous physical exertion or excessive exposure to heat, in which the body's temperature regulation fails and sweating no longer helps or even stops completely. Victims of the use of ecstasy or other stimulants exhibit the same symptoms as victims of heatstroke.

What are you doing?

• Ask the victim to press on the wound themselves if possible.
• Leave the victim lying down or in a position that feels most comfortable.
• Have someone call 112 or call yourself if you are alone, in case of serious injury with heavy blood loss, and when the victim feels ill or looks pale after blood loss. In other situations, call the GP emergency line.
• Put the phone on speakerphone so you can hear the operator's instructions while keeping your hands free.
• Put on disposable gloves if immediately available.
• Apply a tourniquet in the event of extremity (arm/leg) amputation or apply a pressure dressing on or as close as possible to the site of blood loss.
• If this is not available, apply firm pressure directly to the wound, preferably with a piece of fabric. For a large wound, use two hands, using your body weight if necessary.
• Protect the victim from hypothermia.
• Take care of the amputated body part. Have another healthcare provider do this, or do it yourself as soon as the bleeding has stopped or is taken over by professional care.

In the case of a complete amputation, always treat the bleeding first, and only then attend to the severed body part. Often, the amputation wound will not bleed heavily initially immediately after the accident due to the contraction of muscles and blood vessels.

@First aid 

Wrapping an amputated body part (amputate)

Execution:

• First, wrap the amputated body part in a clean and dry plastic bag.
• Then place this plastic bag in another plastic bag with melting ice or ice to which water has been added. Or place it in a cooler, but do not bring the amputated body part into direct contact with the water or ice.
• Hand over the amputated body part to professional healthcare providers.