Patient Factors & Considerations
  • Always take a full history, specifically identifying whether the patient is taking any anti-coagulation medication (e.g. warfarin, aspirin, etc.). This will delay clotting times and may predispose the patient to unidentified bleeds (especially in head injuries).
  • Always observe the Trauma Management Principles and Relief of Pain clinical practice guideline
  • For all management, ensure that all relevant infection control methods are utilised.
  • Always explain the procedure to the patient.
  • Consider appropriate analgesia.

Sprains & Strains

Use the RICE principle for the management of sprains and strains:

  • Rest – limit walking if lower limb injury
  • Ice – cold packs
  • Compression – apply a bandage
  • Elevation – to limit swelling, may need a sling applied for lower arm, wrist and hand injuries
If a strain or sprain is severe or you are in any doubt, manage as a fracture.

Minor wounds

  • Rest and reassure
  • Assess for type of bleeding (capillary, venous, arterial)
  • Determine the cause of the injury
  • Clean the wound and surrounding skin, removing foreign material (e.g. gravel); this may be best achieved by irrigation or gentle flush with sterile saline and/or chlorhexidine (followed by saline solution)
  • Apply sterile non adhesive gauze/bandage and direct pressure to the wound if no foreign bodies visible.
  • Elevate the limb, keep patient sitting if a scalp/facial wound
  • Bandage securely – check for circulation below bandage site (capillary refill, pulse, skin colour, sensation)
  • Do NOT remove first pad
  • If bleeding strikes through first bandage apply another on top of the first bandage; consider additional haemorrhage control


  • Sit the patient upright, don’t lie them down as they can swallow the blood and this may lead to vomiting later
  • Apply firm pressure with your finger and thumb to the soft part just below the bridge of the nose for 10 minutes
  • Provide the patient with a bandage, towel or "bluey" to place under their nose
  • Ask the patient to breathe through their mouth
  • Inform the patient not to blow their nose for several hours after the bleeding has stopped
  • If bleeding doesn’t stop after 10 minutes, consider Cophenylcaine
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