- 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
- 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