Tuesday, February 9, 2016

Wilderness or Grid Down Medical Skills 1: Breaks and Dislocation

Medical training is serious and should be given by competent medical professionals. This article and the whole medical series is not medical advice. It is for informational purposes only. Find good medical training in your area before actually doing the procedures in this series.
This is a series designed to give you a basic medical knowledge of what I consider medical skills you should have if there is no help in sight. The skills are:
Broken bones
Establishing an airway
Deliver a baby
Know The Symptoms of a Heart Attack, Heat Exhaustion or a Stroke
Basic Wound Dressing Techniques

Setting a Broken Bone
I am not a doctor. I am not a healthcare provider in any way. But I have lots of kids. I’ve dealt with lots of injuries and watched how professionals took care of them and their procedures. Obviously this minimal experience and You tube videos do not constitute training. But I feel in certain situations I could take care of certain injuries.
Without an X-ray of the injured area it is very difficult to really know what has happened in the injury. But some things are obviously broken. Learn what a broken bone looks like so that you can recognize it when you see it again. I broke my collar bone in a car accident and would not have known it by just looking at the injury. Enduring pain, difficulty in moving the injured area, bruising, and swelling are all signs of a fracture or break. None of these symptoms mean a fracture for sure and could indicate other injuries.
Obviously, if you have a broken bone, you’ll want to go to a professional to have the bone reset.
However, in an emergency situation, and no way a professional will be able to care for the injured person, you must be able to help. What can you do to set the bone or at least hold it in place until you can get some help?
There are two types of fractures - open and closed. Open fractures typically have a bone protruding through the skin and includes an open wound. A closed fracture has no open wound.

If you have an open fracture, it is recommended that you manipulate the injury as little as possible. This is due to the fact that you can mess up nerves and blood vessels.
If you notice that there is a lot of swelling, numbness or discoloration below the break, this may be a sign that a major blood vessel has been severed. If this is the case, you’ll need to control the internal bleeding, allow the person to rest and provide them with lots of fluids.
If you feel that you need to quickly place the bone back in position you can use a tree notch to assist you in holding your arm in place while you adjust.
If the broken bone is in a very muscular area (ie. thigh), you’ll need to create a splint until you can get some help. Here is an example of a splint that you can make in the wilderness:
Wait for the swelling to go away before you set a bone.
If the bone is out of its natural position, setting it will help it heal. But if you do not know how to set a bone correctly, you can cause a lot of damage by doing it wrong. If possible, someone with experience should set a bone. Many communities have experienced bonesetters or community health workers who know how to do this well.
Step 1:
First give pain medicine. You can also give an anti-anxiety medicine like to help the person stay calm.
Step 2:
Ask a helper to hold the part close to the body still or tie it to something that will not move.
Step 3:
Pull the more distant part with a slow, steady, strong force. Do not yank, but pull hard enough to separate the bones.
Step 4:
When the pieces of bone are separated, gently line up the two edges and let them come back together.
Do not try to set a bone if the break seems to go into the joint or if there seems to be more than one break, leaving a “floating” piece of bone in the middle. Do not jerk or force the bones in place. This can cause permanent damage. Get help.
Make a cast
Casts can be made from pieces of cloth and a syrup or plaster mix that dries hard.
In Mexico several different plants such as tepeguaje (a tree of the bean family) and solda con solda (a huge, tree-climbing arum lily) are used to make casts. In India, traditional bone setters make casts using a mixture of egg whites and herbs. The methods are similar. Any plant will do if a syrup can be made from it that will dry hard and firm and will not irritate the skin. Usually the plant is boiled in water until a thick syrup forms. Or use Plaster of Paris mixed with water.
How long does a broken bone take to heal? A young child heals in a few weeks. An old person’s bones take months and may never heal properly. Keep a cast on the arm, or keep it immobilized, for at least a month. Legs should stay immobilized for about 2 months.
As we’ve said, do not try this at home.
Dislocated bones are when bone joints have been separated. They can be very painful. They can push against nerve and blood vessels causing nerve tenderness and your circulatory system to have trouble.
You can tell if you have a dislocated bone because it will be tender along the joint, have swelling, discoloration, limited range of motion and sometimes deformity.
You can use simple weights to pull the bones back into place. If done properly, the pain should decrease and allow for natural function and circulation.
I feel we all should have a working knowledge of this procedure.

Semper Paratus
Check 6