Ntra. Sra.

de Lourdes School Physical

3th de ESO Theory 3rd term Education

First Aid (I)

Sports injuries
1. What is an injury?
An injury is an accident that occur suddenly when we are exercising, or as a result of
poor warm up, fatigue, not to take into account safety rules, etc.
While some sports injuries are immediately evident, others can creep up slowly and
progressively get worse.

2. Bone lesions
2.1 Types
• Fissure, hairline fracture, or stress fracture: is a hairline crack in the bone that
develops because of repeated or prolonged forces against the bone.
o Instead of resulting from a single impact, they are the result of
accumulated trauma from repeated submaximal loading, such as
running or jumping.
o They most commonly present as pain that usually falls off with rest
but may be constantly present with a more serious bone injury.
o Percussion or palpation to the bone may reproduce symptoms
• Broken bones: They occur when the physical force exerted on the bone is stronger
than the bone itself. They can happen after accidents, falls… There are many types
of fractures, but the main categories are:
o An open fracture is one in which the bone breaks through the skin.
o A closed fracture: the bone breaks but there is no open wound in the skin
o A displaced fracture: The two ends of the bone are not lined up straight.
o A non-displaced fracture, the bone cracks but maintains its alignment.

2.2. Outward signs

• Broken bones: Immobility and intense pain with immediate hematoma in the
affected part and swelling
• Fissures: They may go unnoticed, but the increase in pain betrays them.
2.3 How to act in case of a broken bone?
• Standing still, movement can aggravate the injury.
• Apply cold immediately to the affected area.
• Go properly immobilized to a hospital.
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2.4. Broken arm or wrist

Signs of a broken arm or wrist include:
• Severe pain and tenderness. Bruising and swelling
• Difficulty moving the hand or arm. The wrist or arm being an odd shape.
• Bleeding (if the bone has damaged the skin) – sometimes the bone may poke
through the skin.
• Tingling and numbness.

Because of the shock and pain of breaking your arm, you may also feel faint, dizzy or
sick.

If you think you or someone else has a broken arm or wrist:

• Call 112. Avoid moving the affected arm as much as possible – it may help to
support it in a sling that goes under the arm and around the neck.
• Stop any bleeding by applying pressure to the wound with a clean pad.
• Apply ice to the injured area
• Don't eat or drink anything in case you need surgery to fix the bone when you
get to hospital.

5.4.1 How to make an arm sling

An arm sling stops someone’s arm moving (immobilisation) and protects it so it can
heal. It’s also a useful warning to others that someone has an injury so they should be
careful around them.
Step 1 of 4: Support their bad arm
• Ask them to support their bad arm with their other hand. Slide the triangular
bandage underneath it, with the longest edge (the base) parallel to their body
at the tip of the little finger. The tip of the bandage (the point) should stick out
past their elbow.
Step 2 of 4: Pull the top bit
• Gently pull the top bit under their bad arm and around the neck to the opposite
shoulder.
• Take the bit that’s hanging down over their arm and up to meet the other end
at their shoulder.
Step 3 of 4: Make a reef knot
• Tie the ends together in a reef knot at the hollow above their collar bone and tuck in
the ends.
Step 4 of 4: Adjust the sling
• Adjust the sling so that it supports their arm all the way to the top of their little
finger.
• Twist the tip by their elbow until it fits snugly around their elbow and tuck it in or
safety pin it.

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3. Muscular injuries: strain

A strain is also a stretch or tear, but it happens in a muscle or a tendon. Tendons link
muscles to the bones.
It is a contraction-induced injury in which muscle fibers tear due to extensive
mechanical stress. This mostly occurs as result of a powerful eccentric contraction or
overstretching of the muscle. Therefore, it is typical for non contact sports with dynamic
character such as sprinting, jumping

3.1 Grades of severity

Grade I (Contusión)
• Strains affect only a limited number of fibers in the muscle. There is
no decrease in strength and there is full active and passive range of
motion.
• Pain and tenderness are often delayed to the next day.
Grade II (Desgarro)
• Strains have nearly half of muscle fibers torn. Acute and significant pain
is accompanied by swelling and a minor decrease in muscle strength.
• Pain is reproduced on muscle contraction.
Grade III (Rotura)
• Strains represent complete rupture of the muscle. This means either the
tendon is separated from the muscle belly or the muscle belly is actually
torn in 2 parts.
• Severe swelling and pain and a complete loss of function are
characteristic for this type of strain.

4. Sprains
A sprain is a stretch or tear in a ligament. Ligaments are bands of fibrous tissue that
connect bones to bones at joints.
Sprains usually happen when a person falls, twists, or is hit in a way that forces the
body out of its normal position.
The most common type of sprain is a sprained ankle. Wrist and thumb sprains are also
common, particularly in sports like skiing, where it’s not unusual to fall and land on an
outstretched palm.

4.1 Grades of severity

• Grade I: is stretching of the ligament or a
very mild tear, with little or no instability at
the joint.

• Grade II: is a more serious but still

incomplete tear, with some looseness in the
joint.

• Grade III: is a completely torn or ruptured

ligament. This is not a broken bone, but can
feel like one since it’s often impossible to put
weight on the joint or use the affected limb because the joint isn’t stable.

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5. Treatment: RICE
The gold standard of care for sprains and strains is known as “RICE” therapy. It stands
for:
• Rest:
o Don’t put weight on the injured area for 24 to 48 hours.
o This includes not lifting with an affected wrist or elbow.
o If you physically cannot put weight on an injured knee or ankle, see your
doctor.
• Ice:
o Put a bag of ice on the injured area for 10 minutes at a time, and then take it
off for at least 30 minutes over the course of the first 3 days.
o Wrap the ice in a damp cloth or put it in a plastic bag. (Don’t put ice directly
on your skin).
o The cold constricts blood vessels and slows down the inflammatory
process, which eases pain and swelling.
o But using ice for too long at a time can cause injury, so take breaks.
• Compression:
o You can either wrap an injured wrist, ankle, knee, or elbow in an elastic
bandage, or buy a compression sleeve.
o Like ice, compression helps to keep the swelling down.
• Elevation:
o Lie down and place the injured area on a pillow, and raise it above the leve l
of your heart.
o This will keep fluid from collecting in the area, so you don’t have as much
swelling.

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First Aid (II)

Incident preventions
If we think that we have suffered an injury, the first thing that we have to do is to value
its seriousness. It we think that it is serious or if we have doubts about it, we have to
ask for help (Emergency Call 112)
Remember the “PCA” rule. Prevent – Call – Aid.
(In Spanish P.A.S “Protege, Avisa, Socorre”)

1. What to do when an accident?

You have to act calmly but quickly. In this order do:
1. Protect from other possible accidents (Prevent)
a. In case of traffic accident, remove the ignition keys to avoid explosions,
and put a signal 100 metres before the accident place.
2. Ask for help by phone or make sure someone else does (Call)
a. Dial 112 and identify yourself giving name and ID, with a balance of
injuries and gravity and the place of the accident.
3. Succour: Help and reassure the wounded (Aid)
a. Let him know that help is on the way. Keep calm and transmit it.
If we don’t know what to do, do not act! If we think there may be a back injury, Do not
move!

2. When we have to ask for medical help?

The main symptoms that indicate that the assistance of an ambulance is required as
soon as possible to move an injured person to a hospital are the following:
• Loss of consciousness
• An acute confused state
• Persistent, severe chest pain
• Breathing difficulties
• Severe bleeding that cannot be stopped
• Severe allergic reactions
• Severe burns or scalds

3. What you should never do

- Apply CPR (cardiopulmonary resucitation) techniques without knowing how to do it
- Apply ice, oil, vinegar or toothpaste to a burn.
- Slapping on the back to a person who has choked.
- Change the dressings to stop a haemorrhage because they have much blood. The
clot already produced would be destroyed.
- Move a person who has suffered a severe hit and bloods by nose or ear.
- Forcing the casualty to move a joint that suffers a possible fracture.
- Light a cigarette lighter or manipulate electrical switches where it smells of gas.
- Force to throw up who has ingested a corrosive substance such as bleach.
- Remove the helmet from a biker or motorcyclist who has suffered an accident.
- Remove clothing adhering to the skin of a burned person.

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4. What to do after an incident
If someone is injured in an incident, first check that you and the casualty aren't in any
danger. If you are, make the situation safe.
When it's safe to do so, assess the casualty and, call 112.

5. Assessing a casualty
The three priorities when dealing with a casualty are commonly referred to as ABC,
which stands for: Airway – Breathing – Circulation. It is for essential steps used by first
aiders for performing CPR. Airway, breathing, and circulation are all vital for life, and
each is required, in that order, for the next to be effective.

Airway
- If the casualty appears unresponsive, ask them loudly if they're OK and if they can
open their eyes.
- If they respond, you can leave them in the position they're in until help arrives.
While you wait, keep checking their breathing, pulse and level of response:
• Are they alert?. Do they respond to your voice?. Do they respond to pain?
- If there's no response to any stimulus (are they unconscious)? leave the casualty in
the position they're in and open their airway. It ensures an open pathway and
prevents airway obstruction.

How open airways:

- The jaw-thrust manoeuvre is used to prevent the tongue from obstruction the upper
airways in supine patients.
- It is performed by placing the index and middle
fingers to physically push the posterior aspects of
the mandible upwards while their thumbs push
down on the chin to open the mouth. When the
mandible is displaced forward, it pulls the tongue
forward and prevents it from obstructing the entrance to the trachea.

Breathing
In the unconscious patient, after the airway is opened the next area to assess is the
patient's breathing, to find if the patient is making normal respiratory efforts.
- To check if a person is still breathing:
• Look to see if their chest is rising and falling
• Listen over their mouth and nose for breathing
sounds
• Feel their breath against your cheek.

Circulation
Circulation is the original meaning of the "C". In modern protocols, this step is omitted
as it has been proven the difficulty in accurately determining the presence or absence
of a pulse, and that, in any case, there is less risk of harm by performing chest
compressions on a beating heart than failing to perform them when the heart is not
beating.
For this reason, first aiders proceed directly to cardiopulmonary resuscitation, starting
with chest compressions, which is effectively artificial circulation.

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6. Cardiopulmonary resuscitation (CPR)

It is an emergency procedure that combines chest compressions with artificial
ventilation in an effort to manually preserve intact brain function until further measures
are taken to restore spontaneous blood circulation and breathing in a person who is in
cardiac arrest.
- Chest compressions:
o Place the heel of your hand on the breastbone
at the centre of the person’s chest. Place your
other hand on top of your first hand and
interlock your fingers.
o Position yourself with your shoulders above
your hands.
o Using your body weight (not just your arms),
press straight down by 5-6 cm on their chest.
o Keeping your hands on their chest, release the compression and allow the
chest to return to its original position.
o Repeat these compressions at a rate of 100 to 120 times per minute until an
ambulance arrives or you become exhausted.
- Artificial ventilation: Mouth-to-mouth resuscitation.
o After every 30 chest compressions, give two rescue breaths.
o Tilt the casualty's head gently and lift the chin up with two
fingers. Pinch the person’s nose. Seal your mouth over their
mouth and blow steadily and firmly into their mouth for about
one second. Check that their chest rises. Give two rescue
breaths.
Continue with cycles of 30 chest compressions and two rescue breaths until they begin
to recover or emergency help arrives.

7. Recovery position
The recovery position is designed to prevent obstruction of the airway

Placing a patient in the recovery position:

- Prevents tongue form blocking the throat.
- Allow liquids to drain from the mouth.

To put someone in the recovery position, you can follow these steps:
- Kneel by the casualty’s waist.
- Place the hand nearest you at right angle.
- Take the hand furthest to you and place it back of their hand against their cheek
closest to you.
- Lift the farthest leg above the knee and place their foot on the floor.
- Using their knee as a lever, roll the person towards you and onto their side.
- Ensure their head is still tilted back and they are on their side.

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8. Fainting (Syncope)
Fainting (syncope) is a sudden temporary loss of consciousness. When you faint, you'll
feel weak and unsteady before passing out for a short period of time, usually only a few
seconds.

There may not be any warning symptoms, but some people experience:
• a sudden, clammy sweat • blurred visión
• feeling sick (nausea) • spots in front of your eyes
• lightheadedness • ringing in your ear

- If you feel you're about to faint, lie down, preferably in a position where your head is
low and your legs are raised. This will encourage blood flow to your brain.
- If it's not possible to lie down, sit with your head between your knees.
- If a person faints and doesn't regain consciousness within one or two minutes, put
them into the recovery position.
- You should then dial 112 and stay with the person until medical help arrives.

9. Choking
Choking happens when someone's airway suddenly gets blocked, either fully or partly,
so they can't breathe.
9.1 Mild choking: encourage them to cough
If the airway is only partly blocked, the person will usually be able to speak, cry, cough
or breathe.
- To help with mild choking in an adult:
• Encourage the person to keep coughing to try and clear the blockage.
• Ask the person to try to spit out the object if it's in their mouth.
• Don't put your fingers in their mouth to help them.
- If coughing doesn't work, start back blows.

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9.2 Severe choking: back blows and abdominal thrusts
The person will not be able to breathe. Without help, they will become unconscious.
Don't give abdominal thrusts to babies under one year old or to pregnant women.
Back blows (To help an adult)
• Stand behind the person and slightly to one side. Support their chest with one
hand. Lean the person forward so that the object blocking their airway will come
out of their mouth.
• Give up to five sharp blows between the person's shoulder blades with the heel
of your hand. (The heel is between the palm of your hand and your wrist).
• Check if the blockage has cleared. If not, give up to five abdominal thrusts.

Abdominal thrust (Heimlich maneuver)

• Stand behind the person who is choking.
• Place your arms around their waist and bend them forward.
• Close one fist and place it right above their belly button.
• Put the other hand on top of your fist and pull sharply inwards and upwards.
• Repeat this movement up to five times or the blockage is cleared.

If the person's airway is still blocked, call 112 and continue with the cycles of five back
blows and five abdominal thrusts until help arrives.
If the person loses consciousness and they're not breathing, you should begin cardio-
pulmonary resuscitation (CPR) with chest compressions.

10. Anaphylaxis (Anaphylactic shock)

It is a severe allergic reaction that occur after an insect bite or eating certain foods.
- The adverse reaction can be very fast, occurring within seconds or minutes of
coming into contact with the substance the person is allergic to (allergen).
The symptoms include:
• Feeling lightheaded
• Breathing difficulties
• A fast heartbeat
• Clammy skin
• Lost of consciousness

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- During anaphylactic shock, their tongue and throat may swell, obstructing their
airway. Call 112 immediately.
- Check if the person is carrying any medication. Some people who know they have
severe allergies may carry an adrenaline self-injector.
- Make sure they're comfortable and can breathe as best they can while waiting for
medical help to arrive.

11. Low blood sugar (hypoglycaemia)

A low blood sugar, is when the level of sugar (glucose) in your blood drops too low.
It mainly affects people with diabetes, especially if they take insulin.

11.1 Symptoms of low blood sugar

Early signs of a low blood sugar include:
• Sweating, feeling of warmth • Nausea, vomiting, discomfort
• Tingling lips • Feeling tired
• Feeling shaky or trembling • A fast heartbeat (palpitations)

11.2 Treating a low blood sugar yourself

- If have hypo symptoms:
• Have a sugary drink or snack: try a non-diet drink or fruit juice, or sweets,
• Eat something that contains carbohydrate: a slice of toast, a couple of biscuits
or a glass of milk.

- Treating someone who's unconscious or very drowsy

• Put the person in the recovery position and don't put anything in their mouth.
• Give them an injection of glucagon medicine if it's available and you know how
to do it.
• Call 112

12. Alcohol poisoning

Alcohol poisoning occurs when a person drinks a toxic amount of alcohol, usually over
a short period of time.
Being poisoned by alcohol can damage your health or even put your life in danger.
It's important to be aware of how much you're drinking and the effect this could have on
your body.

12.1 Signs and symptoms of alcohol poisoning

The signs and symptoms of alcohol poisoning include:
• Confusion, severely slurred speech, loss of co-ordination, vomiting
• Irregular or slow breathing
• Hypothermia: (pale or blue-tinged skin caused by low body temperature)
• Stupor (being conscious but unresponsive). Passing out and being
unconscious.
• Hypoglycaemia.

In the most severe cases, alcohol poisoning can lead to coma, brain damage and
death.

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12.2 When to seek medical help
If you suspect alcohol poisoning, dial 112 immediately. While you're waiting:
• Try to keep them sitting up and awake
• Give them water if they can drink it.
• If they've passed out, lie them in the recovery position and check they're
breathing properly.
• Keep them warm and stay with them.

- Never leave a person alone to 'sleep it off'.

- The level of alcohol in a person's blood can continue to rise for up to 30-40 minutes
after their last drink. This can cause their symptoms to suddenly become much
more severe.
- You also should NOT
o give them coffee or any more alcohol,
o put them under a cold shower
o walk them around.
These won't help them and may even be dangerous.

12.3 Dangers of alcohol poisoning

If a person is poisoned by alcohol they could…
• choke on their vomit leading to fatal lung damage.
• develop more severe hypothermia.
• have seizures as a result of lowered blood sugar levels.
• become severely dehydrated, which can cause permanent brain damage.
• stop breathing or have a heart attack.

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