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Injury Prevention during the Big Freeze

Monday, 11 January 2010

Today Dr. Philip will be providing us with all the information needed to tackle these ice related injuries and explains what we should do if we are suffering from a fall and how to prevent any future tumbles.

Why is it Relevant Today?

According to the HSE, Emergency Departments around the country were busier than usual over the Christmas period, much of which can be attributed to the cold snap in the weather which has led to an increase in the number of people presenting with sprains and fractures as a result of slips and falls on icy roads and footpaths.

The HSE also reported that, From midnight on Christmas Day The Mid Western Regional Hospital in Limerick reported a total of 55 fractures in a 24 hour period, a figure they would normally see over the course of a week.
www.hse.ie

Dr. Philip MacMahon, GP


Dr Philip will be going through all the different injuries that you could sustain from a fall on an icy path. He will give us advice on care and treatment and also some handy tips for future prevention!

The following information can be found on the NHS website:
www.nhs.uk

The most common injuries caused by a fall during the Big Freeze.

1. Sprains

2. Strains / Pulled Muscles

3. Fractures

4. Head Injury

5. Bruising

1. SPRAINS

Cause

A sprain occurs when one or more of your ligaments have been stretched, twisted or torn. Ligaments are strong bands of tissue around joints, which connect one bone to another, and help to keep your bones together and stable.
Sprains often occur in ligaments around a joint, such as your ankle or your knee. However, the joint is not dislocated or fractured.
In a minor sprain, some of the fibres within the ligament are stretched. In more serious sprains, the ligament may be torn, either partially or completely.
A damaged ligament can cause inflammation, bruising and pain around the affected joint. The most common locations for sprains are the ankle, knee, thumb and wrist.
Symptoms

Common symptoms of a sprain include:

. pain around the affected joint
. being unable to use the joint normally, or being unable to put weight on it
. bruising
. tenderness
. swelling and inflammation

The swelling from a sprain will often occur soon after the injury. However, the bruising may not show until some time later or may even not show at all. Bruising can appear some distance from the affected joint as blood from the damaged tissues seeps out along the muscles and other structures, around the joint, before coming close to the skin.

Detection

When to seek medical help

You should see your GP or another healthcare professional for a sprain if:

. you have severe pain and cannot put any weight on the injured joint, or muscle
. the injured area looks crooked or has lumps or bumps (other than swelling) that are not normally present
. you cannot move the injured joint
. the limb gives way when you try to use the joint
. you have numbness in any part of the injured area
. the pain has not improved after four days of self-treatment.

Treatment

. Sprains - moving the injured joint
Healthcare professionals advise that you should not immobilise your injured joint and should not stop moving completely. As soon as the pain allows you to move your joint, you should start doing flexibility (range of motion) exercises. Your GP can give you information and advice about the exercises that will be suitable for you.

2. STRAINS / PULLED MUSCLES

Cause

A muscle strain is a stretch or tear of the tissue or fibres that make up your muscles. Sometimes, a strain is referred to as 'pulling a muscle'.

Most muscle strains happen if a muscle is:
. Overstretched.
. Forced to tighten (contract) too strongly.

Symptoms

The symptoms of muscle strains depend on how severe the injury is. They can include:
. pain in the affected muscle,
. swelling, and
. bruising

Detection

When to seek medical help

Similar to a sprain, you should see your GP or another healthcare professional for a strain if:
. you have severe pain and cannot put any weight on the injured joint, or muscle,
. the injured area looks crooked or has lumps or bumps (other than swelling) that are not normally present,
. you cannot move the injured joint,
. the limb gives way when you try to use the joint,
. you have numbness in any part of the injured area, or
. the pain has not improved after four days of self-treatment

Treatment

. Strains - immobilising the injured muscle
For the first few days after the injury you are advised to immobilise your injured muscle and keep it still. If your injury is severe your GP may also recommend that you use crutches.
The length of time that you should keep your muscle immobile will depend on how severe your injury is. The aim is to allow the muscle to start healing so that you can move it without tearing or pulling it again in the same place.

After a few days you will probably be advised to start moving and using the muscle.

How to treat sprains and strains at home

Most mild to moderate sprains and strains can be treated at home.

Sprains and strains - using RICE
Healthcare professionals advise that immediate treatment of sprains and strains should follow RICE therapy. RICE stands for rest, ice, compression, and elevation.

Rest - stop the activity that caused the injury, and rest the injured joint or muscle. Avoid activity for the first 48-72 hours after you injure yourself. Your GP may recommend that you also use crutches.

Ice - for the first 48-72 hours after the injury apply ice wrapped in a damp towel to the injured area for 15-20 minutes every 2-3 hours during the day. Do not leave the ice on while you are asleep and do not allow ice to touch your skin directly as this may cause a cold burn.

Compression - compress or bandage the injured area in order to limit any swelling and movement that could damage it further. You can use a crepe bandage, a simple elastic bandage or an elasticated tubular bandage. It should be wrapped snugly around the affected area but it should not be too tight. You should remove the bandage before you go to sleep.

Elevation - keep the injured area raised and supported on a pillow to help reduce the swelling. If your leg is injured you should avoid long periods of time where your leg is not raised.
Sprains and strains - avoiding HARM

For the first 72 hours after a sprain or muscle strain you should avoid HARM. This means you should avoid:

Heat - such as hot baths, saunas or heat packs (applying a controlled amount of heat to affected joints)

Alcohol - this will increase bleeding and swelling and decreases healing

Running - or any other exercise that could cause more damage

Massage - which may increase bleeding and swelling.

4. FRACTURES

Cause

A break or a crack in a bone is known as a fracture. Fractures can affect any bone in the body.
Bones can fracture in a number of different ways. A simple (or closed) fracture is a clean break to the bone that does not damage any surrounding tissue or break through the skin.
A compound fracture happens when the skin is breeched above the fracture site. Hence the serious risk of infection. .


Symptoms

The symptoms of a fracture depend on the bone affected and the severity of the injury, but can include:
. pain and swelling
. bruising or discoloured skin around the bone or joint
. the limb or part of the body being bent at an unusual angle
. inability to move or put weight on the injured limb or part
. a grinding or grating sensation or sound in the bone or joint
. bleeding - if it is an open fracture.

Detection

Fractures are usually diagnosed from your symptoms, along with a physical examination by the doctor. An X-ray confirms the diagnosis.
Unless it is absolutely necessary, do not move a person with a fractured limb until a splint has been applied by a doctor or paramedic to prevent movement above and below the fracture.
If you think you may have fractured a bone, seek medical help immediately.

Treatment

Treatment of a fracture starts with lining up the ends of the broken bone so that the natural healing process can begin. Aligning the broken bone is known as reducing the fracture.
Fracture reduction is normally done under general anaesthetic (where you are asleep). Surgery may be used to realign bones or bone fragments or it may be done without surgery by manipulating or pulling the bone fragments.
Once aligned, the ends of the broken bone must be held in the proper position while they heal. This is known as immobilisation.

HEAD INJURY

Cause

A knock, bump, or blow to the head is a common type of injury. For most people, a head injury is usually quite minor. A minor head injury, or a bump, or knock, to the head will not usually result in any permanent damage, and any symptoms are usually mild and short-lived. As long as someone who sustains a head injury remains conscious, and there is no deep cut or damage to their head (such as broken bone), there will not usually be any damage to the brain. A minor injury will not usually require any specific treatment, apart from rest and close observation.

Symptom

A minor head injury often causes a bump or bruise on the exterior of the head. Other symptoms may also include:
. nausea,
. mild headache,
. tender bruising, or mild swelling of the scalp, and
. mild dizziness.

If you, or your child, experience these mild symptoms after a knock, bump, or blow to the head, then you (or they) do not require any specific treatment.

Detection

Most people will make a full recovery after sustaining a minor head injury. However, if you have hurt your head, or if your child has, and you notice a change in your, or their, behaviour, or the symptoms worsen, you should seek medical assistance immediately.
If your child sustains a minor head injury, they may cry or be distressed. This is quite normal. With attention and reassurance, most children will settle down. However, seek medical assistance if your child continues to be distressed.

Treatment

After sustaining a minor head injury, you should rest and not take part in any strenuous activity for 48 hours. Do not drink alcohol or take any medication that helps you to sleep.
If you experience a headache or mild discomfort after a head injury, then it is safe for you to take a painkilling medicine, such as paracetamol or ibuprofen.

BRUISES

Cause


Bruises appear where tiny blood vessels, called capillaries, have broken or burst, leaking blood under the skin. The blood vessels burst as a result of banging or hitting your skin.

Symptoms & Detection

Bleeding under the skin makes a red or purple mark, which over time fades through shades of yellow or green. Bruises often feel tender or swollen at first.

Treatment

Treat bruises on your skin by limiting the bleeding. You can do this by cooling the area with ice packs. Place ice cubes or frozen vegetables in a plastic bag, wrap in a towel, and press over the area.


Creams containing Arnica are also known to help speed up the healing process. These can be bought from any health food store.

If you suffer from bruising regularly you can increase your intake of Vitamin C which is known to improve the bodies resistance to bruising.

Prevention is better than cure:

. Take precautions against falling - keep stairs, walkways, gardens and driveways free of clutter and in winter, put sand or salt on icy spots outside your home.
. Do not wear shoes that have a worn heel on one side. Wear boots or shoes with good grip on the soles.
. Avoiding running or walking on uneven surfaces.

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