Injury Emergencies

Bone and Joint Injuries

Bone and Joint Injuries

Dislocation

What is it?

An injury in which the ends of your bones are forced from their normal positions.
Dislocation usually involves the body's larger joints. In adults, the most common site of the injury is the shoulder. In children, it's the elbow. Your thumb and fingers also are vulnerable if forcibly bent the wrong way.

Signs/Symptoms:

A dislocation requires prompt medical attention to return your bones to their proper positions.

Plan of Action:

If you believe you have dislocated a joint:
Bone and Joint Injuries

Fractures (broken bones)

What is it?

A broken bone.

Symptoms:

Plan of Action:

Don't move the person except if necessary to avoid further injury. 
If the broken bone is the result of major trauma or injury, call 911 or your local emergency number.
Also call for emergency help if:
Bone and Joint Injuries

Sprain

What is it?

An injury to a ligament caused by tearing of the fibers of the ligament. The ligament can have a partial tear, or it can be completely torn apart.
Ankle sprains are the most common type of sprain. Wrist, knee and thumb sprains are also common. Sprained ligaments often swell rapidly and are painful. Generally, the greater the pain and swelling, the more severe the injury is. For most minor sprains, you probably can start initial injury treatment yourself.

Plan of Action:

Rest, Ice, Compress, Elevate (R.I.C.E.)

Rest
Your doctor may recommend not putting any weight on the injured area for 48 to 72 hours, so you may need to use crutches. A splint or brace also may be helpful initially. But don't avoid all activity.
Even with an ankle sprain, you can usually still exercise other muscles to minimize deconditioning. For example, you can use an exercise bicycle with arm exercise handles, working both your arms and the uninjured leg while resting the injured ankle on another part of the bike. That way you still get three-limb exercise to keep up your cardiovascular conditioning.
Ice
Use a cold pack, a slush bath or a compression sleeve filled with cold water to help limit swelling after an injury. Try to ice the area as soon as possible after the injury and continue to ice it for 15 to 20 minutes, four to eight times a day, for the first 48 hours or until swelling improves. If you use ice, be careful not to use it too long, as this could cause tissue damage.
Compress
Compress the area with an elastic wrap or bandage. Compressive wraps or sleeves made from elastic or neoprene are best.
Elevate 
Elevate the injured limb above your heart whenever possible to help prevent or limit swelling.
Sprains can take days to months to recover. As the pain and swelling improve, gently begin using the injured area. You should feel a gradual, progressive improvement. Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others), may be helpful to manage pain during the healing process.
It is essential to restore strength and stability to the injured limb prior to a return to sports or fitness activities. A physical therapist or other sports medicine provider can provide you with the appropriate strength and stability exercises to optimize healing and minimize the risk of repeat injury.
The injuries that cause sprains can also cause serious injuries, including fractures. See your doctor if your sprain isn't improving after two or three days.

When to Seek Emergency Care:

Chemical Injuries

Chemical Injuries

Chemical Burns

What is it?

Tissue damage caused by strong acids, drain cleaners, paint thinner, gasoline and many other substances.
Usually, you are aware of such a burn and its cause. But sometimes you may not immediately recognize a burn caused by a milder chemical. As with some sunburns, the damage may develop hours after the exposure. Major chemical burns need emergency medical help. Minor chemical burn can usually be treated with first aid.

Plan of Action:

If you think you have a chemical burn, take these steps immediately:

When to Seek Emergency Care:

Call 911 or seek immediate care for major chemical burns, which:
If you're unsure you've been exposed to a toxic chemical, call a poison control center then call 911. There are two ways to get help from Poison Control in the United States: online at www.poison.org or by calling 800-222-1222. Both options are free, confidential and available 24 hours a day. If you seek emergency medical help, take the container or the name of the chemical with you.
Chemical Injuries

Chemical Splash in the Eye(s)

What is it?

When any chemical splashes in your eye(s).

Plan of Action:

1. Flush your eye(s) with water. 
Use clean, lukewarm tap water for at least 20 minutes. Use whichever of these approaches is quickest:
2. Wash your hands with soap and water. Thoroughly rinse your hands to be sure no chemical or soap is left on them.
3. Remove contact lenses. If they don't come out during the flush, then take them out.

CAUTION

Seek emergency medical assistance:

After following the above steps, seek emergency care by an eye specialist (ophthalmologist) or call 911 or your local emergency number. Take the chemical container or the name of the chemical with you to the emergency provider. If readily available, wear sunglasses to help reduce sensitivity to light.

Electrical Injuries

Electrical Injuries

Burns

What is it?

Tissue damage from hot liquids, the sun, flames, chemicals, electricity, steam and other causes. 

Plan of Action:

Minor Burns
For major burns until emergency help arrives:

When to seek emergency care:

Call 911 or seek immediate care for major burns, which:
Electrical burns, including those caused by lightning, and major chemical burns need emergency medical care. A minor burn might need emergency care if it affects the eyes, mouth, hands or genital areas. Babies and older adults might need emergency care for minor burns as well.
Electrical Injuries

Electrical Burns

What is it?

A skin burn that occurs when the body comes in contact with electricity.

Symptoms:

Plan of Action:

For minor electrical burns:
When to contact your doctor:
A person who has been injured by contact with electricity should be seen by a health care provider. The damage may be worse than it looks from the burn on the skin. Sometimes an electrical injury can cause damage to skin, muscles, blood vessels and nerves, often in an arm or a leg. The heart, brain and other body organs can be damaged.
Caution

When to seek emergency care:

Call 911 or your local emergency number if the injured person experiences:
Take these actions immediately while waiting for medical help:
Electrical Injuries

Electrical Shock

What is it?

Injury to the body from direct contact with a high-voltage source.
The danger from an electrical shock depends on:

Symptoms:

Plan of Action:

Caution:

When to seek emergency care:

Call 911 or your local emergency number if the injured person experiences:
Take these actions immediately while waiting for medical help:
A person who has been injured by contact with electricity should be seen by a health care provider.

Eye Injuries

Eye Injuries

Black Eye

What is it?

Bruising caused by bleeding in the tiny blood vessels in the skin surrounding the eye.

Plan of Action:

Most injuries that cause a black eye aren't serious. But a black eye could be a sign of a more serious injury, such as an internal injury to the eye or a fracture of the thin bones around the eye. You may have a skull fracture if you have double vision, bruising around both eyes (raccoon eyes) or bleeding from the nose.
Eye Injuries

Corneal Abrasion (scratch on the eye)

What is it?

A superficial scratch on the clear, protective "window" at the front of the eye (cornea). 
The cornea can be scratched by contact with dust, dirt, sand, wood shavings, plant matter, metal particles, contact lenses or even the edge of a piece of paper.

Symptoms:

Plan of Action:

In case of a corneal abrasion, seek prompt medical attention. Left untreated, the abrasion could become infected and result in a sore known as a corneal ulcer.
In the meantime, take these immediate steps:
Use the following pointers to avoid making the injury worse:
Most corneal abrasions heal in a few days but should be treated with antibiotic drops or ointment to reduce the risk of infection.
Eye Injuries

Foreign Object in the Eye

What is it?

Anything that is in the eye that wouldn't normally be there.

Plan of Action:

To help yourself:
To help someone else:
Caution:

When to seek emergency care:

Keep in mind that sometimes an object can scratch your eye. This often feels as though the object is still in the eye even after the object has been removed. This sensation can sometimes take 24 hours to go away.

Fever

What is it?

A rise in body temperature. consisting of 100.4 (38 C) or higher.

Plan of Action:

To treat a fever:

When to seek medical advice:

Seek medical care if someone with a fever has any of the following signs and symptoms:

When to seek emergency care:

Foreign Object in the Ear

What is it?

Anything in the ear canal that normally would not be there.
If left untreated, a foreign object in the ear can cause pain, infection and hearing loss.

Plan of Action:

Remember, if you can't remove the object easily the first time, get help. Also, if the person continues to have pain, discharge from the ear canal, problems hearing, or feeling there is something lodged in the ear, see a health care provider.

Head, Neck, and Spine Injuries

Head, Neck, and Spine Injuries

Head Trauma

What is it?

Any damage to the scalp, skull, or brain caused by injury.

Plan of Action:

To give first aid to a person who has head trauma, call 911 or your local emergency number. 
While waiting for emergency medical help to arrive:
Head trauma that results in concussion symptoms need to be evaluated by a medical professional. Concussion symptoms include nausea, unsteadiness, headaches or difficulty concentrating.
Any of the following symptoms may indicate a serious head injury:

Head, Neck, and Spine Injuries

Headache

What is it?

A painful sensation in any part of the head, ranging from sharp to dull, that may occur with other symptoms.
Most headaches are minor, and you can treat them with a pain reliever. Some headaches, however, signal a dangerous or serious medical problem. Don't ignore headaches that aren't explained or headaches that steadily worsen.

Symptoms:

Get immediate medical attention if your headache:
Immediate medical attention also is needed if your headache occurs with new:
Also seek medical attention if your headache:
 
Head, Neck, and Spine Injuries

Spinal Injury

What is it?

An injury to the spine.

Signs/Symptoms:

Assume a person has a spinal injury if:

Plan of Action:

Head, Neck, and Spine Injuries

Concussions

What is it?

A type of head injury that occurs when the head or body is hit so hard that the brain moves inside the skull.

Signs/Symptoms:

Plan of Action:

Illnesses

Illnesses

Foodborne Illness

What is it?

Illness caused by food contaminated with bacteria, viruses, parasites, or toxins.

Symptoms:

If you are very dehydrated, you might notice:

Plan of Action:

Foodborne illness often improves on its own within a few days.
Call your doctor if:
Seek emergency medical assistance if:
Illnesses

Gastroenteritis

What is it?

An inflammation of your stomach and intestines.

Symptoms:

Depending on the cause of the inflammation, symptoms may last from one day to more than a week.

Plan of Action:

Seek medical attention if:

Illnesses

Motion Sickness

What is it?

Nausea caused by motion.

Symptoms:

Plan of Action:

Usually quiets down as soon as the motion stops. The more you travel, the more easily you'll adjust to being in motion.
If you're susceptible to motion sickness:

Nose Injuries

Nose Injuries

Foreign Object in the Nose

What is it?

Anything in the nose that wouldn't normally be there.

Plan of Action:

Seek Emergency Care if these methods fail. Delays and many failed tries to remove a stuck object can lead to infection and damage. Also see a member of your care team if you see symptoms of infection.
Nose Injuries

Nosebleeds

What is it?

Occur when the tender blood vessels in the nose break.
Common nosebleed causes can include changes of season, dryness, scratching, some medicines, and injuries.
People on blood thinners may have worse nosebleeds than do others. Most often nosebleeds are only annoying and not a true medical problem. But they can be both.

Plan of Action:

When to contact your doctor

Think about using a humidifier. Adding more moisture in your home may help relieve nasal bleeding.

When to seek emergency care

Poisoning

What is it?

Injury or death due to swallowing, inhaling, touching or injecting various drugs, chemicals, venoms or gases. 
Many substances — such as drugs and carbon monoxide — are poisonous only in higher concentrations or dosages.
Certain types of cleaners are only harmful if ingested, while others also emit toxic gases/fumes. 

Symptoms:

Poisoning signs and symptoms can mimic other conditions, such as seizure, alcohol intoxication, stroke and insulin reaction. 
May include:
If you suspect poisoning, be alert for clues such as empty pill bottles or packages, scattered pills, and burns, stains, and odors on the person or nearby objects. 

Plan of Action:

How you treat someone who may have been poisoned depends on:

When to call for help:

Call 911 or your local emergency number immediately if the person is:
Call Poison Help at 800-222-1222 in the United States or your regional poison control center in the following situations:
Be ready to describe the person's symptoms, age, weight, other medications he or she is taking, and any information you have about the poison. Try to determine the amount ingested and how long since the person was exposed to it. If possible, have on hand the pill bottle, medication package or other suspect container so that you can refer to its label when speaking with the poison control center.

What to do while waiting for help:

In the case of an opioid overdose:

If the person is at risk of overdose of opioid pain medication and naloxone (Narcan) is available, please administer.
Increasingly, health care providers are giving people Narcan injectable prescriptions if they are at risk of overdose. Loved ones should be familiar with how to use them.

Caution

Shock

What is it?

A critical condition brought on by the sudden drop in blood flow through the body. 
Shock may result from trauma, heatstroke, blood loss, an allergic reaction, severe infection, poisoning, severe burns, or other causes. When a person is in shock, his or her organs aren't getting enough blood or oxygen. If untreated, this can lead to permanent organ damage or even death.

Symptoms:

When to Seek Emergency Care:

If you suspect a person is in shock, call 911 or your local emergency number. Then immediately take the following steps:

Skin Injuries

Skin Injuries

Blisters

What is it?

A bubble on the skin filled with serum caused by friction, burning, or other damage.

Plan of Action:

If a blister isn't too painful, try to keep it intact. Unbroken skin over a blister may provide a natural barrier to bacteria and decreases the risk of infection. Cover it with a bandage or moleskin. Cut a piece of moleskin into a doughnut shape and place the pad so that it encircles and protects the blister. Then cover the blister and moleskin with gauze.
To relieve blister-related pain, drain the fluid while leaving the overlying skin intact. Here's how:

Prevention:

To prevent friction blisters on your feet, wear shoes that fit well. It also helps to use moisture-wicking socks. Try the various socks, shoes and insoles that are designed specifically to help reduce blistering. You might also try attaching moleskin to the inside of your shoes where it might rub. Or you can dust the inside of your socks with foot powder. Gloves help prevent blisters on your hands.

Skin Injuries

Bruise

What is it?

A bruise forms when blood vessels under the skin break. The trapped blood creates a bruise that's black, purple or blue then changes color as it heals.

Plan of Action:

If the skin isn't broken, you don't need to bandage a bruise. Consider taking a nonprescription pain reliever if needed.
Consult your health care provider if you:
Skin Injuries

Burns

What is it?

Tissue damage from hot liquids, the sun, flames, chemicals, electricity, steam and other causes. 

Plan of Action:

Minor Burns
For major burns until emergency help arrives:

When to seek emergency care:

Call 911 or seek immediate care for major burns, which:
Electrical burns, including those caused by lightning, and major chemical burns need emergency medical care. A minor burn might need emergency care if it affects the eyes, mouth, hands or genital areas. Babies and older adults might need emergency care for minor burns as well.
Skin Injuries

Cuts and Scrapes

What is it?

A minor skin wound that may or may not draw blood.

Plan of Action:

1. Wash your hands. This helps avoid infection.
2. Stop the bleeding. Minor cuts and scrapes usually stop bleeding on their own. If needed,      apply gentle pressure with a clean bandage or cloth and elevate the wound until bleeding      stops.
3. Clean the wound. Rinse the wound with water. Keeping the wound under running tap            water will reduce the risk of infection. Wash around the wound with soap. But don't get          soap in the wound. And don't use hydrogen peroxide or iodine, which can be irritating.            Remove any dirt or debris with a tweezers cleaned with alcohol. See a doctor if you can't        remove all debris.
4. Apply an antibiotic or petroleum jelly. Apply a thin layer of an antibiotic ointment or            petroleum jelly to keep the surface moist and help prevent scarring. Certain ingredients in      some ointments can cause a mild rash in some people. If a rash appears, stop using the          ointment.
5. Cover the wound. Apply a bandage, rolled gauze or gauze held in place with paper tape.      Covering the wound keeps it clean. If the injury is just a minor scrape or scratch, leave it          uncovered.
6. Change the dressing. Do this at least once a day or whenever the bandage becomes wet      or dirty.
7. Get a tetanus shot. Get a tetanus shot if you haven't had one in the past five years and          the wound is deep or dirty.
8. Watch for signs of infection. See a doctor if you see signs of infection on the skin or              near the wound, such as redness, increasing pain, drainage, warmth or swelling.
Skin Injuries

Foreign Object in the Skin

What is it?

An object stuck under the skin such as wood splinters, thorns, slivers of metal or glass, and gravel.

Plan of Action:

When to Seek Medical Help:

For a foreign object that seems to be more deeply embedded in the skin or muscle. 
In addition, seek medical help if:
Skin Injuries

Puncture Wounds

What is it?

A wound made by a pointed object such as a nail. knife, or sharp tooth.

Plan of Action:

1. Wash your hands. This helps prevent infection.
2. Stop the bleeding. Apply gentle pressure with a clean bandage or cloth.
3. Clean the wound. Rinse the wound with clear water for 5 to 10 minutes. If dirt or debris remains in the wound, use a washcloth to gently scrub it off. See a doctor if you can't remove all of the dirt or debris.
4. Apply an antibiotic. Apply a thin layer of an antibiotic cream or ointment (Neosporin, Polysporin). For the first two days, rewash the area and reapply the antibiotic when you change the dressing.
5. Cover the wound. Bandages help keep the wound clean.
6. Change the dressing. Do this daily or whenever the bandage becomes wet or dirty.
7. Watch for signs of infection. See a doctor if the wound isn't healing or you notice any increasing pain, pus, swelling or fever. On light skin, spreading redness is a sign of infection. On dark skin, redness may not be apparent, or the infection's streaks may look purplish-gray or darker than your normal skin.

Seek prompt medical care:

If the injured person hasn't had a tetanus shot in the past five years and the wound is deep or dirty, your doctor may recommend a booster. The injured person should have the booster shot within 48 hours of the injury.
If the wound was caused by a cat or a dog, try to confirm that its rabies vaccination is up to date. If it was caused by a wild animal, seek advice from your doctor about which animals are most likely to carry rabies.

Bleeding

Bleeding

Severe Bleeding

What is it?

Blood pumping from a wound, bleeding that does not slow down with pressure, and/or bleeding that is quickly soaking through bandage after bandage.

Plan of Action:

Call 911 or your local emergency number if the wound is deep or you're not sure how serious it is. Don't move the injured person except if needed to avoid further injury.
Bleeding

External Bleeding

What is it?

Bleeding due to breaking of the skin from cuts, scrapes, etc.
With all bleeding injuries, first identify:
If the flow of blood is continuous, steady, and heavy, consider the wound to be life-threatening.

Plan of Action:

For non-life-threatening bleeding:
When to Seek Emergency Care:

 

Bleeding

Internal Bleeding

What is it?

Bleeding inside the body.
When bleeding occurs inside the body, you may be able to see a bruise under the skin or you may not be able to see anything.
You should suspect internal bleeding if someone:

Plan of Action:

Mouth Injuries

Mouth Injuries

Tooth Loss

Plan of Action:

It's sometimes possible to successfully implant permanent teeth that have been knocked out, but only if you follow the steps below immediately — before you see a dentist.
For permanent teeth, if a sharp surface or shiny surface is apparent, there's a chance that part of the root is still in the socket, and reimplantation becomes less successful. If reimplantation doesn't occur within two hours after the tooth is knocked out — sooner is better — the likelihood of success becomes poor. So it's vital to get emergency dental care.
Mouth Injuries

Bleeding From the Mouth

What is it?

Bleeding occurring inside or on the mouth from the teeth, tongue, lip, gums, or cheek.

Plan of Action:

 

Amputation

What is it?

When any part of a limb is cut or torn off.

Plan of Action:

Act quickly
To protect the amputated part:
Do not place the amputated body part directly on ice