SPORTS INJURIES AND FIRST AID
First Aid
Definition
This is the initial treatment or assistance given to a casualty following acceptable
principles of treatment before being placed under proper medical attention.
Reasons for First Aid
To preserve life
To prevent the casualty conditions becoming worse
To promote recovery
To relieve pain
To control bleeding
Why Should Physical Education Teacher Learn First Aid
Because the Physical Education environment involves play and an accident can
occur the teacher should be able handle those cases before taking the casualty
to the hospital.
Physical Education Teacher (First Aider) need to
- take necessary precautions in order to reduce the occurrences of
accidents
- able to identity the injuries
- treat the injuries
- transport the casualties
Qualities of a good first aider
1. observant in order to notice clues. Signs and symptoms at the scene
injury.
2. resourceful make best use of materials that are hand or improvise to
treat the casualty e.g. neck tie. Belts, newspaper pieces off clothes etc.
3. dextrous ability to act quickly, efficient, effectively without causing
unnecessary pain to the casualty.
4. tactful in order to explain a point without scaring or alarming the
casualty by not telling how ill he is.
5. discriminative decide which casualty should receive the priority treatment
e.g. the noisiest are rarely severely injured.
6. persevering you must be patient, you keep on trying to help the casualty
even if he is not cooperative.
7. sympathetic encourage the casualty sooth him, reassure and comfort
him.
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8. explicit - give clear instructions to the casualty and bystanders.
Content of First Aid Box
1. Antiseptics, dettol, izal etc
2. bandages roller bandage, crepe bandage, triangular bandage, stick
bandage (elastoplast), firm bandage.
3. Cotton wool
4. gauze dressing or dressing pad
5. Splints
6. a pair of scissors
7. a bottle of clean water
8. Glucose or sugar
9. Liniment
10. Deep heat
11. A pair of tweezers for picking thorns or things
12. Thermometer
13. Smelling salt or iodine
14. Pain killers e.g. paracetamol
15. Safety pins
Scope of First Aid/Steps followed by First Aider when attending to a
casualty
1. assess the situation
2. diagnose
3. treatment
4. disposal
Assessing the Situation
- Find out the possible causes of the accidents
- Check on the casualty
- Control the interruptions
- Ensure your safety and that of the casualty
Diagnose
- This is getting clues and information about the casualty by asking,
listening, touching, smelling, feeling, observing (signs and symptoms)
Treatment
- This is the medical treatment given to the casualty/first aid treatment and
you should check the air ways, breathing, circulation, relieve pain, apply
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artificial respiration, control bleeding and determine the level of
consciousness and prevent the condition from becoming worse.
Disposal
- Transport the casualty to the hospital, dispensary, or home depending on
the seriousness of his condition.
- A message explaining the circumstances and treatment given should
accompany the notify the relatives office
- Send for ambulance if serious outdoor accidents or police
Methods of carrying the casualty from the scene of accident
1. Stretchers improvised, sacks
2. Pick a back method this should be used for small and slightly conscious
3. Cradle method to carry small children and others who do not weigh
much
4. Human clutch step on the foot
5. Four handed seat good for casualty who can hold and it involves two
people holding one another hands.
6. Two handed seat
7. Drag-this should be used if the casualty is unable to move and should be
moved quickly from danger and cannot be lifted. Place your arms under
the throe and arm pits and place a soft material below his back.
Removal of Clothing
- clothing should not be removed from the casualty unless its absolutely
necessary.
- do not disturb the casualty or cause him unnecessary pain, remove
clothing from the uninjured part first and then the injured side.
- Do not damage clothing unnecessary, if its to be torn it should be done
along the seam.
Terms Associated with First Aid
1. Casualty a person who has just been injured or has just fallen ill.
2. Mouth to mouth or mouth to nose resuscitation
3. Diagnose find out the medical history of the problem that the casualty is
suffering from.
4. External - heart compression used when the heart stopped beating yet
the casualty is still alive, it involves placing the open palm of the hand
against the casualty breast bone and pressing down several times to re
activate the heart.
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5. Ligaments - the fibres at a joint joining one to bone or bands of strong
flexible fibrous tissue containing both elastic fibres and helps to hold
bones in position at joints.
6. Sign what can be seen on the casualty with the eyes e.g. bleeding,
swelling, etc.
7. Symptoms feelings of the casualty e.g. thirst, cold, high temp, pulse
rate etc
8. Splints a padded piece of wood used to immobilize the injured part
(fracture)
9. Sling a piece of cloth tied on the arm and around the neck in order to
immobilize the injured arm.
10. Tendons fibres joining muscle to bones
11. Recovery position prone lying with one leg and one arm bent and the
head turned to one side. Its advantages: its a stable position i.e. the
casualty cannot roll over easily, it makes breathing easier, if vomiting
occurs it can come out easily without choking him.
12. Dressings - a dressing is a protective covering applied to a wound in
order to
a) prevent infection from germs from the atmosphere
b) Absorb discharge e.g. plasma, pus etc
c) Control bleeding by helping the blood to clot
d) Avoid further injury
e) To hold medicine in place
f) Prevent the casualty from seeing how serious the wound is, so
that he does not panic. N.B. a good dressing should be sterile
(free from germs). E.g. gauze dressing or dressing pad.
13. Bandages these are strips of linen from a flannel, elastic, net, special
paper etc.
a) To maintain direct pressure over a dressing in order to control
bleeding
b) To prevent or to reduce swelling
c) To hold dressing or splints in positions
d) To provide support for a limb or a joint
e) To restrict movement of the injured part i.e. to immobilize it.
f) To assist in lifting and carrying of causalities
N/B bandages should not be tied so tightly to interfere with the
circulation of blood. They should not be too loose, either because
they would fall off. Examples of bandages roller bandage, crepe
bandage, triangular bandage, firm bandage, stick bandage (e.g.
elastoplast) etc.
Sports Injuries
1. bones fractures, bone hernia
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2. joints dislocations, sprain
3. Muscles strain, cramps, tear, sores, hernia
4. Respiration (asphyxia) condition where oxygen doesn't reach the brain
5. Blood circulation shock, fainting, heart disorders, stroke, heart attack
6. Wounds and bleeding external and internal
7. Nervous system unconsciousness, epilepsy, stroke
8. Burns and extreme temperatures- burns and scalds, heat exhaustion,
hypothermia, sunburn, frost bite.
9. Others-aches, foreign bodies, poisons etc.
Bone is the rigid part of the body forming the skeleton, they support the body
making the frame work of the person, they also protect the inner organs e.g.
heart, liver from being exposed and being injured, they also allow movement.
Fracture Its the breaking of bones or cracking of bones, however the
magnitude varies.
Types of Fractures
1. Simple fracture (closed) this is where the skin is not broken and continuity
is there, its very difficult to establish.
2. Compound/open fracture this is where the skin is torn allowing further
infection to enter the body.
3. Complicated this is where the bone may have more than one fracture or
where the bone injuries other parts of the body issue.
4. Green stick its common with small children, its simple cracks on the
bone caused by weight/bending like green twigs cause the bone is not
fully formed.
5. Comminuted fracture the bone is crushed or broken in several places
and splintered into fragments.
6. Impacted end of the bones are pushed into one another and tightly
wedged together.
Signs and Symptoms of a fracture
1. Loss of natural movement
2. Bone protrudes out in case of an open fracture
3. Bleeding
4. Deformity at the point of injury (shorter or longer)
5. Swelling occurs with bruises at the point of injury/bruises occur due to
damage and rupture of blood vessels.
6. Pain is experienced
7. The casualty may be shocked
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Steps to follow when treating a fracture
1. Treat for shock by reassuring the casualty all is well.
2. You should stop any serious bleeding
3. Prevent any movement of the injured part by immobilize it as quickly as
possible, using mechanical splinting i.e. tying the affected area by using
padded pieces of wood,
- must be strong enough.
- long enough
- should be padded to prevent direct pressure
- tied in position above and below
4. Body splinting can also be used in case of a forearm fracture
5. Prevent infection by covering the injured part
6. Arrange for transport to the hospital
NB. A patient with a fracture should not be moved unless there are
sufficient to lift and carry her preferably with a stretcher.
Joints
Joints are formed through linking of two different bones they can be either
movable or immovable.
Movable ball and socket joints e.g. hips, shoulders
Hinge joints this kind of joint allows movement in only one direction e.g. elbow,
knee joints etc.
Injuries
Dislocation is the displacement of one or more bones at a joint i.e. bone or
bones pushed out of their normal articulation e.g. shoulder, elbow, finger, knee,
ankle, jaw, wrists, thumb, toe, hips etc.
Signs Symptoms and
- Severe pain
- Swelling at the point of injury
- Loss of natural movement/deformity
- Swelling and later bruising
Treatment
1. Do not attempt to reduce the dislocation/back to normal position.
2. Immobilize the injured part with bandages and slings
3. Support and secure the injured part using cushions and pillows
4. Treat for shock
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5. Take to hospital as soon as possible
Sprains
- A sprain is when the tendons and ligaments at a joint are torn, because of
sudden twisting of a joint in an unnatural movement/turning and twisting
leading to tearing of muscles.
- Occurs when the weight of the body is thrown onto the joint while its in
unfavourable position
Signs and Symptoms
- Swelling occurs at the point of injury/later brushing
- There is loss of movement power
- There is acute sharp pain
- Place becomes tender to touch
- There might be dislocation i.e. black and blue
Treatment (r.i.c.e)
R-Rest
I-Ice or cold compression
C-Compress by applying bandage to prevent swelling
E-Elevate the injured part.
- rest and support the joint at the most comfortable position
- apply ice bag or cold compression
- massage with liniment
- apply the firm bandage i.e. to prevent swelling
Joints commonly affected are the ankle, knee and the wrist especially
when one is falling.
Injuries on the Muscles
These are fibres that make the flesh part of the body. There are three types of
muscles i.e. skeleton, smooth and cardiac muscle.
1. Muscle Cramp/pull
- This is the sudden involuntary and painful shortening of muscles or a
group of muscles.
Causes
- Poor coordination during exercise
- Chilling when swimming
- Excessive loss of salt and body fluids due to sweating and diarrhoea
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- Lack of regular exercise/unaccustomed exercise and fatigue
- Sudden temp change
- Exercising in high heat and humidity
Signs and Symptoms
- Pain
- Tightness (spasm) in the affected area
- Temporary loss of natural movement
- Sore muscles usually swollen and tender to touch
Treatment
- gentle massage of the affected area/straighten the muscle gently and
firmly
- Massage with liniment
- A drink of slightly salted water
- If the conditions worsens take the casualty to the hospital
2. Muscle Strains
- Is a sharp pain in the muscle due to overstretching of a muscle which
leads to tearing of various fibres, may be due to sudden exercises.
Signs and Symptoms
- Sudden sharp pain at the site of injury
- Pain spreads outwards, giving stiffness and cramp
- There is swelling
Treatment
- Place him on the most comfortable position
- Apply an ice bag on a cold compress for at least 30 minutes/deep heat
- Support the injured part firmly and gently with a bandage
- Elevate the limb
- If in doubt treat for a fracture
- If pain persist you can consult the physician
- Avoid active exercise until you are free from pain through the normal
range of movement.
3. Muscle Tear
- When the fibres of the muscles tear or cut
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4. Muscle Hernia
This is the protrusion of the abdominal contents through the abdominal
muscular wall under the skin, there is swelling which comes after the
exercise, lifting, or coughing, it occurs most frequently in the groin, navel or
scar of an abdominal operation.
Signs and Symptoms
- Painless swelling which may persist or worsen
- Sudden painful swelling with possible nausea and vomiting
Treatment
- Do not attempt to reduce the swelling
- Reassure the casualty
- If vomiting occurs place him in the recovery position
- Seek medical aid
5. Stitch
This is a sharp piercing pain felt in the abdomen just below the ribs. It
comes as result of cramp (spasm) of the diaphragm, it may be caused by
embarking in an activity immediately after food intake, dehydration or fatigue.
Treatment
- Place the casualty in a state of complete rest
- Gently stretch the affected areas
- Rub it gently to increase the flow of blood
- Give the casualty a few sips of warm salty water
Respiration
- Is the transfer of gases in and out of the body
Asphyxia (hypoxia)
- It occurs when there is no enough supply of oxygen in the body tissue and
therefore accumulation of carbon dioxide in the blood.
- Causes of asphyxia
1. Blocking of the airways and lungs e.g.
- choking
- suffocation e.g. mouth and nose obstruction
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- Strangled
- Chest compressed person buried under sand
- Fits e.g. epilepsy, convulsions
- Lung injured e.g. car accident
2. Insufficient Oxygen
- Smoke filled room
- Air pressure e.g. going up to extreme height in a mountain or air craft
3. Drug overdose-poisoning
4. Injury to the brain or spine
5. Poisoning by carbon dioxide, monoxide in car exhaust fumes
6. Others possible causes: - drowning
- choking
- electrical injuries
- asthma
- winding
- hiccups
Signs and Symptoms
- Breathing is difficult, rate and depth increase
- Breathing is noisy and snoring
- Finger nails and lips becomes blue
- Casualty may be confused
- May become unconscious
- Frothing at the mouth
Treatment
- Remove the causes from the person or the person from the cause
- Open the airway
- Check breathing and pulse
- If the person is not breathing but has a pulse, apply artificial ventilation
- Apply chest compression if there is no pulse
- If breathing place him in the recovery position
- Seek medical help as soon as possible if the conditions worsens
Drowning
This is the inability to control balance while in water normally the patient will have
swallowed a great deal of water and the mouth may be full of mud, or sea weed.
- The lungs will also contain a considerable amount of inhaled water.
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- Drowning is one of the causes of aspyxia (i.e. lack of oxygen in the blood
and the tissues do not receive an adequate supply).
Prevention of drowning
1. Never swim alone, make sure there is somebody who can help
2. Swim at a safe bathing place
3. Beware of unfamiliar areas since they may have hazards
4. Dont swim when tired, or righter after eating.
5. Before diving make sure the water is deep enough
6. Know you own ability and dont overestimate.
Treatment
1. get the person out of water as quickly as possible you can rescue lying
down and extend the hand for him to hold, extend a pole, plank, shirt etc.
2. try to have the head lower than the rest of the body, the water may drain
from respiratory tract
3. If the person is clothed undo the tight clothing around the neck, waist
4. Clear the mouth of any mud, sand and debris
5. Start artificial respiration
6. Wrap the patient with dry blankets
7. Send or transport the patient to the hospital
Blood Circulation Disorders
Oxygen is carried from the lungs in the blood and its pumped through tubes
called arteries, capillaries and veins by the heart.
Fainting
This a brief loss of consciousness caused by lack of enough oxygenated blood
supply to the brain.
Causes
- Standing still for too long or running
- Frightening, bad news, horrifying sight
- Sudden sharp pain
- Lack of food
- Fatigue-long period of sitting in a hot stuffy place
Signs and Symptoms
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- Sudden or gradual unconscious
- Pulse becomes shallow and weak
- Breathing becomes shallow and weak
- Skin becomes pale, cold and damp
- The person may yawn
Treatment
- Make the person lie down preferably under a shade and lift the legs
slightly above the position of the head
- Loosen the tight clothing around the neck, chest, waist so that the blood
may move freely.
- Ensure the casualty has plenty of fresh air e.g. by fanning on his face.
- Check any treat any injury caused by falling
- The person can have sips of water
- Reassure as the person comes around.
Shock
- Is a state of collapse of all the body system due to loss of blood and other
body fluids from the circulatory system, so that no enough oxygen is
carried to the brain and other parts of the body.
Causes
- Immediate sharp pain
- Loosing a lot of blood
- Repeated vomiting or diarrhoea
- Dehydration too much loss of body fluids
- Large burn and severe allergic reactions
- Revealing of good or bad news, horrifying sight
Signs and Symptoms
- casualty may feel weak, faint, frightened, thirsty or sick (may vomit)
- skin becomes pale, cold and damp may have a cold sweat
- casualty may be anxious, mental confusion, weak and may loss
consciousness
- breathing becomes shallow and fast
- pulse rate increases, heart beats more than 80 bts per minute but is
weaker and irregular
- the person may yawn and sigh
Treatment
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- remove him from the site or the cause
- rest him either sitting or lying on the back comfortably
- reassure him by being calm and confident
- keep the person warm cover with a blanket or coat
- loosen any tight clothing
- if the person is thirsty moisten the lips with water (but don t give anything
to eat or drink)
- check the breathing
- check the heart beats apply external chest compression
- remove to hospital immediately
Heart Attack
- This is caused by blocked arteries
Signs and Symptoms
- Sudden and extreme pain in the centre of the post, may spread to the
arms, throat, jaw, to or back.
- Sudden dizziness causing the person to stop and lean on something
- Sweating may develop
- Person may become breathless
- Fast pulse becoming weaker and irregular
- Signs and symptoms of shock
- Casualty may become unconscious
- Breathing and heart beat may stop
Treatment
- Insist the casualty does not move without help
- Loosen tight clothing
- Follow the shock treating procedures
Cardiac Arrest
- When the heart actually stops beating due to extensive coronary
obstruction
Signs and Symptoms
- person becomes unconscious
- no pulse at the neck (carotid pulse)
- breathing and heart beat stop
- skin becomes ashen
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Treatment
- send for help
- apply mouth to mouth ventilation and chest compression
- take to hospital
Stroke
- condition caused by a blood clot cutting of the blood supply (to the brain)
or internal bleeding in the brain.
Signs and Symptoms
- History of high blood pressure
- There is no sign of injury
- Loss of power and sensation in arm or leg and the speech may be slurred
Wounds
- a wound is an abnormal break in the skin or any other body tissue which
lets the blood to escape.
Types of Wound
1. clean cut (incised) - caused by e.g. knife, razer blade.
2. Puncture/gun shot wound the depth is greater than the length it is
caused by a pointed instrument e.g. a nail or a needle and may be deep
injuring other internal organs.
3. Abrasion an injury to the skin caused by scuffing or forceful scraping
(peeling of the skin), the outer part of the skin is lost e.g. thro sliding or
friction.
4. Bruise/contusions an injury to the deeper tissues and the skin is not
broken,
- caused by a blow form a first or a club, falling or being struck with a blunt
object.
- The small blood vessels are broken and blood escapes into these tissues
causing them to swell and become dark in colour.
Signs and Symptoms
- swelling occurs
- discoloration/dark
Treatment
- Bath the bruised part with cold compress (ice) to limit the amount of
blood that escapes into the tissue/thus reducing the amount of
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swelling if extreme, keep the part elevated, - ice bag method
apply polythene bag filled with crushed ice.
5. lacerated wound here the skin and tissues are torn and the edges of the
wound are irregular.
5. Athletes Foot
Athletes foot is a fungus disease that attacks the spaces between the toes.
It is also known as Singapore foot but its official name is tinea.
Causes
- walking bare foot over wet, infected place e.g. bathrooms, toilets etc
- wearing socks of an infected person
Treatment
- frequently wash the feet with soap and water, e.g. two or three times a
day.
- dry the feet thoroughly then sprinkle with fungicide e.g. baby powder
- wear socks with shoes to absorb the sweat and prevent the shoe from
damaging the skin
- when indoors wear sandals so as to give the feet good air circulation and
keep them dry.
6. Blisters
This is a swollen lump on the skin with accumulation of fluids inside and the
top skin is light and after some times it ruptures. This are caused by friction
either because of walking bare foot on a hard ground, wearing tight shoes or
loose shoes.
Complications associated with wounds
a) infections
b) bleeding or haemorrhage
c) shock
d) injury to deeper organs
e) fractures
Treatment of External Wounds
- Wash your hands or put on the gloves
- Clean the wound and the surrounding with running clean water and cotton
wool.
- Dry the wound with sterile cotton wool or you deep it in antiseptic
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- Apply antiseptic and put a dressing and bandage firmly
- Keep the injured part raised if possible.
N/B When bleeding part is raised the blood flow is reduced because:
a) the blood pressure is reduced so only a little blood flows.
b) blood flows away from the bleeding part to a lower part of the body to
gravitational pull.
Major External Bleeding
If the bleeding is very severe try and slow it by:
a) press the sides of the wound gently or direct to flatten the blood vessels in
the area (direct pressure)
b) Lay the casualty down with the head lower than the feet if possible, as
treatment for shock.
c) Keep the injured part in raised position
d) Wipe away foreign particles from the wound, using cotton wool.
e) Apply a sterile clean dressing and cover it with a cotton wool to help
absorb blood and bandage the wound firmly.
f) Immobilize the injured part by a suitable method e.g. a sling for the arm.
Take the casualty to the hospital.
N/B: In case a foreign body is embedded deep in the flesh e.g. an arrow,
piece of glass, wood etc.
a) press the sides of the wound firmly together
b) do not try to remove the body it may injure other parts of the body
c) apply a dressing to the wound
d) put a good layer of cotton wool over the dressing and then apply the ring
pad around the object.
e) Bandage firmly in such a way that you do not apply direct pressure over
the object sticking in the wound.
f) take to the hospital.
Bleeding
Is an escape of blood from the blood vessels, it may be internal or external.
Causes
1. direct injury to the blood vessels e.g. wounds, cuts or surgery
2. disease of blood vessels wall like ulcers (caused by infections)
3. disease of blood itself e.g. haemophilia
4. accidents/crash
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Nose Bleeding
- Escape of blood through the nose.
Causes
1. blowing of nose damaging the blood vessels/picking the nose
2. punch on the nose
3. high blood pressure in the head due to hot atmospheric temperature, the
pressure bursts the blood capillaries.
4. Abrupt of change of temperature or colds
Treatment
- get the person to sit with the head forward
- loosen any tight clothing round the neck and chest
- get the casualty to breath through the mouth and pinch the soft part of the
nose firmly for about 10 minutes.
- dont swallow blood and lift your head
- after it stops do not blow the nose for a hour
- If bleeding starts again seek medical help
Internal Bleeding
- blood escape in the internal blood vessels not immediately seen but
eventually becomes visible e.g. vomiting up a blood, cough up blood,
through ears etc.
Source type of blood vessel involved;
arterial bleeding
- blood bright red in colour, due to presence of oxygen
- spurts from wound coincides with heart beat
- escapes from part of wound nearest the heart
- escapes under greater pressure
Venous/vein
- blood dark red in colour due to small amount of oxygen
- flows in a steady stream and not under greater pressure
- escape from the part of the wound further away from the heart
Capillaries bleeding
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- occur in superficial wounds e.g. in a graze
- blood oozes from the wound
- neither bright nor dark red or colour
- wetly up all over the wound
Signs and Symptoms
- History on medical condition that could cause internal bleeding
- The skin becomes pale and white, cold and clammy to touch
- The pulse become rapid and weak
- Air hunger respirations, the patient sighs and gasp for air
- Patient will look anxious afraid and restless
- He may become unconscious
- Patient complain of thirst due to withdrawal of fluids
- He may become dizzy, blurred vision, mental confusion
- Blood escapes through the body opening
Treatment
a) tell the person not to move
b) reassure the casualty, not to be anxious and afraid
c) if possible raise the legs
d) loosen any tight clothing around thee neck, chest and waist
e) if the person becomes unconscious then place in the recovery position
f) If breathing and heart beat stops apply mouth to mouth ventilation
g) Keep the casualty covered unde the blanket
h) Do not give anything to eat or drink
i) Remove to hospital immediately
Effects of Extreme Temperature/Hot
1. Sun burn
- the sun can cause severe burns
- signs and symptoms
- casualty skin is hot red, tender and swollen with possible blistering
Treatment
- remove the person to the shade and cool the skin by sponging with cold
water
- give the person sips of cold water at frequent intervals
- if blisters do not break them but seek medical help
2. Heat Exhaustion/heat stroke/sun stroke
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- it affect people in hot weather, when the casualty loses too much water and
salt by sweating or due to prolonged exposure to excessive heat or sun in a
situation where circulation of air is inadequate.
Signs and symptoms
- Sudden loss of consciousness
- Very high fever
- Absence of sweating
- If unfavourable coma, convulsion and death
- Weakness
- Headache, dizziness, nausea
- Pain in the vicinity of the heart
- Skin becomes dry and hot
- Body temperature rises to 40.6 c or higher
Treatment
- Lower temp
- Fanning
- Remove the tight clothing
- Lay him down in a cool place
- Fan the casualty for coolness and fresh air
- Give him some water
Extreme Cold
Frost bite
- occurs when the extremities of the body such as ears, nose, chin, hands and
get very cold, freeze the skin and other body issue.
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