injured shoulder is lower than the uninjured one.
Usually the victim is unable to raise his arm above the
level of his shoulder. The injured person may attempt to
support the injured shoulder by holding the elbow of that
side in his other hand; that is, in fact, a characteristic
position assumed by a person with a broken collarbone.
Since the collarbone lies near the surface of the skin, you
may be able to detect the point of fracture by the
deformity and localized pain and tenderness.
TREATMENT. When the fracture is open, stop the
flow of blood and treat the wound before attempting to
treat the fracture. You must bend the victim's arm on his
injured side and place his forearm across the chest. The
palm of his hand should be turned in, with the thumb
pointing up. His hand should be raised about 4 inches
above the level of his elbow. Support his forearm in this
Figure 10-53.--Swathe bandaging of fractured rib victim.
position by means of a wide sling.
Next, use a wide roller bandage (or any wide strip
strips of bandage to secure the arm to his chest. Wide
of cloth) to fasten the victim's arm to his body. Wrap the
strips of adhesive plaster applied directly to the skin of
bandage several times around his body, and ensure it
his chest for immobilization should not be used, since
goes down over the hand so the arm is held close against
the adhesive tends to limit the ability of his chest to
his body.
expand and thus interferes with proper breathing.
Treat the victim for shock and obtain medical care
Treat the victim for shock, and obtain medical care
as soon as possible.
as soon as possible.
FRACTURE OF THE RIB
FRACTURE OF THE NOSE
A fracture of the nose usually causes localized pain
When the ribs are broken, the victim should be kept
and swelling, a noticeable deformity of the nose, and
comfortable and quiet so the greatest dangerthe
extensive nosebleed.
possibility of further damage to the lungs, heart, or chest
wall by the broken ends-is minimized.
TREATMENT. First, stop the nosebleed. Have the
victim sit quietly, with his head tipped slightly
The common finding in all victims with fractured
backward. Instruct the patient to breathe through his
ribs is pain localized at the fracture site. By asking the
mouth, not his nose. If the bleeding does not stop within
patient to point out the exact area of pain, you can often
a few minutes, apply a cold compressor ice bag over his
determine the location of the injury. There mayor may
nose.
not be a rib deformity or chest wall contusion or
laceration of the area. Deep breathing, coughing, or
Treat the victim for shock and obtain medical care
movement is usually painful. The patient generally
as soon as possible. A permanent deformity of the nose
wishes to remain still and may often lean toward the
may result if the fracture is not treated promptly.
injured side, with one hand over the fractured area to
immobilize the chest and to ease his pain.
FRACTURE OF THE JAW
A person with a fractured jaw may suffer serious
bound, strapped, or taped when the victim is reasonably
comfortable; however, they may be splinted by the use
great difficulty in talking, chewing, or swallowing. Any
of external support. If the patient is considerably more
movement of the jaw causes pain. The teeth maybe out
comfortable with his chest immobilized, the best
of line, and there may be bleeding from the gums.
method is to use a swathe bandage (fig. 10-53) in which
Considerable swelling may develop.
the arm on his injured side is strapped to his chest with
the palm flat, the thumb up, and with the forearm raised
TREATMENT. One of the most important phases
to a 45-degree angle. Immobilize his chest, using wide
of emergency care is to clear the upper respiratory
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