A cut to the eye
The eye can be cut by the entry of a sharp fragment of glass, metal or grit. If the eye is cut, or there is anything embedded in it, do not touch it.

First aid procedure:
1. Get the casualty to lie down on his or her back and close both eyes as movement in the undamaged eye will also affect the injured one. It is very important that the casualty keeps it still, so as to avoid any further damage.
2. Gently cover the eye with an eye pad, a handkerchief or an unmedicated dressing. Secure it lightly with a bandage.
3. It is advisable to bandage both eyes again, because the two eyes move together in unison, so as to prevent any movement. Explain why you are doing this to the casualty and offer reassurance.
4. Take offer send dial 000 the casualty to hospital lying flat.

A blow to the eye
A blow to the eye may cause bleeding behind the cornea. Blood may then be visible in the iris the coloured part around the pupil. In this case the injury may be serious. Do not delay: place a loosely bound dressing over the eye and then dial 000 for medical help immediately.

However, bleeding in the white of the eye is not necessarily serious, although you should still see your doctor. It occurs quite commonly and may have no obvious cause.

A black eye
An injury to the soft tissues in and around the eye socket or to the eyelid, can cause a bruise that swells and discolours dramatically, known as a black eye. Both swelling and discoloration are a result of bleeding under the skin.

First aid procedure:
1. Apply a clean, cold, wet cloth to the area for 10 minutes.
2. Reduce the swelling by placing a cloth-covered plastic bag filled with ice against the eye. A pack of frozen peas is suitable.
3. If the swelling is so large that the casualty is not able to see, cover the eye with a dressing.
4. If any disturbance of vision follows a blow to the eye, seek medical aid.

A foreign body in the eye
A speak of dust or grit or a loose eyelash are the most common foreign bodies to enter the eye. They can be very irritating and, if lodged under an eyelid, may cause inflammation, watering, blurred vision, and considerable pain.

A foreign body on the white of the eye should not be difficult to remove. However, do not attempt to remove anything on the coloured part of the eye the iris or the pupil or embedded in the eye but seek immediate medical aid instead.

First aid procedure:
1. Ask the casualty not to rub the eye. Advise him for her to blink rapidly a few times instead.
2. If this does not work, ask the casualty to sit down, facing the light. Stand behind the casualty and ask him or her to lean back. Then, holding the chin with one hand and using the index finger and thumb of the other hand, open the affected eye. Ask the casualty to look in each direction in turn up, down, left and right so enabling you to examine every part of the eye.
3. If you can see the foreign body, try to flood it out with clean preferably sterile water using a glass or an eye irrigator. Failing that, use a jug of tap water or place the casualty’s head under a running tap. Incline the casualty’s head away from the sound eye, so that the water drains away over the cheek.
4. If this does not work, ask the casualty to look up. Pull down the lower lid and, if you can see the offending object, remove it gently with the rolled, damp corner of a clean handkerchief or tissue, or with a moistened swab.
5. If none of this works, cover the affected area with an eye pad and seek medical aid.

A chemical in the eye
A corrosive chemical that enters the eye, whether liquid or solid, can damage the surface of the eye and may cause scarring and even dlindness. It is important to wash it out as quickly as possible.

First aid procedure:
1. Tilt the head so that the injured eye is downward. This prevents the chemical running into the unaffected parts of the eye.
2. Keep the eye open gently with your fingers and rinse out the eye with cold running water.
3. Continue rinsing the eye for 10-15 minutes. It may well take that long before the chemical is thoroughly washed out.
4. Close the eye, cover it with a clean, dry pad, and seek medical aid at once.

Flash burns to the eye
Prolonged exposure to glare from a bright surface, such as snow or water, or from ultra-violet light, or a welding torch, can damage the surface of the eye. Symptoms, such as pain, sensitivity to light, redness and watering, may not appear for some time.

First aid procedure:
1. Reassure the casualty and then cover both eyes with sterile eye pads.
2. Take or send dial 000 the casualty to hospital.

How can I avoid eye injury?

• Always wear protective goggles if you are working with high speed machinery including garden strimmers or spraying chemicals into the air.
• If you wear spectacles, use plastic lenses if you participate in any sport.
• Be sure never to direct any sharp or pointed object towards the eye.

Slight bleeding
Slight bleeding from a minor cut, scratch or abrasion usually stops spontaneously within a few minutes as the blood clots over the wound. You may need to press on the wound to help stop the bleeding. However, it is important to clean and cover the wound to prevent germs from entering and causing an infection.

First aid for slight bleeding
Clean your hands first and then carefully removed any visible loose glass, metal, gravel and so on, from the wound. Rinse the wound under running water, if possible, and gently clean the area with soap and water or an antiseptic wipe. Always work from the wound outwards.

If blood clots have formed, make sure you do not disturb them when you clean as this may cause the wound to bleed again. Dab the area dry and if the wound is small, cover with a plaster. For larger wounds, cover with a sterile pad and bandage.

Severe bleeding
If blood spurts from a wound or flows so heavily that is does not clot, apply direct pressure by pressing a bandage over the wound for several minutes. If the blood still does not clot, this is considered to be severe bleeding and should recieve urgent medical attention. While waiting for medical help, continue trying to stop the flow of blood with continued firm pressure on a pad or dressing.

First aid for severe bleeding
1. Lie the casualty down, with the head slightly down and the legs up, to prevent fainting.
2. If bleeding is from a limb, try to raise the injured part of the body. This will reduce the flow of blood to it.
3. Place a clean cloth over the wound and firmly apply pressure.
4. If the wound gapes, hold its edges firmly together.
5. Maintain the pressure by bandaging a pad tightly over the wound.
6. Do not remove the blood-soaked bandage, but apply another cloth or pad over the top and bandage tightly.
7. Apply an ice pack to the area to constrict the blood vessels and lessen the supply of blood to the wound.
8. Try to keep the casualty calm while you wait for medical help, or take him or her to the nearest hospital accident and emergency department as quickly as possible.

Severe bleeding and embedded objects
Do not apply direct pressure on the wound if there is an object firmly embedded in it. Instead:
1. Apply pressure immediately above and below the area of the wound.
2. Do not probe to remove the embedded object; it may be helping to ‘plug’ the wound and stem the flow of blood.
3. Lie the casualty down and raise the injured part of the body, if possible.
4. Loosely drape a gauze cloth over the wound and the embedded object.
5. Carefully build up pads of cotton wool around the object until they are at least the same height as the object.
6. Secure edges of padding with a bandage – but take care not to place the bandage over the object.

Bleeding from head injuries
Head injuries usually bleed profusely. For superficial wounds, apply steady pressure with a clean cloth or pad. For severe wounds, tie a clean pad tightly to the wound, but do not press as you risk pushing a foreign body or fragment of broken bone into the brain. Call an ambulance or take the casualty to hospital immediately.

Bleeding from abdominal injuries
An abdominal wound is a serious injury and the casualty should be taken to hospital as quickly as possible after first aid. If no organs are visible, control the bleeding with a pad. If organs are visible, cover the wound lightly with a moist dressing. Do not touch or attempt to reposition the organs.

MINOR  WOUNDS
1. Carefully remove any visible loose objects from the wound.
2. Rinse under running water.
3. Clean carefully, taking care to wipe away from the wound.
4. If the wound is small, cover it with a plaster. For bigger wounds, cover with a pad and use a bandage to secure it.

SIGNS OF SEVERE BLOOD LOSS
Urgent medical help is essential for severe blood loss. Signs include:
*Pale or bluish skin, particularly on the lips, ears, nose and nail beds.
*A weak pulse, which may also be more rapid.

SEVERE WOUNDS
1. Raise the injured limb and press a clean pad over the site of the wound, applying a firm pressure to stem the flow of blood.
2. Maintain the pressure by bandaging the pad tightly over the wound, but not over a foreign body.
3. Call an ambulance to take the casualty to hospital.

Muscle injuries caused in this way through tissue damage are common. More rarely, a muscle may be so badly injured that it is ruptured – that is, torn right through.

What causes muscle injuries?
A muscle injury is the result of a muscle being overstretched. This happens easily through a sudden movement, reaching too far, lifting something that is soo heavy, or sometimes even through laughing or sneezing violently-particularly when someone is either unfit, tense or cold. It is in order to minimize the risk of muscle injuries that athletes, sportsmen and women and dancers warm up before they go into action.

Muscle injuries are referred to as pulls, tears or strains and usually no really clear distinction is made between these different terms. People are frequently confused about the difference between a strain and a sprain. In fact, strains are muscle or tendon injuries, in which only a few fibres are torn, whereas sprains are injuries to the ligaments which bind the joints together. Both types of injury can be caused in the same way – by sudden movements, falls or unaccustomed exercise.

How are muscle injuries diagnosed and treated?
These injuries cause pain and restricted movement, and you will usually be aware of them when they occur. There will be pain or stiffness on moving, possibly with swelling or tenderness in the area of the injured muscle. An x-ray may be needed to establish that a fracture is not responsible for any of these symptoms.

In many cases the muscle will heal without medical attention, although in some cases the injury may be so painful at first that painkillers are needed. Muscle-relaxant drugs and the support of a bandage can help.

What can I do myself?
In the early stages, rest the affected area and apply a cold compress or ice pack a pack of frozen peas is an ideal substitude to reduce swelling and soothe pain. If the pain is severe, take some painkillers-aspirin or ibuprofen are the most effective – in the recommended dose. If possible, give the injury the support of a crepe bandage, but do not apply this too tightly or the circulation may be impaired.

Try not to use the effected muscle for at least two days or until any swelling has gone down. Muscle injuries heal with some scarring of the damaged fibres, which cause muscles to shorten in length. For this reason, it is very important to do gentle stretching exercises before returning to anything more vigorous.

When should I see my doctor?
Most muscle injuries heal on their own quite quickly and it is usually not necessary to see your doctor. However, if the pain or swelling is very severe, or if the symptoms do not begin to clear up after a few days and cause you concern, see your doctor.

What will the doctor do?
The doctor will examine the injury and check on your range of movements. A stronger painkiller or muscle relaxant drug may be prescribed and you may be advised to support the injury with a bandage, a sling for an arm injury or crutches for a leg injury. This will allow you to rest the damaged muscle while it heals. In some cases it may be put in a plaster cast for a few weeks.

Your doctor may refer you for physiotherapy to help build up the strength in an injured muscle that has been solw to heal, and to show you how to do the correct stretching exercises after an injury has healted. In the rare cases where a muscle has been ruptured, surgery may be necessary to enable the damaged muscle to heal properly.

Are muscle injuries dangerous?
Muscle injuries are not usually dangerous. A ruptured muscle may not heal properly without surgery and this will impair its use.

As people grow older their muscle take longer to heal, but by following the procedures recommended below, or by seeking medical help in more severe cases, complete recovery can be achieved.

What can I do to avoid muscle injuries?
Regular exercise keeps muscles strong and in good tone. Running, swimming and cycling are all effective. When exercising, warm up beforehand. When lifting heavy objects, bend your knees, not your back, and get help with heavy jobs.

SYMPTOMS

• Stiffness and difficulty when trying to make certain movements.
• Tenderness and swelling at the site of the injury.
• Local pain.

ALTERNATIVE  TREATMENT

• Many people find treatment by a qualified osteopath very successful for muscle injuries that are not responding to home treatment.
• Cold compresses help to reduce swelling. Heat, such as a hot bath ar an infra-red lamp, can help to relieve painful muscle spasm, but it should not be applied to the injured area for the first 48 hours.
• Herbalists recommend applying arnica ointment to the injury.

• A road accident
• A fall, particularly in a person who is elderly, unwell or drunk.
• A sports accident
• Dangerous occupations, such as mining or construction work.
• Illegal fighting.

There are 3 types of commonly known and potentially dangerous head injuries:

1. Concussion / Blows
Concussion is unconsciousness, however brief, that results from a head injury such as:

• A blow on the head.
• A blow to the jaw.
• A fall on to the feet from a height, which causes the brain to the shaken within the skull.

The loss of consciousness, may be so brief that even the casualty may not be aware of it.

When the casualty regains consciousness, he or she may feel nauseous and may not be able to remember what happend just before or just after the incident. If the casualty remains unconscious, you should suspect compression see below.

The Symptoms for Concussions include:

• Blurred vision.
• Dizziness.
• Unsteadiness.
• Difficulty in concentrating.
• Nausea and vomiting.
• Headaches.

First Aid Guide for Concussion

1. For a casualty who swiftly regains consciousness, watch for any deterioration in the level of response, even after apparent recovery. Check breathing and pulse.
2. Ensure that the casualty remains in the care of a responsible person after the causative incident.
3. Advice the casualty to see his or her doctor.
4. Someone injured while playing sport should not be allowed to continue without medical approval.
5. If the casualty remains unconscious after three minutes, place in the recovery position and ask for an ambulance. Monitor essential signs.

2. Skull Fracture
If a blow to the lead is violent enough to cause an obvious sclap wound or bruising, it may have caused a skull fracture. In areas where the skull is very thin, for example in children and some adults, a fracture may have occurred, even though there may be little evidence of external damage. Common sites of a skull fracture are at the crown and the base of the skull. The signs of a fractured skull may include:

• A sclap wound.
• Loss of consciousness or a temporary, fluctuating consciousness.
• Blood, or a clear, watery cerebro-spinal fluid coming from the nose or ear.
• Bloodshot or black eye following a head injury.

First Aid Guide for a Skull Fracture

1. If the casualty is unconscious, check breathing and pulse and place them in the recovery position.
2. Help a conscoius casualty lie down, with head and shoulders raised and supported. If there is discharge from an ear , cover with a sterile dressing. If you suspect a spinal injury, treat appropriately.
3. Control any bleeding from the scalp. Look for and treat other injuries.
4. Dial the emergency number for an ambulance. Check breathing, pulse rate and level of response at intervals.

3. Compression
Compression is a very serious condition that usually requires surgery. It occurs when pressure is exerted on the brain by a buildup of blood within the skull, by swelling, or by a bony fragment if there is a skull fracture.

It can follow concussion or a skull fracture and may develop immediately or up to several days after the casualty appears to have recovered from the incident. It may also be due to a number of other causes, such as a stroke, infection or tumour.

The Symptoms of Compression include:

• Noisy breathing.
• A rinse in temperature.
• A slow pulse.
• Unequal dilation of the pupils of the eye.
• Weakness or paralysis which occurs on one side of the body.
• Intense headache.

First Aid Guide for Compression
If you suspect that a casualty may be suffering from compression, you should arrange for urgent medical attention. Depends on where you are, reach for a phone and dial your local emergency number and ask for an ambulance. Check breathing and pulse, and be prepared to resuscicate. Examine for an injury or bleeding and treat as required. Place the injured person in the recovery position.

OTHER USEFUL INFORMATION:

How can  we examine the skull?
Run your hands over the scalp to identify any swelling, bleeding, or area of soft indentation that may indicate a fracture. Always handle the head and neck carefully, recalling the consequences of spinal cord damage.

Do not attempt to drag or pull a  casualty by holding his body parts because the person could be hurt or injured in different parts of his body. Always get professional help or someone with First Aid knowledge when dealing with an injured person.

• Simple and hairline
  Fractures occur when the bone breaks but does not protrude or damage skin and surrounding tissue.
• In open or compound
  Fractures, there is a wound leading to the site of the fracture. Bone may protrude from the wound.

Sub-categories of fracture include comminuted, where the bone is shattered into pieces, and impacted, in which one bone is pressed into another.

Neck and spine fractures are particularly serious because of the risk of permanent paralysis due to spinal cord damage.

First Aid Guide for Fractures
Procedures to follow:
1. Check for vital signs pulse and breathing. If these are absent, begin cardio-pulmonary resuscitation CPR and call an ambulance or doctor.

2. Watch for signs of shock weakness; cold, clammy skin; rapid, shallow breathing; faint pulse; nausea and possible vomiting; fainting or loss of consciousness. Keep the casually lying down, warm and calm until medical help arrives.

3. Place a clean cloth or hand if a cloth is not available over the wound and apply gentle pressure. If any bone is protruding, build up pads of material around the bone until you can bandage over the top of the wound.

4. Do not move the casualty. If you must, to avoid further injury, make sure the injured part is immobilized. This is especially important if you suspect a fracture of the spine.

5. Do not give food or fluids because this could cause a delay in giving a general anaesthetic.

6. Do not let the casualty attempt to ‘try out’ an arm, leg or other suspected broken bone until the casualty has been examined by a doctor.

Supporting a fracture
If a broken arm or leg is suspected,the limb should be immobilized to help pervent further injury; and also to help relieve pain.

If an ambulance is likely to arrive within 30 minutes, the casualty can be immobilized using pillows to bolster the injury. In the case of lower limb injuries, if removal to hospital is likely to be delayed by more than 30 minutes, a splint should be used.

The injured part can be steadied with your hands until a more secure from of support is provided.

Upper limb injuries, in which the elbow can be bent, may be supported with a sling. If the casualty is capable of holding the broken arm across the chest, ask them to do so. Place soft padding over the arm, and hold the arm in place with a sling.

If the arm cannot be bent, place soft padding between the injured arm and the body, and then secure the limb with three broad bandages, one around the upper wrist and hips, one around the forearm and trunk, and one around the upper arm and upper trunk.

For lower limb injuries, place padding material such as clothing, a sheet or a blanket between the two limbs, and use bandages to secure the injured leg to the uninjured leg.

If a fractured leg is bent or angled so that you cannot immobilize it you may need to apply traction by pulling steadily in the line of the bone. Stop applying traction if it is causing intolerable pain.

Slings and bandages should be tied snugly but not so tight as to constrict blood flow. Check the fingers or toes of the injured limb every 10 minutes to ensure that the circulation is not being cut off.

First aid for neck and spinal fractures
Any accident that places excessive force or pressure on the neck or back can result in fracture. An injury to the spinal cord in the neck can result in total paralysis from the point of injury down. If the injury takes place in the lower back, the arms and upper body will retain movement but the lower part of the body will not.

If you suspect a neck or spinal injury follow these procedures:
1. Check for vital signs pulse and breathing. If they are absent, begin CPR.
2. Call for an ambulance or emergency doctor.
3. Do not move the casualty until the neck and back are immobilized. Even if the person is in a painful or awkward position, keep the casualty still until help from someone experienced in moving accident victims is available. See box below.
4. To stabilize the head and neck in the position in which the person is lying, slide a rolled pad under the neck and then place stabilizting objects like pads or books at the top and sides of the head to keep it from moving.

A casualty may be anxious to test whether he she can move. Reassure the person but do not let them move. If necessary, have several people restrain the casualty until help arrives.

SYMPTOMS
These might include:

• Swelling.
• Pain and tenderness.
• Deformity or misalignment of the injured part.
• Inability to use the injured part.
• Protrusion of bone through the skin.

IMPORTANT
Apply gentle traction as you straighten a limb. If this is painful, stop at once.

If a ‘sprain’ is swollen and painful for several days, see a doctor. Often, fractures can be detected only by x-ray.

WARNING
Do not attempt to move an accident victim with a suspected broken bone unless it is absolutely necessary. If the person must be moved to avoid further serious injury: for example, from a burning building or car, quickly immobilize the limb and get the victim onto a firm object that can serve as a stretcher. Or you can place him or her on a blanket and carefully drag the blanket, but not the person.