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MANAGEMENT OF JOINT AND MUSCLE INJURIES
ENVIRONMENTAL INJURIES

Hospital Corpsman Revised Edition - Complete Navy Nursing manual for hospital training purposes
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dislocations (such as those of the jaw, finger, or shoulder) if there is no arterial or nerve involvement (pulse will be palpable and there will be no numbness below the joint). Treat all other dislocations as fractures, and evacuate the victim to a definitive care facility. DISLOCATION OF THE JAW.—When the lower jaw is dislocated, the victim cannot speak or close the mouth. Dislocation of the jaw is usually caused by a blow to the mouth; sometimes it is caused by yawning or laughing. This type of dislocation is not always easy to reduce, and there is considerable danger that the operator’s thumbs will be bitten in the process. For your own protection, wrap your thumbs with a handkerchief or bandage. While facing the victim, press your thumbs down just behind the last lower molars and, at the same time, lift the chin up with your fingers. The jaw should snap into place at once. You will have to remove your thumbs quickly to avoid being bitten. No further treatment is required, but you should warn the victim to keep the mouth closed as much as possible during the next few hours. Figure 4-45 shows the position you must assume to reduce a dislocated jaw. DISLOCATION OF THE FINGER.—The joints of the finger are particularly susceptible to injury, and even minor injuries may result in prolonged loss of function. Great care must be used in treating any injury of the finger. To reduce a dislocation of the finger, grasp the finger firmly and apply a steady pull in the same line as the deformity. If it does not slip into position, try it again, but if it does not go into position on the third attempt, DO NOT TRY AGAIN. In any case, and whether or not the dislocation is reduced, the finger should be strapped, slightly flexed, with an aluminum splint or with a roller gauze bandage over a tongue blade. Figure 4-46 shows how a dislocated finger can be immobilized by strapping it to a flat, wooden stick, such as a tongue depressor. DISLOCATION OF THE SHOULDER.— Before reduction, place the victim in a supine position. After putting the heel of your foot in the victim’s armpit, grasp the wrist and apply steady traction by pulling gently and increasing resistance gradually. Pull the arm in the same line as it is found. After several minutes of steady pull, flex the victim’s elbow slightly. Grasp the arm below the elbow, apply traction from the point of the elbow, and gently rotate the arm into the external or outward position. If three reduction attempts fail, carry the forearm across the chest and apply a sling and swathe. An alternate method involves having the patient lie face down on an examining table with the injured arm hanging over the side. Apply prolonged, firm, gentle traction at the wrist with gentle external rotation. A water bucket with a padded handle placed in the crook of the patient’s elbow may be substituted. Gradually add sand or water to the bucket to increase traction. Grasping the wrist and using the elbow as a pivot point, gently rotate the arm into the external position. Sprains Sprains are injuries to the ligaments and soft tissues that support a joint. A sprain is caused by the violent wrenching or twisting of the joint beyond its normal limits of movement and usually involves a momentary dislocation, with the bone slipping back into place of its own accord. Although any joint may 4-55 Figure 4-45.—Position for reducing a dislocated jaw. Figure 4-46.—Immobilizing a dislocated finger.







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