The
part of the body that could be extremely injured in sport is the
musculoskeletal system. When these injuries occur the tissues respond in ways
that may damage not only the tissue involved in the injury but also the
surrounding tissues. The tissues do this by bleeding and swelling. Therefore,
every first aid effort should be directed toward achieving this primary goal to
reduce bleeding and welling, and inflammation that results from the injury
which affect the surrounding tissues. We are going understand the best ways to
use the skills achieve the primary goal of first aid.
Immediate Care of Sports Injury (The
PRICE Principle)
In
the past, first aid providers have focused much attention on RICE or ICER as
principles for best immediate care of sports injuries. However, this important
principle seemed to have been ignored. That principle is the protection
principle. Adding protection to RICE, it will give the PRICE principle. The best
way to achieve the goal of first aid is to apply the PRICE principle.
However,
PRICE only expanded the reagent by adding P, for protection. Let us now discuss
PRICE – Protection; Rest; Ice; Compression and Elevation.
1. Protection
We had discussed that protection is the first thing a first aid provider does to an injured player or athlete. This involves preventing the athlete from moving and at the same time keeping other athletes and hazard away from the injured athlete.
2. Rest
Rest
is the next component of the principle. It means immobilizing the injured part
of the body by splinting or preventing weight bearing with crutches. This is a
very important part of any treatment. It involves resting the athlete from any
activity that can cause more pain. The athlete is not allowed to return to
active play until he has been cleared by the medical team. Though the amount of
time needed for rest may not be the same for all injuries, body parts that
incur minor injuries need approximately seventy two (72) hours of rest before
rehabilitation, (Prentice, 2006).
Figure
1 illustrates RICE principle after the athlete has been protected.
3. Ice
This
is cold application or therapeutic use of cold called cryotherapy. Application
of ice in the first 72 hours after an injury helps to reduce pain and control
swelling. Therefore, ice should be used for most conditions involving strains,
sprains and contusions.
Ice
treatment comes in different forms. We have ice bag, ice message, frozen gel
pack, gel cold pack, ice whirl pool, chemical cold pack, and ice water pucket.
No matter the type of ice used, a good rule of thumb is to apply a cold pack to
a recent injury for a twenty minute (20 minute) period and repeat every one to
two (1-2) hours throughout a waking day. Number of days you apply the cold
depends on the severity of the injury and site. All cold applications will
produce the following responses – cold, pins and needles, dull aching and
numbness sensations. So, if the athlete manifests these reactions, do not
panic, as they are normal and should be expected.
However,
there are some conditions that will make you avoid ice application. They are
called contraindications.
Contraindications to Cold Application
Application
of ice may be harmful in some situations. The following are some reasons to
avoid ice application.
•
If the athlete lacks feeling in the injured area, do not apply ice;
•
If he is allergic to cold, do not apply ice;
•
Do not apply ice in combination with a tight compression wrap;
•
Do not apply ice directly over an open wound;
• Do not apply ice directly over the ulnar nerve. This nerve is located at the medial distal end of the humerus, close to the elbow.
Caution:
Do not apply ice directly over the personnel nerve at the lateral proximal end
of the tibia, close to the knee. The ulnar and peroneal nerves are superficial
nerves.
What
if you live or work in an area where you have no access to the exotic cold
packs, does that mean you should use cold application to help injured persons?
No! The absence of exotic cold packs need not deter you from cold application.
You can produce your own ice as a first aid provider, crush it and put it in a
clean plastic bag you have in your first aid box. There is a consensus among
experts this is the most effective way of applying cold to the body. This form
of ice is relative cheap. You can also purchase it and put in a cooler before
game and practice session.
4. Compression
Compression of an acute injury is as important as ice and
elevation, but in some cases even more important. Compression places external
pressure on an injury thereby, mechanically reducing bleeding and swelling. It
is best achieved by using a commercially available elastic wrap which come in
different sizes we mentioned other varieties of bandages that can be used for
compression.
It is best you place the ice pack directly against the skin with
the elastic wrap or bandage over the pack securing it. Wrap in a closed spiral
fashion, starting from the lower end of the limb to the upward end.
The wrap forming the compression should not be extremely tight, so
as to allow circulation. You should be able to slip two fingers under the warp
when secured or anchored. Regularly check the fingers and toes to make sure
there is good circulation.
The compression material can also be used to apply cold treatment,
for instance, you can soak the elastic wrap in water and freeze it in a
refrigerator. This can provide both compression and cold when applied to an
acute injury, (Prentice, 2006). The compression may cause some pain even when
properly secured. However, learning that leaving it in place
is more beneficial will make you to leave it is place. The compression is very
important in controlling bleeding. So, if it is hastily removed because of the
pain experienced by the athlete, he may suffer more dangerous consequences. The
compression wrap should be left in place for at least 72 hour following acute
injury, (Prentice, 2006).
5. Elevation
This is the last in the PRICE principle or reagent but in no way the
least. However, it is a very simple procedure and self-explanatory. It involves
raising the injured part of the body. When used in combination with ice (cold)
and compression, elevation reduces internal bleeding. It helps the veins to
drain blood and other body fluids away from the site of injury, and returns
them to the body’s circulatory system. It also helps to stop swelling.
Therefore, elevate the injured part above the heart as much as possible for the
first 72 hours after acute injury. The greater the degree of elevation, the
more effective the reduction in swelling. When elevating an injured lower
extremity, make sure that the adjacent joints are well supported with padding
or pillows. For example, in an ankle sprain, the leg should be placed so that
the ankle is virtually straight up in the air with the knee supported.
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