When two bones that form a joint come out of their place, it is called a dislocation. Symptoms of this trauma are intense pain, inability to move and deformity of the joint. It is an injury that can affect almost any joint, including the elbows, shoulders, knees, ankles and hips, but there have been cases of dislocation even in the knuckles of the hands and feet. It is considered an injury that requires urgent intervention, but you can learn to manage it as long as the victim has no access to medical care.
Steps
Part 1 of 2: Initial Dislocation Assessment
Step 1. Cover the joint with sterile tissue
It is important to prevent infections, especially if there are skin wounds at the site of the dislocation.
- Wait for help to arrive before attempting to wash or "clean" the wound (if there is a wound or other skin lesion). If you try to perform this wash without the proper sterile equipment and without professional preparation, you can increase the risk of infection instead of reducing it.
- For now, covering the lesion is sufficient to limit the chances of it becoming infected.
Step 2. Immobilize the joint
If there is an open wound, you should use non-stick gauze. Remember that it is very important not to try to reposition or realign the joint in any way; you could cause further damage and it is better to just lock the limb in the position it is in, waiting for the specialized medical staff to arrive who will be able to handle the situation better.
- Be sure to immobilize the limb both upstream and downstream of the dislocated joint to ensure maximum stability.
- If it is a shoulder, you can use a shoulder strap to immobilize it; you can also make your own by tying a long piece of fabric into a ring shape. Make sure the shoulder strap holds the limb firmly against the body. Instead of wrapping the bandage around your neck, wrap it around your torso first and then secure it at the nape of your neck.
- If you need to treat another joint, such as the knee or elbow, a splint is your best bet. You can make it with sticks or any other rigid object and use duct tape or strips of fabric to hold it in place.
Step 3. Check the limb
This way you make sure that it does not lose tactile sensitivity, that it does not alter the temperature or that it does not slow the arterial pulse. These signs indicate an obstruction in blood flow or damage to the nerves that control the limb. If so, you need to seek medical help immediately.
Check the heartbeat in the limb, at the point furthest from the center of the body - this means that you need to feel the pulse, if the dislocation affects the shoulder or arm and the back of the foot or behind the ankle, if the injury has affected a leg
Step 4. Do not offer the victim food while treating the dislocation
Doctors usually prefer to work on a patient on an empty stomach, especially if surgery is required.
Step 5. Know when to seek immediate medical help
If the patient shows the signs or symptoms described below, call 911 immediately as this could be an emergency:
- Severe bleeding;
- Other traumatic injuries;
- Possible injury to the head, neck or spine (do not move the victim if you fear possible damage to the neck or spine, as moving could make the situation worse);
- Loss of tactile sensation in the joint or extremities (fingers and toes)
- Always call for help immediately, even if none of the conditions listed above occur. While these are troubling and urgent symptoms, all dislocations are major trauma, requiring professional evaluation and medical attention. If possible, take the person to the nearest emergency room; if you can't do it, call 118.
Part 2 of 2: Treating the Symptoms of a Dislocation
Step 1. Relieve pain by applying a cold compress to the joint
By doing this, you reduce the swelling that increases the pain. Be careful not to place the ice or the compress directly on the skin, as this could damage it; always wrap the ice pack in a cloth.
Keep the compress in place for no more than 10-20 minutes at a time
Step 2. Offer the patient ibuprofen (Brufen) or acetaminophen (Tachipirina) if the pain is very severe
Follow the instructions on the leaflet regarding the dosage. Both of these drugs are available in pharmacies without a prescription.
Step 3. Prepare the victim for what will happen next
Once in the hospital, she will undergo a joint realignment. This procedure is called "reduction" and often requires partial sedation of the patient, as it is quite painful (however, in the long term it reduces pain and accelerates recovery).
- The orthopedist will immobilize the joint for several weeks. He will make sure to lock the limb in the correct position after reduction and at this point the body will proceed to the natural healing process.
- Under certain circumstances, a surgical operation is required when reduction is not achievable manually. In this case, the joint will be immobilized at the end of the surgery.
Step 4. Begin the rehabilitation process to be able to use the joint again
Several weeks of physiotherapy are required to help the patient regain range of motion in the injured area. This therapy helps strengthen the surrounding muscles to avoid the risk of relapse.
