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 Emergency & First Aid: First Aid for Dislocations 
 
A dislocation is a separation of the end of a bone and the joint it meets. Bones that touch in the joints sometimes separate when they are overstressed.

Injuries related to dislocations include damage to the membrane lining the joint as well as tears to nearby muscles and ligaments.

Causes of dislocations include:

  • Injuries from contact sports
  • Rheumatoid arthritis
  • Inborn joint defects
  • Joints weakened by previous injury
  • Suddenly jerking a toddler's hand or arm. (Force applied in the wrong direction can snap the ball of the upper arm bone out of the shoulder socket.)

The shoulders are especially prone to dislocation injuries. Fingers, hips, ankles, elbows, jaws and even the spine can be dislocated as well. A dislocated vertebrae in the spine often damages the spinal cord and can paralyze body parts lower than the injury site.

Signs and Symptoms

A dislocated joint is:

  • Misshapen
  • Very painful
  • Swollen
  • Discolored

Sometimes it is hard to tell a dislocation from a broken bone. It is best to seek medical attention if you suspect a dislocation. It is unwise to try to put a dislocated bone back into its socket.

When treated professionally, you can expect the dislocated joint to function within 24 to 48 hours. Activity may need to be limited for the next four to six weeks, though, to give the injury enough time to heal.

Prevention

  • Protect a previously injured joint by wrapping it with an elastic bandage or tape.
  • Wear protective pads (shoulder, wrist, knee, etc.) when taking part in contact sports or in other activities in which you may fall or otherwise get injured.

Questions to Ask

Is there an injury to the neck or spine?Yes: Seek CareGive First Aid
No
Get Emergency Care and give first aid before emergency care. (See "Neck & Spine Injuries").
Is there severe bleeding around the injury?Yes: Seek CareGive First Aid
No
Get Emergency Care and do first aid before emergency care. (See "Cuts, Scrapes and Punctures".) Also:
  • Do not give the injured person anything to eat or drink until after he or she has been treated. If the dislocated joint has to be repositioned, the person may have to be given anesthesia.
  • Monitor for signs of shock. (See "Shock".)
  • Do not try to straighten a misshapened bone or joint.
Are there any of these problems?
  • An area that is deformed
  • A limb that is pale, cold or numb
  • A limb that is very painful, swollen or one that can't bear weight
Yes: Seek CareGive First Aid
No
Get Medical Care and do first aid before medical care:
  • Without moving the injured area, remove clothing and jewelry (if any) that covers the injured area. You may have to cut clothing off.
  • Check for internal problems to blood flow and nerves. [Note: Be able to report these signs to emergency personnel.]
    • Feel for a pulse: at the wrist for an injury to the arm; just above the inside ankle bone for an injury to the leg.
    • Lightly touch the victim's fingers or toes and ask if the victim feels your touch.
    • Ask if the victim can move or wiggle his or her fingers or toes.
  • Do not try to straighten a misshapened bone or joint.
  • Keep the injured body part from moving:
    • Apply a splint in the position in which the injury was found. Try not to move the injured area as you splint. To make a splint: Place objects that will provide support on both sides or around the injured area making sure the supports extend above and below the injury. (Use boards, rolled newspapers or towels, sticks, etc.) Tie or tape the supports above and below (not on top of) the injured area. Use scarves, belts, strips of cloths, etc. for ties. Tie them to stabilize the injured area, but not too tight so as to cut off circulation. Loosen the splint if the area beyond the splint turns pale or throbs with pain or if the injured area swells only after the split is applied.
    • If objects for supports are not available, tie the injured body part to an uninjured area of the body to immobilize the injury. Keep the injured body part in the same position you found it.
    • Put a dislocated arm or shoulder in a sling:
      • Use a triangular cloth or make one by taking a square cloth that is about a yard long on each side and fold it on the diagonal.
      • Put the injured arm across the chest at a right angle. Fold the material in half.
      • Slide the sling at the half way fold under the injured arm, making sure the material is beyond the elbow of the injured arm.
      • Bring one point of the sling up and over the shoulder of the uninjured side and the other point straight up over the shoulder of the injured side.
      • Tie the two points together behind the neck. Tie to one side so the knot doesn't press into the back of the neck.
Self-Care

Self-Care After Medical Care

Dislocations, like other joint injuries, are often best treated by R.I.C.E. (rest, ice, compression and elevation) during the first 24 to 48 hours after the injury.

  • Rest. Rest the injured joint as much as possible.
  • Ice. Place crushed ice in a plastic bag, wrap it in a towel and apply to injured area for 20 to 30 minutes. Repeat each hour until the swelling eases. Ice helps to reduce the bleeding, swelling and pain.
  • Compression. Apply a snug, wet elastic bandage to the injured joint. Numbness, tingling or increased pain means the bandage is too tight.
  • Elevation. Raise the injured ankle or knee above the level of the person's heart. Place it on a pillow, folded blanket or stack of newspapers.

Give the person acetaminophen, ibuprofen or naproxen sodium for pain according to the recommended dosage on the label. Do not give aspirin if there is any bleeding because aspirin is a mild blood thinner that may worsen the bleeding. [Note: Do not give aspirin or any medication with salicylates to anyone 19 years of age or younger unless a doctor tells you to.]

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