Burns, fractures and other physical injuries
This domain covers thermal, chemical and electrical burns, suspected fractures and spinal injury, and other common workplace trauma. Examiners look for cooling discipline and for immobilisation in the position found.
Burns
Cool the burn with cool running water for 20 minutes, starting as soon as possible - this limits tissue damage and pain. Remove jewellery and clothing near the burn unless it is stuck to the skin. Cover with cling film laid in sheets, or a clean non-fluffy dressing. Do not apply ice, butter, toothpaste or oil, and do not burst blisters. For chemical burns, brush off dry powder before irrigating copiously; for electrical burns, switch off the power first and check for entry and exit wounds.
Fractures and dislocations
Suspect a fracture with pain, swelling, deformity, crepitus, or inability to use the limb. Immobilise in the position found using a splint or sling, check circulation, sensation and movement beyond the injury before and after splinting, and do not attempt to straighten a deformed limb. Cover open fractures with a sterile dressing. For suspected spinal injury - after a fall from height, a heavy impact or with neck pain, tingling or loss of bladder control - keep the head and neck still and support manually until help arrives.
Head and eye injuries
Watch for drowsiness, vomiting, unequal pupils, clear fluid from the ears or nose, and seizures after a head blow. For a chemical splash to the eye, irrigate with clean water for at least 20 minutes, holding the eyelid open.
Worked example
A worker scalds a forearm with hot water. Reasoning: remove the wet sleeve and watch, cool under running water for 20 minutes, keep the rest of the body warm, cover with cling film and refer for assessment because the burn is larger than the palm.
Traps that cost marks
- Cooling for only a minute or two, or using ice.
- Peeling stuck clothing from a burn.
- Straightening a deformed fracture or forgetting to recheck distal circulation.