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First Aid For Fracture : Emergency steps to treat fracture while waiting for medical assistance to arrive. A fracture of a bone is certainly a possibility at sea, with boats heeling over and crew members moving around the boat. One way of reducing the risk of fractures is to ensure your crew move around the boat with bent knees, weight low and the golden rule of one hand for the job and one hand for the boat. Open and closed fracture: open fracture is where the broken bone has punctured through the skin, closed fracture is where the broken bone is still under the skin. If assistance will be some time you may need to consider splinting the limb, but only if you really need to. Head injuries can be commonly seen in falls, assault victims, road traffic accidents and sports related accidents. Apart from the injuries to the external structures like skin, muscles and bone, it has to be kept in mind that the brain in its tightly confined space can be damaged directly or indirectly as a result of these forces. On the other hand, a simple fall in an elderly patient can cause rupture of small veins inside skull leading to slowly expanding hematoma (a blood clot) which may present as symptoms like changes in behavior, headache, and drowsiness over weeks until clot enlarges to a degree that cause loss of consciousness and ultimately death. Most important condition out of all these worth attention is extra-dural hemorrhage (collection of blood between skull and outermost layer of meninges that cover the brain).

Therefore it has to be borne in mind that all head injury patients (who had considerable impact or lost consciousness briefly) should at least be kept under observation at least for 24hrs. Even a tiny laceration can bleed profusely as skin of the scalp is one of most richly supplied area with blood vessels.
Apply firm pressure over the wound using a clean piece of cloth or if available wads of gauze and then wrap a bandage around head tightly. Keep partially avulsed pieces of scalp together during above process as these can heal completely due to rich blood supply. Use log-roll to turn patient to lateral side to protect the airway if patient is unconscious. 3.  It is much better to admit all head injury patients who had considerable trauma, to a head injury observation unit at least for 24hrs.
These are very dangerous as the brain and its coverings are exposed to outside environment permitting micro-organisms to enter these vital areas leading to fatal infections. Apart from fractures externally visible, base of the skull can get fractured in head trauma. Cover the fractured area with a sterile gauze dressing but do not apply direct pressure on wound.

Do not try to wash the area or to remove debris.Keep the patient still as possible until medical help arrives. These range from sharp force trauma leading to cuts and lacerations at one end to blunt head trauma causing contusions and skull fractures resulting from both types above.
As an example a sudden ‘whiplash’ movement of head commonly seen in road traffic accidents can lead to massive intracranial hemorrhage compressing the brain leading to death, with out any visible external head injuries.
Here the patient loses consciousness for a very brief period following a blow to head, and then he may appear quite normal for few hours called lucid interval where blood slowly collects inside before losing consciousness for the last time.
Therefore when moving these patients be extremely careful and follow the guidelines on handling such patients.
Suspicious signs of this condition is; leakage of blood or bloodstained fluid (Cerebro-spinal fluid) via nose or ear, loss of smell, loss of vision, loss of hearing and bruising behind ears.

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