FIRST AID

What causes nosebleeds?

The most common causes are dryness (often caused by indoor heat in the winter) and nose picking. These 2 things work together -- nose picking occurs more often when mucus in the nose is dry and crusty.

Other, less common, causes include injuries, colds, allergies or cocaine use. Children may stick small objects up the nose. Older people may have atherosclerosis (which is the hardening of the arteries), infections, high blood pressure and blood clotting disorders, or they may be taking drugs that interfere with blood clotting, such as aspirin. Sometimes, the cause of nosebleeds can't be determined.

Why is the nose prone to bleeding?

The nose has many blood vessels in it to help warm and humidify the air you breathe. These vessels lie close to the surface, making them easy to injure.

Are nosebleeds serious?

A few nosebleeds stem from large vessels in the back of the nose. These nosebleeds can be dangerous. They may occur after an injury. This type of nosebleed is more common in the elderly and is often due to high blood pressure, atherosclerosis, daily aspirin use or bleeding disorders. Usually, the older the patient, the more serious the nosebleed.

You'll need to get medical attention if a nosebleed goes on for more than 20 minutes or if it occurs after an injury (such as a fall or a punch in the face), especially if you think you may have a broken nose. A nosebleed after a fall or car accident could be a sign of internal bleeding.

Frequent nosebleeds may mean you have a more serious problem. For example, nosebleeds and bruising can be early signs of leukemia. Nosebleeds can also be a sign of blood clotting disorders and nasal tumors (both cancerous and non-cancerous).

What should I do when I get a nosebleed?

A nosebleed can be scary to get -- or see -- but try to stay calm. Most nosebleeds look much worse than they really are. Almost all nosebleeds can be treated at home.

If you get a nosebleed, sit down and lean slightly forward. Keeping your head above your heart will slow the bleeding. Lean forward so the blood will drain out of your nose instead of down the back of your throat. If you lean back, you may swallow the blood. This can cause irritate your stomach.

Use your thumb and index finger to squeeze together the soft portion of your nose. This area is located between the end of your nose and the hard, bony ridge that forms the bridge of your nose. Keep holding your nose until the bleeding stops. Don't let go for at least 5 minutes. If it's still bleeding, hold it again for another 5 to 10 minutes.

Once the bleeding stops, don't do anything that may make it start again, such as bending over or blowing your nose.

Pinch your nose to stop a nosebleed

See your doctor if:

• The bleeding goes on for more than 20 minutes.
• The bleeding was caused by an injury, such as a fall or something hitting your face.
• You get nosebleeds often.

What will my doctor do for a nosebleed?

Your doctor will try to find out where the bleeding is coming from in your nose. He or she will probably ask you some questions and examine your nose. If the bleeding doesn't stop on its own or when pressure is applied, your doctor may cauterize the bleeding vessel or pack your nose to stop the bleeding.

Cauterization involves using a special solution called silver nitrate or an electrical or heating device to burn the vessel so that it stops bleeding. Your doctor will numb your nose before the procedure.

Packing the nose involves putting special gauze or an inflatable latex balloon into the nose so that enough pressure is placed on the vessel to make it stop bleeding.

Tips on preventing nosebleeds

• Keep children's fingernails short to discourage nose picking.
• Counteract the drying effects of indoor heated air by using a humidifier at night in your bedroom.
• Quit smoking. Smoking dries out your
• Open your mouth when you sneeze.

First Aid Kit Essentials

Why do I need a first aid kit?

Falls, bee stings, burns, allergic reactions -- all of these are common accidents that can happen in any home or on any outing. That’s when a first aid kit comes in handy. When you have a well-stocked first aid kit, you have the supplies you need to be ready for most minor emergencies.

Putting a kit together is as simple as placing some basic items in a small container, such as a plastic tub, tool kit or tote bag. Keep one in your medicine cabinet at home, making sure it’s out of young children’s reach.

What do I need in a first aid kit?

Here’s a breakdown of some supplies every first aid kit needs.

Dressings and bandages:

• 25 adhesive bandages of various sizes (brand names: Band-Aid, Curad, others)
• 5 sterile gauze pads (3 x 3 inches)
• 5 sterile gauze pads (4 x 3 inches)
• Gauze roll
• Eye shield or pad
• Roll of adhesive tape
• Elastic bandage (brand names: ACE, Coban, others) for wrapping wrist, elbow, ankle and knee injuries (3 to 4 inches wide)
• 2 triangular bandages for wrapping injuries and making arm slings
• Sterile cotton balls and cotton-tipped swabs

Equipment and other supplies:

• 2 pair latex or non-latex gloves (These should be worn any time you may be at risk of contact with blood or body fluid of any type.)
• Instant cold pack
• 5 safety pins to easily fasten splints and bandages
• Turkey baster or other suction device to flush out wounds
• Aluminum finger splint
• Syringe and medicine spoon for giving specific doses of medicine
• Thermometer
• Tweezers to remove ticks, insect stingers and small splinters
• Scissors for cutting gauze
• Breathing barrier for giving CPR
• Blanket
• Hand sanitizer (liquid and/or wipes)
• First aid manual
• List of emergency numbers

Medicine for cuts and injuries:

• Antiseptic solution or wipes, such as hydrogen peroxide, povidone-iodine (one brand name: Betadine) or chlorhexidine (one brand name: Betasept)
• Antibiotic ointment (brand names: Neosporin, Bactroban) that contain ingredients such as bacitracin or mupirocin
• Sterile eyewash or saline, such as contact lens saline solution
• Calamine lotion for stings or poison ivy
• Hydrocortisone cream, ointment or lotion for itching

Other medicines:

• Pain and fever medicines, such as aspirin, acetaminophen (one brand name: Tylenol) or ibuprofen (brand names: Advil, Motrin). (Note: Do not give children and teenagers aspirin, because it has been related to a potentially serious disease called Reye's syndrome in children younger than 18 years of age.)
• Antihistamine (one brand name: Benadryl) to treat allergies and swelling
• Decongestants to treat nasal congestion
• Anti-nausea medicine to treat motion sickness and other types of nausea
• Anti-diarrhea medicine
• Antacid to treat upset stomach
• Laxative to treat constipation

Think about any special needs in your family, such as those of a child or elderly person, as well as allergies or diseases. Add supplies as needed for these conditions. Also, be sure to refill your kit with any supplies you have used or that may have expired.

Can I purchase a first aid kit?

Yes. The American Red Cross and many drugstores sell first aid kits with the necessary items. Remember, for the kit to be useful, you need to know how to use it. You may want to take a Red Cross first aid course or at least purchase a first aid manual to learn first aid basics.

Cardiopulmonary Resuscitation (CPR)

When is CPR important?

CPR may be done when a person stops breathing or the heart stops beating (like when a person has a heart attack or almost drowns). When it's possible that the person may get better, CPR is an important life-saving technique. CPR can help keep oxygenated blood circulating in the body, which can help prevent brain and organ damage.

However, when a patient has an advanced life-threatening illness (such as advanced stages of cancer) and is dying, CPR may not be the best option. It's important for the patient, family members and doctor to talk about this issue before the need arises.

What happens during CPR?

CPR consists of 2 stages: chest compressions (forceful pressing on the chest to stimulate the heart) and artificial respiration (mouth-to-mouth rescue breathing).

Electric stimulation to the chest (called an automated external defibrillator or AED, which a device that help start the heart) and special medicines are sometimes used to resuscitate a person whose heart has stopped beating. This is usually done for 15 to 30 minutes. A tube may also be put through the mouth or nose into the lung. This tube is then connected to a breathing machine and helps the person breathe.

What happens if CPR isn't done?

A person will become unconscious almost immediately and will die in 5 to 10 minutes.

What are the benefits of CPR?

For a patient who has an advanced life-threatening illness and who is dying, there are really no benefits.

CPR may prolong life for patients who have a better health status or who are younger. CPR may also prolong life if it's done within 5 to 10 minutes of when the person's heart stopped beating or breathing stopped.

What are the risks of CPR?

Pressing on the chest can cause a sore chest, broken ribs or a collapsed lung. Patients with breathing tubes usually need medicine to keep them comfortable. Some patients who survive may need to be on a breathing machine in the intensive care unit (ICU) to help them breathe for a while after they receive CPR.

Few patients (fewer than 10%) in the hospital who have had CPR survive and are able to function the way they used to. Many patients live for a short time after CPR, but still die in the hospital. CPR may also prolong the dying process.

Patients who have more than one illness usually don't survive after CPR. Almost no one who has advanced cancer survives CPR and lives long enough to leave the hospital. Of the few patients who do, many get weaker or suffer brain damage. Some patients may need to live on a breathing machine for the rest of their lives.

How do I learn CPR?

CPR is a skill that you need to learn by taking an accredited first-aid training course. This course will probably teach you how to perform CPR and how to use an automatic external defibrillator (AED). 

First Aid: Cuts, Scrapes and Stitches

How should I clean a wound?

The best way to clean a cut, scrape or puncture wound (such as a wound from a nail) is with cool water. You can hold the wound under running water or fill a tub with cool water and pour it from a cup over the wound.

Use soap and a soft washcloth to clean the skin around the wound. Try to keep soap out of the wound itself because soap can cause irritation. Use tweezers that have been cleaned in isopropyl alcohol (rubbing alcohol) to remove any dirt that remains in the wound after washing.

Even though it may seem that you should use a stronger cleansing solution (such as hydrogen peroxide or iodine), these things may irritate wounds. Ask your family doctor if you feel you must use something other than water.

What about bleeding?

Bleeding helps clean out wounds. Most small cuts or scrapes will stop bleeding in a short time. Wounds on the face, head or mouth will sometimes bleed a lot because these areas are rich in blood vessels.

To stop the bleeding, apply firm but gentle pressure on the cut with a clean cloth, tissue or piece of gauze. If the blood soaks through the gauze or cloth you're holding over the cut, don't take it off. Just put more gauze or another cloth on top of what you already have in place and apply more pressure for 20 to 30 minutes.

If your wound is on an arm or leg, raising it above your heart will also help slow the bleeding.

Should I use a bandage?

Leaving a wound uncovered helps it stay dry and helps it heal. If the wound isn't in an area that will get dirty or be rubbed by clothing, you don't have to cover it.

If it's in an area that will get dirty (such as your hand) or be irritated by clothing (such as your knee), cover it with an adhesive strip (one brand: Band-Aid) or with sterile gauze and adhesive tape. Change the bandage each day to keep the wound clean and dry.

Certain wounds, such as scrapes that cover a large area of the body, should be kept moist and clean to help reduce scarring and speed healing. Bandages used for this purpose are called occlusive or semiocclusive bandages. You can buy them in drug stores without a prescription. Your family doctor will tell you if he or she thinks this type of bandage is best for you.

Should I use an antibiotic ointment?

Antibiotic ointments (some brand names: Neosporin, Ultra Mide) help healing by keeping out infection and by keeping the wound clean and moist. A bandage does pretty much the same thing. If you have stitches, your doctor will tell you whether he or she wants you to use an antibiotic ointment. Most minor cuts and scrapes will heal just fine without antibiotic ointment, but it can help the wound close up and help reduce scarring.

What should I do about scabs?

Nothing. Scabs are the body's way of bandaging itself. They form to protect wounds from dirt. It's best to leave them alone and not pick at them. They will fall off by themselves when the time is right.

When should I call my doctor?

Call your doctor if your wound is deep, if you can't get the edges to stay together or if the edges are jagged. Your doctor may want to close your wound with stitches or skin adhesive. These things can help reduce the amount of scarring.

You can close small cuts yourself with special tape, called butterfly tape, or special adhesive strips, such as Steri-Strips.

Call your family doctor if any of the following things occur

• The wound is jagged
• The wound is on your face
• The edges of the cut gape open
• The cut has dirt in it that won't come out
• The cut becomes tender or inflamed
• The cut drains a thick, creamy, grayish fluid
• You start to run a temperature over 100°F
• The area around the wound feels numb
• You can't move comfortably
• Red streaks form near the wound
• It's a puncture wound or a deep cut and you haven't had a tetanus shot in the past 5 years
• The cut bleeds in spurts, blood soaks through the bandage or the bleeding doesn't stop after 20 minutes of firm, direct pressure

How do I take care of stitches?

You can usually wash an area that has been stitched in 1 to 3 days. Washing off dirt and the crust that may form around the stitches helps reduce scarring. If the wound drains clear yellow fluid, you may need to cover it.

Your doctor may suggest that you rinse the wound with water and rebandage it in 24 hours. Be sure to dry it well after washing. You may want to keep the wound elevated above your heart for the first few days to help lessen swelling, reduce pain and speed healing.

Your doctor may also suggest using a small amount of antibiotic ointment to prevent infection. The ointment also keeps a heavy scab from forming and may reduce the size of a scar.

Stitches are usually removed in 3 to 14 days, depending on where the cut is located. Areas that move, such as over or around the joints, require more time to heal.

What is skin adhesive?

Skin adhesive is another way to close small wounds. Your doctor will apply a liquid film to your wound and let it dry. The film holds the edges of your wound together. You can leave the film on your skin until it falls off (usually in 5 to 10 days).

It's important not to scratch or pick at the adhesive on your wound. If your doctor puts a bandage over the adhesive, you should be careful to keep the bandage dry. Your doctor will probably ask you to change the bandage every day.

Don't put any ointment, including antibiotic ointment, on your wound when the skin adhesive is in place. This could cause the adhesive to loosen and fall off too soon. You should also keep your wound out of direct light (such as sunlight or tanning booth lamps).

Keep an eye on your wound. Call your doctor if the skin around your wound becomes very red and warm to touch, or if the wound reopens.

Do I need a tetanus shot?

Tetanus is a serious infection you can get after a wound. The infection is also called "lockjaw," because stiffness of the jaw is the most frequent symptom.

To prevent tetanus infection when the wound is clean and minor, you'll need a tetanus shot if you haven't had at least 3 doses in your life, or haven't had a dose in the last 10 years.

When the wound is more serious, you'll need a tetanus shot if you haven't had at least 3 doses before or if you haven't had a shot in the last 5 years. The best way to avoid tetanus infection is to talk to your family doctor to make sure your shots are up to date.

First Aid: Burns

What causes burns?

You can get burned by heat, fire, radiation, sunlight, electricity, chemicals or hot or boiling water. There are 3 degrees of burns:

• First-degree burns are red and painful. They swell a little. They turn white when you press on the skin. The skin over the burn may peel off after 1 or 2 days.
• Second-degree burns are thicker burns, are very painful and typically produce blisters on the skin. The skin is very red or splotchy, and may be very swollen.
• Third-degree burns cause damage to all layers of the skin. The burned skin looks white or charred. These burns may cause little or no pain because the nerves and tissue in the skin are damaged.

How long does it take for burns to heal?

• First-degree burns usually heal in 3 to 6 days.
• Second-degree burns usually heal in 2 to 3 weeks.
• Third-degree burns usually take a very long time to heal.

How are burns treated?

The treatment depends on what kind of burn you have.

See a doctor if:

• A first- or second-degree burn covers an area larger than 2 to 3 inches in diameter.
• The burn is on your face, over a major joint (such as the knee or shoulder), on the hands, feet or genitals.
• The burn is a third-degree burn, which requires immediate medical attention.

First-degree burn

Soak the burn in cool water for at least 5 minutes. The cool water helps reduce swelling by pulling heat away from the burned skin.

Treat the burn with a skin care product that protects and heals skin, such as aloe vera cream or an antibiotic ointment. You can wrap a dry gauze bandage loosely around the burn. This will protect the area and keep the air off of it.

Take an over-the-counter pain reliever, such as acetaminophen (one brand name: Tylenol), ibuprofen (some brand names: Advil, Motrin) or naproxen (brand name: Aleve), to help with the pain. Ibuprofen and naproxen will also help with swelling.

Second-degree burn

Soak the burn in cool water for 15 minutes. If the burned area is small, put cool, clean, wet cloths on the burn for a few minutes every day. Then put on an antibiotic cream, or other creams or ointments prescribed by your doctor. Cover the burn with a dry nonstick dressing (for example, Telfa) held in place with gauze or tape. Check with your doctor's office to make sure you are up-to-date on tetanus shots.

Change the dressing every day. First, wash your hands with soap and water. Then gently wash the burn and put antibiotic ointment on it. If the burn area is small, a dressing may not be needed during the day. Check the burn every day for signs of infection, such as increased pain, redness, swelling or pus. If you see any of these signs, see your doctor right away. To prevent infection, avoid breaking any blisters that form.

Burned skin itches as it heals. Keep your fingernails cut short and don't scratch the burned skin. The burned area will be sensitive to sunlight for up to one year, so you should apply sunscreen to the area when you're outside.

Third-degree burn

For third-degree burns, go to the hospital right away. Don't take off any clothing that is stuck to the burn. Don't soak the burn in water or apply any ointment. If possible, raise the burned area above the level of the heart. You can cover the burn with a cool, wet sterile bandage or clean cloth until you receive medical assistance.

Is there anything I shouldn't do when treating a burn?

Do not put butter or oil on burns. Do not put ice or ice water directly on second- or third-degree burns. If blisters form over the burn, do not break them. These things can cause more damage to the skin.

What do I need to know about electrical and chemical burns?

A person who has an electrical burn (for example, from a power line) should go to the hospital right away. Electrical burns often cause serious injury to organs inside the body. This injury may not show on the skin.

A chemical burn should be flushed with large amounts of cool water. Take off any clothing or jewelry that has the chemical on it. Don't put anything on the burned area, such as antibiotic ointment. This might start a chemical reaction that could make the burn worse. You can wrap the burn with dry, sterile gauze or a clean cloth. If you don't know what to do, call 911 or your local poison control center, or see your doctor right away.

Cast Care

Why do I need a cast?

You have been given a cast to help your broken bone or torn ligaments heal. A cast can help keep the injured area from moving so you can heal faster without risk of repeated injury. The amount of time you'll need to wear your cast depends on the type of injury you have and how serious it is. Your doctor may want to check your cast 1 to 3 days after putting it on to be sure that the cast isn't too tight and that your injury is starting to heal.

Will the broken bone hurt?

Almost all broken bones cause pain. The cast should relieve some pain by limiting your movements. Your pain should become less severe each day. Call your doctor immediately if the pain in the casted area gets worse after the cast has been applied. New pain or numbness may mean that the cast is too tight. You should also call your doctor right away if you have new pain that develops in another area (for example, pain in your fingers or forearm if you have a wrist or thumb injury, or pain in your toes or calf if you have an ankle or foot injury).

To relieve discomfort that can occur when you get a cast, raise the cast above your heart by propping your arm or leg on pillows (especially in the first 48 hours after you first get the cast). You will have to lay down if the cast is on your leg. This may reduce pain and swelling. Flexing your fingers or wiggling the toes of the affected limb also helps reduced swelling and discomfort.

Is it okay to get the cast wet?

With some fiberglass casts, you can swim and bathe. However, most casts shouldn't get wet. If you get a cast wet, irritation and infection of the skin could develop. Talk to your doctor about how to care for your cast.

To avoid getting the cast wet during bathing, you can put a plastic bag over the cast and hold it in place with a rubber band. You can also buy a waterproof cast cover.

If the cast does get wet, you may be able to dry out the inside padding with a hair dryer. (Use a low heat setting and blow the air through the outside of the cast.)

What can I do about itching?

If your skin itches underneath the cast, don't slip anything sharp or pointed inside the cast to try and itch the spot. This could damage your skin and you could get an infection. Instead, try tapping the cast or blowing air from a hair dryer down into the cast

What else should I know?

Try to keep the area around the edge of the cast clean and moisturized (but do not put lotion down inside the cast). Check the skin around the cast for irritation, chafing or sores.

Check with your doctor if a bad smell is coming from the inside of your cast (especially if you are running a fever). This may mean you have an infection.

Don't break off or file down any part of the cast. This could weaken the cast and make it more likely to crack or break. If there is an area of the cast that is uncomfortable, try padding it with a small towel or soft adhesive tape.

Caring for Your Incision After Surgery

When do I remove the bandage?

Your bandage should be removed the day after surgery. Your doctor may ask you to replace your bandage each day. Most wounds don't require a bandage after a few days, but you may decide to wear a bandage to protect the incision.

The incision is red. Is this normal?

The edges of a healing incision may be slightly red. Redness is normal, but call your doctor if the redness is increasing or if it spreads more than half an inch from the wound. Call your doctor if you see pus in the incision or if the incision is more than mildly tender or painful.

Your doctor may ask you to put an antibiotic cream on the incision. You can buy some antibiotic creams without a prescription.

What do I do if the incision bleeds?

If your bandage becomes bloody, replace it with dry gauze or another bandage. Applying pressure directly to the incision for a few minutes will usually stop the bleeding. If the wound keeps bleeding after you apply pressure, call your doctor.

Do I need to keep the incision dry?

Keep your incision clean and dry for the first 24 hours. Avoid showering or bathing the first day. Try taking a sponge bath instead. It's usually okay to wash with soap and water by the second day. Take a shower instead of a bath if you have stitches or skin tape on your incision. Gently towel dry the incision after washing.

Will the stitches be removed?

Internal stitches are absorbed by your body gradually and don't need to be removed. Your doctor will remove stitches that don't absorb into the tissues. Stitches are usually removed 3 days to 3 weeks after surgery, depending on where they are and how quickly you heal.

Your doctor may apply skin tape after the stitches are removed. Skin tape provides additional wound support. The tape can be removed in 3 to 7 days. Healing skin may need months to regain most of its strength.

Should I limit my activities?

Limiting movement of the area around your incision improves healing. Avoid activities that could cause your incision to pull apart. Your doctor may ask you to avoid lifting, straining, exercise or sports for the first month or so after surgery. Call your doctor if the incision pulls apart.

Should I avoid sun exposure?

A healing scar will darken and become more noticeable if it gets sunburned. Limit your sun exposure for the first 6 months after surgery. When you go outdoors during the day, cover your scar with tape or sunscreen.

Head Injuries: What to Watch for Afterward

What are the main causes of head injuries?

A serious head injury is most likely to happen to someone who is in a car wreck and isn't wearing a seat belt. Other major causes of head injuries include bicycle or motorcycle wrecks, falls from windows (especially among children who live in the city) and falls around the house (especially among toddlers and the elderly).

Are head injuries serious?

They can be. Bleeding, tearing of tissues and brain swelling can occur when the brain moves inside the skull at the time of an impact. But most people recover from head injuries and have no lasting effects. See the box below for a list of types of head injuries.

How can the doctor tell how bad the damage is?

The doctor will ask about how the injury occurred, about past medical problems, and about vomiting, seizures (fits) or problems breathing after an injury.

The injured person may need to stay in the hospital to be watched. Sometimes, tests that take pictures of the brain, such as a computerized tomography (CT) or a magnetic resonance imaging (MRI) scan, are needed to find out more about possible damage.

Types of head injuries

• A concussion is a jarring injury to the brain. A person who has a concussion usually, but not always, passes out for a short while. The person may feel dazed and may lose vision or balance for a while after the injury.
• A brain contusion is a bruise of the brain. This means there is some bleeding in the brain, causing swelling.
• A skull fracture is when the skull cracks. Sometimes the edges of broken skull bones cut into the brain and cause bleeding or other injury.
• A hematoma is bleeding in the brain that collects and clots, forming a bump. A hematoma may not be apparent for a day or even as long as several weeks. So it's important to tell your doctor if someone with a head injury feels or acts oddly. Watch out for headaches, listlessness, balance problems or throwing up.

What happens after a head injury?

It's normal to have a headache and nausea, and feel dizzy right after a head injury. Other symptoms include ringing in the ears, neck pain, and feeling anxious, upset, irritable, depressed or tired.

The person who has had a head injury may also have problems concentrating, remembering things, putting thoughts together or doing more than one thing at a time.

These symptoms usually go away in a few weeks, but may go on for more than a year if the injury was severe.

Will the head injury cause permanent brain damage?

This depends on how bad the injury was and how much damage it did. Most head injuries don't cause permanent damage.

What about memory loss?

It's common for someone who's had a head injury to forget the events right before, during and right after the accident. Memory of these events may never come back. Following recovery, the ability to learn and remember new things almost always returns.

Is it true that the person must be kept awake after the injury?

No. If the doctor thinks the person needs to be watched this closely, he or she will probably put the person in the hospital.

Sometimes, doctors will send someone who has had a head injury home if the person with them is reliable enough to watch the injured person closely. In this case, the doctor may ask that the person be awakened frequently and asked questions such as "What's your name?" and "Where are you?" to make sure everything is okay.

Get help if you notice the following symptoms:

• Any symptom that is getting worse, such as headaches, nausea or sleepiness
• Nausea that doesn't go away
• Changes in behavior, such as irritability or confusion
• Dilated pupils (pupils that are bigger than normal) or pupils of different sizes
• Trouble walking or speaking
• Drainage of bloody or clear fluids from ears or nose
• Vomiting
• Seizures 

Casts and Splints

What are casts and splints?

Casts and splints are hard wraps used to support and protect injured bones, ligaments, tendons and other tissues. They help broken bones heal by keeping the broken ends together and as straight as possible. Casts and splints also help relieve pain and swelling, and protect the injured area from more harm.

What is the difference between a cast and a splint?

All casts are custom-made with fiberglass or plaster. A cast wraps all the way around an injury and can only be removed in the doctor's office.

A splint is like a half cast. The hard part of a splint does not wrap all the way around the injured area like it does with a cast. Instead, there are usually 2 hard areas connected with an elastic bandage or other material that hold the splint in place. Unlike casts, splints can be easily removed or adjusted. Splints can be custom-made from fiberglass or plaster, or may be ready-made. Splints come in lots of shapes and sizes for different injuries.

How long does a cast or splint stay on?

A splint usually stays on for several days to a few weeks. If your injured area is very swollen, you may need a splint until the swelling goes down. You may still need a cast after the swelling goes down. Also, if your injury is swollen, both splints and casts may need to be adjusted in the first few days. As the swelling goes down, a cast or splint may become too loose. If swelling increases, the splint or cast may become too tight.

Casts that are kept in good condition can stay on for several weeks. Your doctor will tell you how long your cast will need to stay on.

What if the pain gets worse?

Some people have mild pain and swelling if they don't rest the injured area enough. To avoid this, it is important to remember the following:

• Keep the injured area above the level of your heart (for instance, prop it up with pillows).
• Wiggle your fingers or toes while resting.
• Apply ice, if needed. Ice can be used for 15 to 30 minutes over a cast or splint as long as it doesn't get the splint or cast wet or touch the skin for too long.
• Talk to your doctor before taking pain medicine.

When should I call my doctor?

Call your doctor right away if you have:

• Increased pain
• Numbness, tingling, burning or stinging on or near the injured area
• Circulation problems (if your skin, nails, fingers or toes become discolored, pale, blue, gray or cold to the touch, or if you have trouble moving your fingers or toes)
• Bleeding, pus, drainage or bad smells coming from the cast
• A wet, broken or damaged cast or splint

Your doctor may need to adjust, remove or change your splint or cast.

Can I bathe or shower if I have a cast or splint?

Yes. But be sure to keep your cast or splint dry, especially during baths and showers. Casts and splints made from plaster can break if they get wet. Fiberglass casts are water-resistant, but the lining will absorb water. And if moisture gets trapped in the cast or splint, it can irritate your skin or cause an infection.

When you bathe or shower, wrap 2 layers of plastic over the cast or splint and make sure a plastic bag is tightly sealed over it. This will make it water-resistant, but not waterproof, so do not put the cast or splint directly in water.

What else do I need to know if I have a cast or splint?

Take good care of your cast or splint to help your injury heal properly. Also remember:

• Never stick objects inside a cast or splint. They can get stuck, break off or damage your skin.
• Don't get dirt or sand inside a cast or splint.
• Don't apply powders or deodorants inside a cast. If you have severe itching, call your doctor.
• Never break off pieces of your cast or splint or try to adjust it yourself. If it needs to be adjusted, call your doctor.
• Check the cast and the exposed skin daily. If you notice damage to the cast or any injury, call your doctor.

How is a cast taken off?

Your doctor will use a special cast saw with a blade that vibrates but does not spin. It cuts through the outer layer, but not the lining.

Never remove a cast yourself. Using any type of home saw or cutting materials could cause serious injury to your skin, blood vessels and injured limb.

Dog Bites: How to Teach Your Children to Be Safe

Most dogs will never bite anyone. However, any dog may bite if it feels threatened. Children are the most common victims of dog bites. Infants and young children should never be left alone with a dog. This handout tells you how to teach your children to avoid getting bitten.

What should I do if I want a dog for a pet?

Take time to learn about the breed of dog you want. To learn about dog breeds, talk with a veterinarian, read books about dogs and search the Internet. Don’t get a dog only because of the way it looks. If you have an infant or young child, think about getting a puppy. Be especially careful if you have a baby in your house. Aggressive dog breeds aren’t right for families with children. Neutered male dogs are generally less aggressive.

Consider taking your new dog to obedience school. Keep your dog’s immunizations up to date. Have your dog checked regularly by a veterinarian.

What do I tell my children about dogs?

• Don’t go near strange dogs.
• Never bother a dog that is eating, sleeping or caring for puppies.
• Tell an adult about any stray dogs.
• Always have an adult with you when you play with a dog.
• Never tease a dog.
• Never pet a dog without first letting it smell you.

What should I tell my children to do when a dog approaches them?

• Don’t run away and scream.
• Stand very still, “like a tree.” (See first picture below.)
• Avoid making direct eye contact with the dog.
• If you fall or are knocked down, act “like a log.” (See second picture below.)
• When the dog understands that you are not a threat, it will probably walk away.
• If a dog bites you, tell an adult right away.

A dog is a wonderful addition to a family, but it can be a problem if you aren’t careful. Always talk to children about how they should act when they’re with a dog. Remember that dogs can feel threatened by new surroundings or strangers