Acute Care

Ice being applied to a knee

Let’s take a look at acute care. Please note that acute means very recent, it does not comment on severity. In this case, we’re talking about the first 3 days after injury, and that isn’t severe enough to justify A&E (or if they release you with nothing too much to worry about). If your problem is not improving after 3-4 days, then it may be time to seek a diagnosis with more specific advice and care.

The best, and most important piece of general advice (after first aid) is POLICE:

PROTECT – This may be a splint, or a brace; or it may be the application of common sense; basically, avoid aggravating factors; surprisingly enough, they can aggravate things.

OPTIMAL LOADING – Movement is essential to allow full perfusion of oxygen and nutrients (and white blood cells and serum), allow the body to actively heal itself, and minimise scar formation; this also means not to be afraid to use the injured area – let the pain guide you here. There’s a Goldilocks zone, between doing so little, which hampers healing; and too much, which aggravates the injury.

Minor, acute injury

ICE – Real ice is better than fake cold from gels and sprays; but often less convenient. Always wrap your ice pack in a thin layer of dry material; this prevents you getting an ice burn. For the first day or so use it in bursts of 1-3 minutes, repeating 1-3 times in the first day (this should be having some anti-inflammatory effects and is a little controversial). After that, use bursts of 10-15 minutes, repeating every 60-90 minutes (this should be having some pro-inflammatory effects).

COMPRESSION – Has a dual effect, it minimizes excessive oedema, by not allowing it room to expand, and provides an element of support to a joint, allowing the ligaments more rest. Don’t wear strapping for more than a few days without seeking further advice (unless it’s bandaging for an open wound, or a broken bone, obviously).

ELEVATION – Helps drain oedema, blood and lymph from the area, basically, try to keep the injured area higher than the heart so it can drain – obviously, easier with limbs than torso injuries; don’t use for more than a couple of days.

NB: The use of ice is controversial at the moment, due to the early anti-inflammatory effect (inflammation being the first stage of healing, and therefore essential). However, this is mostly down to opinion pieces and research on inappropriate use of ice whilst looking at inflammatory markers, not appropriate use, or actual patient health.

Protect, Optimal Load, Ice, Compression, Elevation

#POLICE #AcuteCare #NewInjury #SportsInjury #Tewkesbury

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