You are called for a 78-year-old female who fell earlier in the day. As you enter her kitchen, you observe her sitting in a chair with ecchymotic areas to her left cheek and left arm. There also appears to be blood on her pants. She is on home oxygen for COPD and is breathing in a moderately labored manner. The patient states that she fell a few hours ago, and now the pain and swelling in her arm are unbearable. She has also developed significant lower neck pain. What should you do first?

Emergency Medical Services (EMS) or EMTs should follow the RICER method for the first 24 to 48 hours after treating a soft tissue injury. RICER stands for Rest, Ice, Compression, Elevation, and Referral. The sooner you treat a soft tissue injury, the greater the chance of a complete recovery.  Here are some general guidelines for treating bleeding wounds: Bleeding: Use a gloved hand and sterile gauze to apply direct pressure to the wound Venous bleeding: Use a latex gloved hand and sterile gauze to apply direct pressure to the wound Lacerations: Use surgical tape or medical adhesive to... Show more

Emergency Medical Services (EMS) or EMTs should follow the RICER method for the first 24 to 48 hours after treating a soft tissue injury.

RICER stands for Rest, Ice, Compression, Elevation, and Referral. The sooner you treat a soft tissue injury, the greater the chance of a complete recovery. 

Here are some general guidelines for treating bleeding wounds:
Bleeding: Use a gloved hand and sterile gauze to apply direct pressure to the wound
Venous bleeding: Use a latex gloved hand and sterile gauze to apply direct pressure to the wound
Lacerations: Use surgical tape or medical adhesive to close the wound
Open chest injuries: Apply an occlusive dressing
Bleeding that continues or recurs: Apply a tourniquet to an extremity above the level of bleeding
Shock: Treat for shock by raising legs, fluid administration, maintaining body temperature, and administering high-concentration oxygen where appropriate 

Here are some general guidelines for treating soft tissue injuries:
Impaled objects: Bandage the impaled object and surrounding dressings in place
Large, entrapping objects: Be prepared for rapid patient deterioration after removal from entrapment
Crush injuries: Treat as you would any other blunt force trauma
Fractures: Immobilize potential fractures
Pain control: Use ice to reduce swelling and pain 

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