Initial Injury Treatment
The R.I.C.E. Regime

It is worth covering an important aspect to injury treatment This is what is commonly known as The R.I.C.E. Regime. This pnemonic is for:

REST - Today this may be literally translated to alteration in activity. Basically it means taking the necessary steps to allow ensure that the injury is stabilised and not aggravated. Protecting the injured area by reducing whatever movement and activities necessary is the essence of the REST part. There should be no cheating regarding this. Insufficient rest will mean that further tissue damage and bleeding is likely to occur. THE first FORTY EIGHT HOURS are especially critical in this respect.

ICE The use of ice and cold therapy is well documented in the injury treatment. Ice, correctly applied, reduces the local temperature of the body. This causes a slowing down of the local physiology or normal working of the tissues. This means that the particular body part requires less nutrients and produces less waste products. Together with a phenomenon known as VASO-CONSTRICTION such changes limit the degree of tissue damage and swelling. Vaso-constriction is the narrowing or closing down of blood vessels. This occurs naturally if cold is applied to the body. In the case of injury where there are damaged blood vessels closing them down will limit the amount of bleeding that occurs which means there will be less swelling and bruising to deal with.

This is one of the reasons why wounded soldiers in cold conditions have been found alive. The cold had dropped their heart rate and other vital bodily functions to such a low level that they were able to survive much longer without dying as a result of their injuries.

It is considered beneficial in injury treatment to apply ice or cold for no longer that twelve to fifteen minutes at a time and repeat this in the region of every three to four hours in the first two or three days post injury. Longer applications greater than approximately twelve to fifteen minutes can begin to produce an opening of the blood vessels again. This is part of a process known as HUNTING'S REACTION. In addition it is important to allow some return of normal circulation to the area and check this regularly to ensure the surrounding tissues are not starved of nutrients and their vital blood supply.

ALTHOUGH READILY AVAILABLE ICE OR COLD THERAPY SHOULD ONLY BE USED FOR INJURY TREATMENT UNDER QUALIFIED MEDICAL SUPERVISION. PROTECTION FOR THE SKIN VIA THE USE OF A PROTECTIVE LAYER OF PLASTIC OR OIL IS NECESSARY TO PREVENT BURNS.

ICE OR COLD THERAPY SHOULD NOT BE USED BY THOSE WITH ANY HISTORY OF CARDIAC DISEASE OR DIABETES AS IT CAN HAVE DETRIMENTAL AND SERIOUS EFFECTS IN BOTH CASES. THIS IS PARTICYULARLY OF APPLIED TO THE LEFT UPPER LIMB OR SHOULDER IN THE CASE OF CARDIAC DISEASE SUFFERERS OR THE PERIPHERIES (PARTICULARLY THE FEET) IN THE CASE OF DIABETICS.

COMPRESSION - The value of compression cannot be overstated in injury treatment. The correct application of compression can significantly reduce injury complications and rehabilitation time. Compression constricts the local blood flow and tissue swelling. As mentioned with the ice therapy this has highly beneficial effects for injury resolution.

Compression can refer to manual compression applied over a blood vessel or an applied strapping or bandage. In the case of the latter care must always be taken to ensure that the compression is applied correctly and that existence of the compression is communicated if there is transfer of care, i.e. if anyone else is taking over care of the injured party. This is because a compressive bandage left is situ can result in severe loss of blood supply and possibly tissue death.

ELEVATION - Elevation of a limb following injury will again help to minimise the effects of the trauma by using gravity to limit blood flow and swelling. This can have an enormous effect as can easily be demonstrated by the discomfort and swelling that occurs in a dependant limb compared to an elevated one.

The duration of the initial extended elevation period should be for at least the first forty eight hours, until the bleeding has stoped or untilthe swelling has subsided. Following the initial period regular periods of elevation are often beneficial in preventing excessive swelling and allowing better blood flow and hence healing.

So there in essence we have the R.I.C.E. Regime. It's been around for a long time. it works and it is simple. Use it or as much of it as you can. It will pay you well.

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