• Pain only, traumatic swelling, bruises with intact skin, cuts, abrasions, puncture wounds or open wounds of varying size and severity
• Injury to internal organs must be recognized and referred, including subtle

Signs of organ damage, e.g.:

o blood in the urine – kidney or bladder damage
o shock – internal bleeding
o blood or serous drainage from the ear or nose – skull base fracture

• An injury causing a sprain or strain may be initially overlooked. Exclude fractures by performing appropriate X-rays

Note

• Closed injuries and fractures of long bones may be serious and damage blood vessels
• Contamination with dirt and soil complicates the outcome of treatment