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Soft Tissue Injuries - RICE vs PRICE vs METH

On all our first aid course we use that definition that first aid is the "immediate, temporary care for the ill and injured" i.e what can we do as first aiders to manage the incident as a whole and look after our casualty as best we can before more skilled help arrives if necessary.

On both our Fitness Sports First Aid course and our Pitch-side Sports First Aid course we look at using SALTAPS and progressive function testing to assess injuries. First aid treatments are simple and medicine is complicated. For example a sprain or fracture is simply a swollen, damaged, painful injury site to the first aider whether it is a sprain or a fracture is often not clear and decisions are made based on the feedback from the casualty and what can be seen.

If an injury painful to move, regardless of whether it is a sprain/strain/ACL/knee trauma and it is decided that the casualty will not return to play the first aid treatment of RICE should start as soon as is possible. With more serious injuries where the casualty cannot move the injury site must be kept still while further medical help is sought.

First aid treatments are evidence based or based on established convention. There are some specific occasions when ice must never be used in first aid: if the injury site is without sensation, if there is poor circulation, over an open wound, over an obvious fracture. We realise that whether the use of ice does more harm than good is an ongoing debate between professionals in the sporting arena. Whilst there is a consensus that more studies are needed, professionals give different advice based on their own experiences and theories, with there being no evidence either to support either the use of ice or to not ice!

So, for better or worse, (P)RICE remains established first aid treatment for a soft-tissue injuries. Rest remains beneficial to acute trauma and METH - Movement, Elevation, Traction and Heat comes into play with rehabilitation and finding the right balance for pain free movement as soon as possible. It isn't part of a first aid course.


SALTAPS Injury Assessment Guide


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