RICE for Injuries

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The Inside Scoop on RICE for Injuries

The Inside Scoop on RICE for Injuries | The Survival Doctorby James Hubbard, MD, MPH

I love acronyms. They’re such great memory tricks. They saved me on many a test in medical school. And many of them I remember to this day. Needless to say, I use them when I can. RICE is one I use the most.

In my posts on sprains and broken bones, I frequently suggest using rest, ice, compression, and elevation as initial treatment. I should probably put this in every injury post I do. Because with RICE (some use PRICE or RICES.; more on that later), along with putting pressure on bleeding, cooling a burn, and stabilizing a neck or back injury before moving a person, you have 90 percent of the basic tenants of initial management of any injury.

So, rather than explain in detail what RICE for injuries means every time I use the acronym, I thought I’d just explain it here and link accordingly. And along the way, even you old pros may learn an extra thing or two.

Quick Reference

Rest: Don’t use the injured part.

Ice: Ice for ten minutes at a time. Wait at least ten minutes between sessions. (Put a cloth between your skin and the ice pack.)

Compression: Wrap the injury with an elastic bandage (not too tightly; you should be able to get two fingers underneath). Loosen if your fingers or toes start tingling or get numb, blue, or cold.

Elevation: Elevate the injury above your heart or as close to that as you can.

Splint: Put something firm on either side of the injury, and wrap.

What Does RICE Do?

In general, using RICE for injuries prevents two major complications:

  1. Further injury. If a broken bone is moving around it tends to get further out of place and the bone fragments tend to injure more tendons, muscles, and blood vessels.
  2. Major swelling. Injured areas tend to swell. It’s your body’s way of splinting and cushioning the injury—to protect it and keep it from moving. But too much swelling of an arm or leg can actually cut off the circulation to a hand or foot. Also, it can impede nutritious fluids from getting to the injury to help it heal. In addition, swelling stretches the tissues and can increase your pain.
What Does RICE(S) Mean?

Rest. Some people would add a P (protection) before RICE, but I think that’s implied by rest. Merriam-Webster defines rest in part as:

    1. … a bodily state characterized by minimal functional and metabolic activities.
    2. a: freedom from activity or labor.

And that’s what it means here. Don’t use an injured wrist. Don’t walk or an injured ankle. You’re only going to run the risk of injuring it more.

Now I know there are situations where you have no other choice, but even then, you can limit your activity. Use a cane or crutch. And with time, depending on the injury, using it may help it heal. But initially, rest.

What About Heat?

As far as blood vessels are concerned, heat does the opposite of cold. Heat increases the blood flow to the heated tissue. After a few days, if most of the swelling has subsided, heat can help heal by bringing more nutrients to the injured tissue.

Ice. Your injured area swells because blood vessels release and leak fluid into the tissue. This can be a clear fluid (serum) or whole blood or both. Cold causes blood vessels to constrict and allow less blood flow.

Too much cold for too long, however, can cause tissue injury, even frostbite. For that reason, if you’re using ice or an ice pack, cover it with a cloth so the skin is not in direct contact with the ice. And use the ice pack for only about ten minutes at a time. Then leave it off for about ten minutes, at least, before putting it back on.

Compression. Wrapping your injury with an elastic bandage decreases blood flow pressure and limits swelling.

But be careful. If you wrap it too tight, or the swelling continues too much, you could completely cut off the blood flow. Body parts don’t live without some blood flow. Even with an elastic bandage, make sure you can get a couple of fingers between the bandage and the skin, and loosen it if your fingers or toes start tingling or get numb, blue, or cold.

Elevation. This means elevate the injured part above your heart level or as close as you can get. If it’s a leg, you’ll have to sit or lie down to do this. For an arm, you may need a sling or a cushion. (You can create a simple sling with the bottom of your shirt. Just safety pin it up into a loop. This video demonstrates that.)

How to Make a Splint

For more detail on how to make different kinds of splints, check out these videos:

Why? Injured areas tend to swell. Pressure from the blood flow pushes fluid from the blood vessels to the injury. Elevating the injured area reverses the blood flow pressure, causing less swelling.

Splint. Some people like to add an S to the RICE. I do. To apply a splint, use something firm (a commercial splint, brace, newspapers, sticks, etc.) on opposites sides of an injured arm or leg (or neck) to keep if from moving. Wrap it in place with the compression bandage. Some people would include this in the Rest section or the Protect section.

 

If you don’t learn anything else about how to treat a sprain, torn ligament or cartilage, or broken bone, learn RICE. Learn what it means and how to use it. Because at some point in life, disaster or not, you can benefit by knowing it.

How about you? Have your ever used these suggestions? Have you ever needed to but didn’t know them?

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