First, Assess the Situation
Before you do anything, ensure the scene is safe for both you and the injured person. Then, quickly assess their condition. Signs of a fracture can include intense pain, swelling, bruising, and visible deformity, like a limb appearing bent or out of place.
The person may have heard or felt a snap or grinding noise at the time of the injury. They will likely have difficulty moving the limb or be unable to put weight on it. Your first priority is to tell the person to stay as still as possible to prevent making the injury worse. Movement can cause the sharp ends of a broken bone to damage nearby muscles, nerves, and blood vessels.
Crucial 'Don'ts' to Remember
What you don't do is just as important as what you do. Never try to straighten a bent limb or push a bone back in if it is sticking out of the skin. This can cause severe damage and increase the risk of infection. Do not move the person unless they are in immediate danger. Avoid giving the person anything to eat or drink, as they may need surgery later. If the injury is to the neck, head, or back, do not move them at all; instead, try to keep their head and neck still and wait for emergency services.
Immobilise the Limb
The main goal of first aid for a fracture is to immobilise the injury to prevent movement. If professional medical help is on its way, you can often provide enough support by placing rolled-up towels, blankets, or jackets on either side of the limb. If you must move the person or if help is delayed, you may need to create a temporary splint. A splint should be rigid. You can improvise with items like rolled-up newspapers or magazines, pieces of cardboard, or sturdy sticks. The key is that the splint must be long enough to extend beyond the joints both above and below the suspected break. For example, a forearm fracture splint should immobilise both the wrist and the elbow.
How to Apply a Makeshift Splint
First, if there is any bleeding, apply pressure to the wound with a clean cloth, but press around the bone, not directly on it if it's an open fracture. Next, place plenty of soft padding—like clothing or towels—between the rigid splint material and the injured limb to protect the skin and increase stability. Secure the splint in place using belts, scarves, or strips of cloth. Tie the fasteners above and below the injury site, but never directly over the break itself. The ties should be snug enough to hold the limb still, but not so tight that they cut off circulation. Leave fingers or toes exposed so you can check them for coldness, numbness, or paleness, which are signs the bandages are too tight.
Manage Pain and Prepare for Help
While waiting for medical assistance, you can help manage pain and swelling. If the skin is not broken, apply a cold pack wrapped in a towel to the injured area for 15-20 minutes at a time. Never apply ice directly to the skin. If possible, and without causing more pain, you can also elevate the injured limb above the level of the heart to help reduce swelling. For an arm, a makeshift sling made from a scarf or a folded piece of cloth can provide support and elevation. Reassure the person and monitor them for signs of shock, such as feeling faint or rapid breathing, in which case you should have them lie down.
