First aid for

fracture
-Anushka

Ninama

What is fracture?
A broken or cracked
bone
Occurs when pressure
is applied to bone
Occurs with / without
displacement of bone
fragments

Causes of fracture
Direct force
Indirect force
Force of
muscular action
Force of
ligaments

Types
Open fracture: Skin
breaks causing open
wound

Closed fracture:
Skin not broken

 Complicated fractures:
Damage of adjacent
organs

 Stress fracture: Hairline

crack due to repeated
stress

 Greenstick fracture: In
children's flexible
bones

Classification

Symptoms
Severe pain
Difficulty in movement
Swelling/ bruising /
bleeding
Deformity / abnormal
twist of limb
Tenderness on
applying pressure

First-aid
Depends on type &
location of fracture

For open fractures

Control bleeding
before
treatment
Rinse and dress
the wound

For open / closed

fractures
Check the breathing
Calm the person
Examine for other
injuries
Immobilize the broken
wound
Apply ice to reduce
pain / swelling
Consult a doctor

Using bandages
Do not apply over
the fracture
Bandaging should
be fairly firm
Place padding
material

Using splints
Rigid enough
Wide enough
Should be long
enough
Well padded
Best applied over the
clothing
Raise the injured part

DO NOT
Massage the affected
area
Straighten the broken
bone
Move without support to
broken bone
Move joints above /
below the fracture
Give oral liquids / food

Prevention
Wear protective
pads / helmets when
driving
Teach children /
practice, safe habits

Aims of first-aid
To prevent further
damage
To reduce pain
To make patient
comfortable
To get medical aid
at the earliest

Skull fracture
Damage to bone may
not appear to be
significant
Fracture crown of the
skull caused by a direct
blow
Fracture base of the
skull caused by indirect
force

Recognition
Wound or bruise on
the head.
Soft area or
depression on the
scalp.
Bruising or swelling
behind one ear.
Bruising around one
or both eyes.

Clear fluid or watery

blood coming from
the nose or an ear.
Blood in the white of
the eye.
Distortion or lack of
symmetry of the head
or face.
Progressive
deterioration in the
level of response.

Your aims
To maintain an
open airway.
To arrange
urgent removal
of the casualty to
hospital.

Treatment
If the casualty is conscious:
Help them to lie down.
Do not turn the head in case
there is a neck injury.
Control any bleeding from
the scalp by applying
pressure around the wound.
Look for and treat any other
injuries.

If there is discharge
from an ear, cover the
ear with a sterile
dressing or clean pad,
lightly secured with a
bandage. Do not plug
the ear.
Monitor and record
vital signs - level of
response, pulse, and
breathing - until
medical help arrives.

If the casualty is unconscious:

Open the airway using the
jaw thrust method and check
for breathing
Be prepared to give chest
compressions and rescue
breaths if needed.
If the position in which the
casualty was found prevents
maintenance of an open
airway or you fail to open it
using the jaw thrust, place
her in the recovery position.

Spine fracture
# Spine is very serious
injury.
Damage to the spinal cord
can result in loss of power
and sensation in the parts
below the injured area.
A mild injury can be made
worse by incorrect
handling.

RECOGNITION
Casualty may inform that
tenderness around the
affected part of the back.
Can feel shooting pains or
electric shocks in limbs and
around the back.
Is unable to feel or move legs
if the injury is in the lower
back or to move any limb at
all if the injury is at neck
level.

Treatment
Advice the casualty not to move.

Advice the casualty not to move.

Support the head in the neutral
position by placing your hands
over his ears, and use rolled-up
coats or blankets to protect and
splint the head, neck and
shoulders.
Cover the casualty with a
blanket.
Loosen tight clothing and ensure
the head and shoulders are
steadied and well-supported.

IMPORTANT
Do not move the casualty
unless life is in danger.
Unconscious casualty with
spinal injury must be placed
in the RECOVERY POSITION,
to protect the airway.
The position should be
modified to keep the head
and trunk aligned at all
times.

Jaw fracture
Jaw # are usually the
result of direct force.
A blow to one side of
the jaw can cause a #
on the other side.
These #s can cause
breathing difficulties.

RECOGNITION
The casualty finds it
difficulty to speak, chew or
swallow without increased
pain.
There may be dribbling and
blood stained saliva if there
is a mouth wound.
Displaced teeth in the
mouth.
Swelling and /or unevenness
along one side of the jaw.

Treatment
Carefully remove any
loose objects such as
dentures or displaced
teeth. Keep the teeth
safe and give them to
the driver/doctor.
Support the injured
jaw till medical aid
reaches you.

IMPORTANT
If the casualty is seriously
injured or unconscious
but breathing normally,
Place the casualty in
RECOVERY POSITION
with the injured side
down and a soft pad
under the head to keep
the weight off the jaw.

COLLAR BONE
# collar bone (clavicle)
is due to a fall on to an
out-stretched hand
where the force is
transmitted along the
forearm and upper
arm to the collar bone.

RECOGNITION
The casualty supports her
arm on the injured side and
inclining the head towards
the injury to relieve the pain.
The casualty is reluctant to
move the arm on the injured
side.
Swelling /deformity may be
visible at the site of injury.

Treatment
Help the casualty
position his arm on the
injured side so that his
fingertips are almost
resting on the opposite
shoulder.
Support the arm in an
elevation sling and place
soft padding between
upper arm and chest.

Secure the limb

to the casualtys
chest by applying
a broad-fold
bandage over the
sling and right
around the body.
Take the casualty
to the hospital.

Upper limb fracture

Pain, tenderness,
inability to use the arm,
deformity, swelling and
possible bruising.
The casualty is
probably supporting the
hand, forearm, and
elbow of the injured
arm with the other arm.

Treatment
If possible gently bend
the casualtys arm at
the elbow so that his
forearm is across his
chest and place soft
padding between the #
site and the body.
Support the arm with
an arm sling.

For additional
support, secure the
casualtys arm to his
trunk by applying a
broad-fold bandage
right around his arm
and trunk.. Avoid #
site.
Take the casualty to
the hospital.

IMPORTANT
Never bend the arm
forcefully.
Check the circulation
after bandaging by
looking at the
fingers; Relax the
sling if necessary.

If the arm can not be

bent
Help the casualty
to lie down with
his arm by his
side or wherever
it is most
comfortable for
him.

Carefully place soft

padding between
the injured limb and
the casualtys body
and apply three
broad-fold
bandages around
the arm and the
body, avoiding the #
site.

Ribs fracture
Broken ribs are
splinted naturally
because they are
attached to the rest of
the rib cage.
Immobilizing the only
upper limb on the
affected side of the
body to help relieve
pain is important.

RECOGNITION
Features of # can be
noticed.
The casualty may tell you
that he feels very sharp pain
in his side, worsened by
deep breaths or coughing.
Highly tender area around
the affected ribs.
He can hear a crackling
sound.

Treatment
Help the casualty
to sit down and
support the arm
on his injured
side in an arm
sling.

If breathing is
affected
Help the casualty
into a half sitting
position so that he is
leaning towards his
injured side.
Support the arm on
the injured side with
an ELEVATION SLING.

IMPORTANT
Chest injuries
involving damage to
several ribs or the
lungs are more serious
and require urgent
medical attention
because there may be
breathing difficulties.

Pelvis fracture
#Pelvis must be handled with
great care because there may
be internal injuries.
The casualty may tell that she
is unable to move the lower
part of her body without
extreme pain and that the area
around pelvis is tender and
uncomfortable.
Unable to stand.
If # is complicated, urine may
be blood stained or signs of
internal bleeding and shock
can be noted.

Treatment
Help the casualty to lie on his
back with legs straight or with
knees slightly bent with a
cushion under them, the most
comfortable position.
Place some soft padding
between the knees and ankles.
Tie the feet and ankles
together with a narrow fold
bandage, and place a broadfold bandage around both
knees.

Lower limb fracture

Pain, swelling, loss of
mobility and shock.
If # is below the knee the
foot may have fallen to one
side although knee is
straight.
If # is above the knee the
limb may look shorter or the
foot and knee may have
fallen sideways.

Treatment
Steady and
support the limb
if necessary get
an assistant and
treat the
wounds.

Holding the ankle

and foot, apply
gentle traction,
carefully pulling in
the long axis of
the limb to bring
it into its normal
line.

Continue
supporting and
using the natural
hollows, place
bandages at the
knees, above and
below the #site
and under ankles.

Bring the sound limb

alongside and place
soft padding between
the legs so that
bandages do not
displace the bones.
Tie the knots on the
uninjured side, starting
at the ankles, knee and
below the # site.

Important
When traction is
being applied, if any
resistance is felt,
stop immediately.
Never leave a
casualtys lower
limb unsupported.

Femur fracture
Steady and support the limb and treat
any wounds.
Apply and maintain gentle traction by
holding the casualtys knee. Bring the
injured leg into a straight line by
pulling in the long axis of the limb
from the ankle.
Support the injured leg at the ankle
and using the natural hollows gently
place the bandages under the
casualtys legs at the knees, above
and below the # and under the
ankles.
Avoid jerky movements while tying
knots on the uninjured side.

Knee fracture
The knee cap can be
broken by a direct blow or
split by violent muscular
pull from thigh muscles.
All knee injuries are painful
and it may be difficult to
tell whether a person has a
broken knee cap or has
damaged cartilage or
ligament.

Recognition
The general features of # are
present.
The casualty may tell that the
knee is extremely painful, and
unable to lift the leg or foot off
the ground.
You may notice that the knee is
bent and any attempt to
straighten it increases the pain
The joint swells up and feels
tense.

Treatment
Help the casualty lie down and
steady the leg in the position
the casualty finds the most
comfortable. Place a small
pillow in the hollow under the
knee and around the knee.
Bandaging is not essential but
the casualty may find it more
comfortable. Bandage the
knee with cotton wool padding
and allowing for swelling.

Important
Do not force
the leg
straight.

Dislocation
A dislocation is a separation
of two bones where they
meet at a joint. (Joints are
areas where two bones
come together.) A dislocated
bone is no longer in its
normal position, which may
result in damage to
ligaments, nerves, and
blood vessels.

Dislocation
A dislocation is a
separation of two bones
where they meet at a joint.
(Joints are areas where two
bones come together.) A
dislocated bone is no
longer in its normal
position, which may result
in damage to ligaments,
nerves, and blood vessels.

Joints
Junction of two or more bones
Immovable joints ; fused
together
Movable joints 3 types 1) ball and socket joints

2) hinge joints
3) joints with limited
movement

Considerations
It may be hard to tell
a dislocated bone
from a broken bone.
Both are emergency
situations and
require the same
first aid treatment.

 Most dislocations, if treated

early, will not result in
permanent injury.
Injuries to the surrounding
ligaments generally take 3 6 weeks to heal. Sometimes,
surgery to repair a torn
ligament is needed.
Injuries to nerves and blood
vessels may result in more
long-term or permanent
problems.

Important
Once a joint has been
dislocated, it is more
likely to happen
again. Follow-up with
an orthopedic surgeon
is recommended after
a dislocation.

Causes
Dislocations are
usually caused by a
sudden impact to
the joint. This
usually occurs
following a blow,
fall, or other
trauma.

Symptoms
Accompanied by numbness or
tingling at the joint or beyond
it
Intensely painful, especially if
you try to use the joint or bear
weight on it
Limited in movement
Swollen or bruised
Visibly out of place, discolored,
or misshapen

Treatment

check the airway, breathing, and

circulation. If necessary, begin
rescue breathing , CPR, or bleeding
control.
Do not move the person if you think
that the head, back, or leg has been
injured.
If the skin is broken, take steps to
prevent infection. Do not blow on the
wound. Rinse the area gently to
remove obvious dirt, but do not scrub
or probe. Cover the area with sterile
dressings before immobilizing the
injury.

 Splint or sling the injury in

the position in which you
found it. Do not move the
joint. Be sure to immobilize
the area above and below
the injured joint.
Check the blood
circulation.
Apply ice packs to ease
pain and swelling.
Take steps to prevent
shock.

Do not
move the person unless the
injury has been completely
immobilized.
move a person with an
injured hip, pelvis, or upper
leg unless it is absolutely
necessary. If you are the only
rescuer and the person must
be moved, drag him or her by
the clothing.

Continued .
attempt to straighten a
misshapen bone or joint
or to change its position.
test a misshapen bone
or joint for loss of
function.
give the person anything
by mouth.

Prevention
Preventing injuries in children:
Create a safe environment around
your home.
Pay careful attention to preventing
falls by gating stairways and keeping
windows closed and locked.
Supervise children carefully. There is
no substitute for close supervision
no matter how safe the environment
or situation appears to be.
Teach children how to be safe and
look out for themselves.

 Preventing dislocations
in adults:
Avoid falls by not
standing on chairs,
countertops, or other
unstable objects.
Eliminate throw rugs,
especially for the elderly.
Wear protective gear
when participating in
contact sports.

Shoulder dislocation
The shoulders are the
most common joint in the
body to dislocate. The
arm is moved away from
the body (abducted) and
externally rotated
(turning the forearm,
palm side up).

Symptoms
The main symptom of a
shoulder dislocation is severe
pain at the shoulder joint.
The patient will have great
difficulty moving your arm
even a little bit.
If the shoulder is touched
from the side, it feels mushy,
as if the underlying bone is
gone

Treatment
If a sling is not available,
rig one by tying a long
piece of cloth in a circle
(a bed sheet or towel
may do nicely).
A pillow placed between
the arm and body may
also help support the
injured shoulder.

Hip dislocation
Causes
High-speed motor
vehicle collisions (MVCs)
are by far the leading
cause of hip
dislocations.Falls from
significant height
andsports-related injury
are also among the top
causes.

Recognition
Posterior: The hip is
flexed, internally
rotated, and adducted.
Anterior: The hip is
minimally flexed,
externally rotated and
markedly abducted

 Patients with a hip

dislocation have
severely limited range
of motion.
movements are
extremely painful &
restricted

Treatment
Don't delay
medical care.
Don't move the
joint.
Put ice on the
injured joint

Elbow Dislocation
The elbow joint,
formed where
these 3 bones
meet, becomes
dislocated, or out
of joint.

Causes
usually a fall

Symptoms
Severe pain in the elbow,
swelling, and inability to bend
your arm are all signs of an
elbow dislocation.
In some cases, you may lose
feeling in your hand or no longer
have a pulse (can't feel your
heartbeat in your wrist).
Arteries and nerves run by your
elbow, so it is possible you
might have injured them during
the dislocation.

Treatment
put ice on the elbow
check pulse.
Check If any feeling
of numbness
results, see a doctor
immediately.

Sprains
The ligaments are
anchored to bone
on each side of the
joint. If a ligament
is stretched or
torn, the injury is
called a sprain.

Symptoms
Pain
Swelling
Bruise
Difficulty to
move the joint

Treatment
RICE
Rest the injured part. Pain is the
body's signal to not move an
injury.
Ice the injury. This will limit the
swelling and help with the
spasm.
Compress the injured area. This
again, limits the swelling. Be
careful not to apply a wrap so
tightly that it might act as a
tourniquet and cut off the blood
supply.
Elevate the injured part. This
lets gravity help reduce the
swelling by allowing fluid and
blood to drain downhill to the
heart.

Strains
A strain occurs when the muscle
tendon unit is stretched or torn.
The most common reason is the
overuse and stretching of the
muscle. The damage may occur
in three areas:
The muscle itself may tear.
The area where the muscle and
tendon blend can tear.
The tendon may tear partially or
completely (rupture).

Symptoms
Pain
Spasm
Swelling

Treatment
RICE

Cramps
Cramp is a sudden ,
involuntary & painful
contraction of muscle
or group of muscles.

Causes
Poor muscle co-ordination
during exercise
Chilling following or during
exercise
Loss of salts in sweating
Diarrhoea or persistent
vomiting
During sleep
Anaerobic metabolism of
muscles

Symptoms
Pain
Feeling of tightness in
the affected area
Contracted muscles
cannot relax

Treatment
Straighten the affected
part of the body
Massage