Principles of Acute Fracture Care

If you suspect you have fractured a bone, or that someone else has, you can take certain steps to stabilize the situation until a doctor can determine the extent of the injuries. When treating a fracture or suspected fracture, your main concerns will undoubtedly be pain, internal or external bleeding, swelling, and immobilizing the affected area to avoid making the injury worse.

Immobilization

• Do not attempt to straighten or reset a broken limb yourself. Instead, immobilize the limb with a sling or splint.

  Use thin but rigid pieces of wood, metal or plastic in your splint, and bind them with a bandage, tape or cloth on either side of the joint or limb. Pad the stiff material with fabric, and be careful not to apply direct pressure to the injured area.

  Use an elbow sling to immobilize the forearm or elbow joint. If a toe or finger is injured, you can immobilize it by taping it to an adjacent finger or toe.

Swelling

• Applying ice will reduce swelling. When you are injured, your body naturally sends more blood to the affected area. Cold temperatures constrict blood vessels and slow the flow of blood, which prevents the area from continuing to swell. It is best to use ice instead of a cold pack, because cold packs do not get as cold as ice.

  Place the ice inside a plastic bag, and hold it against the injured area if the skin is not broken. Otherwise, clean and dress the wound before applying ice. The ice will also numb the pain. Place a towel between the ice pack and the injured area to protect the skin from frostbite.

Open Wounds or Internal Bleeding

• If there is a severe open wound, it's essential to stop the bleeding. Using sterile gauze, press down on the wound to stop the bleeding. If the wound bleeds through the gauze, add more and maintain the pressure. Repeat this as many times as necessary, and wrap the wound without removing any of the gauze. You may need to maintain the pressure until you are able to get emergency medical attention. The doctor or paramedics will take over at that point.

  Internal bleeding may appear as a bruise, or present no visible evidence at all. Symptoms of internal bleeding are similar to those of shock: cold sweats, disorientation and clammy skin. This is a serious situation that calls for immediate medical attention.

Emergency Care

• A known or suspected bone fracture requires professional medical attention as soon as possible. Only a professional with access to an x-ray machine can determine the full extent of the injury and provide appropriate care. A doctor will be able to tell whether surgery or a cast is necessary, and to prescribe medication for inflammation and pain.