FRACTURES       

• Keep the patient still
• Attend to such injuries as an open wound or bleeding before dealing with the fracture
• If necessary, protect the broken bone
• Stay with the patient, and make him comfortable until professional help arrives

First- Aid

• Unless the patient is in a dangerous situation, let him not move
• Look for and control any bleeding. Dress any wounds. If possible, do this without moving the patient
• If expert help is likely to come quickly, let the patient wait, lying quietly, and make him comfortable
• If help is delayed or the patient has to be transported to a doctor, immobilise the fractured part. Make sure that you immobilize not only the whole length of the bone but also the joint
• Protect the patient from shock
• Protect the patient from further injury

Immobilising fractures

Arm:

• If elbow can be bent without pain, place pad in armpit and support forearm with sling.
• Make certain that the forearm slopes slightly upwards.
• If elbow is straight and painful to bend, keep patient lying down.

Leg:

• Keep patient lying down.
• Place padding between legs from groin to just above ankles.
• Put bandage around knees and tie on side. Make figure-of-eight bandage around feet and ankles.

Collar-bone:

• Keep point of elbow supported until sling can hold it; support arm on side of fracture with a sling.
• Place soft pad under armpit.
• Secure upper arm against chest-place wide bandage over arm, across back add chest and tie under armpit on unaffected side

Jaw:

• Gently clear mouth of, any blood or dentures.
• Put thick pad under and around jaw. (Patient's cupped hand can support it temporarily).
• Secure by placing bandage over pad; bring ends up over ears and tie on top of the patient's head.

How to put sling support

Simple arm sling: support elbow, keeping hand raised. Pass bandage between chest and arm. Bring bandage up over forearm and around back of neck. Tie points together over hollow above collar-bone. arm Pin loose end at elbow

Figure-of-eight bandage: carefully place patient's feet together. Lay middle of broad bandage across the soles of the feet. Bring ends of bandage to front of feet; cross over the insteps. Continue 'wrapping' bandage by carrying ends to back of anklms. Cross ends, bring them back to front of ankles and cross again. Take ends back under soles. Secure in place by tying.

Foot and ankle bandage: Use flat cushion or folded cloth around ankle and foot. Secure by tying with narrow bandages.

Some helpful points to remember

·         Deciding whether someone has broken a bone can be difficult - many of the 'classic' features are similar to severe sprain. Pain is common.

·         Restricted movement of the injured part and swelling of tissues in the area can be symptomatic of both sprains and fractures. Also, many fractures retain the broken bone ends in good anatomical position so that another classical feature, deformity, is not always present

·         If a triangular bandage is not available, an adequate emergency sling can be rapidly improvised from clothing. The patient's arm can be placed inside his shirt, supported by the fastened buttons. A tie can also be used.

·         The likelihood of bone damage is high if there was considerable force, such as a hard
blow or a fall. Sometimes diseased bones, or, in the elderly, brittle bones, can break
relatively easily.

·         In the case of a broken backbone, the fracture of a vertebra might create loose pieces of bone that could enter the spinal cord, causing permanent paralysis and loss of feeling.

·         If there is any possibility of such a fracture, do not move the patient. Let him lie as you found him and wait for the doctor or ambulance

·         Meanwhile, make certain he cannot move. Place cushions or other soft articles between the patient's body and any pieces of furniture

Tips

·         Use a sound part of the patient's body as a splint if you have to immobilize a fracture (for example leg to leg, arm to chest). Whenever possible, move uninjured part to the injured part.

·         Place thick padding (use cotton wool, folded towels, scarves, socks and so on) to fill spaces between two parts of the body

• Tie the parts together with firm bandages (if bandages are not
  handy, use scarves, ties, handkerchiefs etc.)

·         Tying knots over the uninjured part will help secure and immobilize it.

• Avoid having a bandage directly over a fracture of the limb

·         Check that any bandages or slings are not so tight that they cut off the circulation

·         DON'T give any food, liquid or tablets to the patient before professional help arrives.