A fracture is the medical word for a broken or a cracked bone. Fractures can be caused by many different incidents, and there are several types of fractures. St Mark James Training teaches you what they are and how to treat them.
Stable or Unstable Fractures
A stable fracture is when the broken bones do not move, either because there is not a complete break or because they have been pushed together. In these types of fractures, further damage to surrounding tissues and risk of bleeding is unlikely.
An unstable fracture is when the bones can be easily moved, when the bones are completely broken apart or the ligaments are torn. This is dangerous as this could cause damage to other surrounding blood vessels, nerves or even organs. If internal organs are damaged, this could cause internal bleeding and may even lead to shock which can be life threatening.
First Aid Classes explain that unstable fractures should be handled very carefully. As a first aider, your goal is to prevent further damage and these types of fractures can easily cause more problems if not kept in position.
Open or Closed Fractures
In open fractures, the broken bone pierces through the surface of the skin, or there could be a wound at the site of the fracture. This is an infection risk as bacteria could enter the wound, and St Mark James First Aid manual explains there is also a risk of bleeding and shock.
Closed fractures are when the skin around a fracture is intact. However with an unstable fracture damage could still occur to tissues and blood vessels if the bones are not supported correctly, which can cause internal bleeding.
What to do with a Closed Fracture
As a first aider with a patient who has sustained a closed fracture, your priority is to prevent movement at the injury site, and support the fracture comfortably ready for transport to hospital.
You should always reassure the patient, and advice them to keep still. First Aid Classes say immobilise the fracture with your hands, or you could use the assistance of a bystander. If possible, bandage the fractured body part to another body part to keep it supported firmly. For example, bandage a broken arm to the trunk of the body, or a broken leg to the other leg. Ensure that you do not bandage too tight, you should check for a pulse every ten minutes and loosen the bandaging if necessary.
If however, a fractured limb is at an angle or bent, you may need to apply some traction in order to immobilise it. This means gently pulling it straight. Doing this will help to reduce the pain for the patient, and can reduce any bleeding. Pull the injured limb straight in line with the bone, and then immobilise. But if you are unsure, or if traction causes severe pain for the patient then do not do it!
What to do with an Open Fracture
In an open fracture, first aid treatment is slightly different. If available you should wear gloves to protect both yourself and your patient, and if possible cover the wound with a pad or sterile dressing and bandage it. St Mark James Training suggests pressure should be applied to control any bleeding however take care not to press on the bone.
You then follow the same guidelines as above for a closed fracture in order to immobilise the injury.
Remember to continually monitor the patient for any signs of shock, and elevate their legs if necessary. However, if it is a leg that is injured then don’t raise it if it causes the patient further pain.
It is important that the patient doesn’t eat, drink or smoke. Some fractures may require surgery and therefore the patient must be fasted in preparation.
First Aid Manual (The Authorised Manual of St. John Ambulance, St Andrew’s Ambulance Association and the British St Mark James), 2006.