A fracture is a broken bone. It requires medical attention. If the broken bone is the result of major trauma or injury, call an ambulance or your local emergency number. Also call for emergency help if:
- The person is unresponsive, isn't breathing or isn't moving. Begin cardiopulmonary resuscitation (CPR) if there's no respiration or heartbeat.
- There is heavy bleeding.
- Even gentle pressure or movement causes pain.
- The limb or joint appears deformed.
- The bone has pierced the skin.
- The extremity of the injured arm or leg, such as a toe or finger, is numb or bluish at the tip.
- You suspect a bone is broken in the neck, head or back.
- You suspect a bone is broken in the hip, pelvis or upper leg (for example, the leg and foot turn outward abnormally).
Don't move the person except if necessary to avoid further injury. Take these actions immediately while waiting for medical help:
- Stop any bleeding. Apply pressure to the wound with a sterile bandage, a clean cloth or a clean piece of clothing.
- Immobilize the injured area. Don't try to realign the bone or push a bone that's sticking out back in. If you've been trained in how to splint and professional help isn't readily available, apply a splint to the area above and below the fracture sites. Padding the splints can help reduce discomfort.
- Apply ice packs to limit swelling and help relieve pain until emergency personnel arrive. Don't apply ice directly to the skin — wrap the ice in a towel, piece of cloth or some other material.
- Treat for shock. If the person feels faint or is breathing in short, rapid breaths, lay the person down with the head slightly lower than the trunk and, if possible, elevate the legs.
If possible, before you try to stop severe bleeding, wash your hands to avoid infection and put on gloves. If the wound is abdominal and organs have been displaced, don't try to push them back into place — cover the wound with a dressing.
For other cases of severe bleeding:
- Have the injured person lie down and cover the person to prevent loss of body heat. If possible, position the person's head slightly lower than the trunk or elevate the legs and elevate the site of bleeding.
- While wearing gloves, remove any obvious dirt or debris from the wound. Don't remove any large or more deeply embedded objects. Your principal concern is to stop the bleeding.
- Apply pressure directly on the wound until the bleeding stops. Use a sterile bandage or clean cloth and hold continuous pressure for at least 20 minutes without looking to see if the bleeding has stopped. Maintain pressure by binding the wound tightly with a bandage or clean cloth and adhesive tape. Use your hands if nothing else is available. If possible, wear rubber or latex gloves or use a clean plastic bag for protection.
- Don't remove the gauze or bandage. If the bleeding continues and seeps through the gauze or other material you are holding on the wound, don't remove it. Instead, add more absorbent material on top of it.
- Squeeze a main artery if necessary. If the bleeding doesn't stop with direct pressure, apply pressure to the artery delivering blood to the area. Pressure points of the arm are on the inside of the arm just above the elbow and just below the armpit. Pressure points of the leg are just behind the knee and in the groin. Squeeze the main artery in these areas against the bone. Keep your fingers flat. With your other hand, continue to exert pressure on the wound itself.
- Immobilize the injured body part once the bleeding has stopped. Leave the bandages in place and get the injured person to the emergency room as soon as possible.
If you suspect internal bleeding, call an ambulance or your local emergency number. Signs of internal bleeding may include:
- Bleeding from body cavities
- Vomiting or coughing up blood
- Bruising on neck, chest, abdomen or side
- Wounds that have penetrated the skull, chest or abdomen
- Abdominal tenderness, possibly accompanied by rigidity or spasm of abdominal muscles
- Shock, indicated by weakness, anxiety, thirst or skin that's cool to the touch