Fractures (broken bones)


Fractures (broken bones)


Fractures will probably mean calling for help and evacuation of the casualty


Fractures



Dealing with fractures, aka broken bones, in the outdoors will almost always require calling for help and evacuation of the casualty to hospital. 


Recognising a Fracture

Out in the field, diagnosing a fracture is imprecise, as you could be dealing with a dislocation, sprain, damaged ligament or indeed a fracture. Sometimes it will be obvious that a bone is in fact broken, for example, when there is obvious deformity of the area or a bone is protruding from the skin. In most cases, the casualty will be in extreme pain.


Types of Fracture

There are many different types of fracture, but for the purposes of this article, we'll talk only of open and closed fractures. Open fractures are when the bone has penetrated the skin and is visible. Closed fractures are where the bones remain inside the skin.


Treating

  • remove the casualty from any harsh external environment, i.e. wind & rain, and place into a storm shelter if available
  • call for help
  • treat - as below 
  • wrap the casualty in additional warm clothes, insulate from the ground to prevent heat loss through conduction, and into a survival bag if possible (without risking movement of the injured area). Cutting open a survival bag and wrapping around the casualty may be a better option
  • monitor casualty whilst waiting

Closed Fractures

  • the aim of first aid in this situation is to immobilise the limb to prevent movement
  • for a suspected broken leg, move the uninjured leg alongside the broken one. Place padding between legs and strap together with whatever you have available; folded triangular bandages, straps from rucksacks, cord etc, taking care no to pull too tight. Tie-off knots on uninjured side of body
  • for a suspected broken arm, place arm in a sling if available, which will provide support

Open Fractures

  • the aim of first aid in this situation is to stop blood loss, infection and immobilise the limb
  • cut away clothing from area
  • apply a sterile dressing to the wound, taking care not to press on any protruding bone
  • you may have to apply pressure around the wound to prevent bleeding but be careful not to press directly on the protruding bone
  • add padding around bone, if required, to enable securing of the dressing 
  • immobilise limb as for closed fracture
  • monitor casualty and be prepared to treat for shock