First Aid Sprain or Fractures

Sprains, strains, dislocations, and fractures can all present with the same symptoms. It is very difficult to determine what the injury may be. It is not necessary to know which injury the victim has as the treatment will be the same for all of them.

If the patient has any of the following symptoms, you should treat for a possible muscle or skeletal injury.

  • Deformity of body part.
  • A grinding or cracking sound when the affected area is moved (usually accompanied by extreme pain). (Do not test for this! It should be reported by the patient.)
  • Bruising and swelling.
  • No pulse below injury site.
  • Inability to use the affected body part normally.

If the injury appears to be severe, EMS should be called as soon as possible.


To help you recall the proper initial steps in first aid, remember the words: R. I. C. E.
(Rest, Ice, Compression, and Elevation)


  • Rest the injured area immediately.
  • If it hurts to move immobilize injured limb; use a splint for extra support.
  • Pain is your body’s message to decrease use of the injured area.

Applying ice immediately to the injured area limits swelling.

  • Place crushed ice in a plastic zip-lock bag with water added to make it softer or a cold pack on the injured area. To avoid frostbite, use a thin piece of material (tee-shirt) between the ice and the skin.
  • Apply ice for 10-20 minutes every 2-4 hours. Stop if the area becomes numb.

Immediately after the injury, use an elastic bandage wrapped over an ice pack to reduce swelling.

  • Wrap the injured area with an elastic  bandage. Wrap the bandage firmly but not too tight to cut circulation off.
  • For the knee injury, start about 4 inches below knee and wrap to the four inches above.
  • For the ankle, start below the ankle on the foot. Use a figure of eight pattern when wrapping around the heel.
  • Remove the bandage for several hours at evening and elevate the leg to relieve pressure and swelling.


  • Rest on the bed and elevate the leg to a height above the victim’s waist.
  • Limb can be elevated by using several pillows. This helps reduce further swelling.

Do not elevate if this causes more pain to the victim.


Method of slinging depends on where the injury occurred.. After applying a sling, ensure circulation has not been compromised.

A splint and sling applied to the forearm.


Support the injured forearm approximately parallel to the ground with the wrist slightly higher than the elbow.

This can be accomplished by using the victim’s shirt or sweater as a sling. Simply pin the bottom hem to their chest using multiple safety pins, going over the arm.

Thigh Bone Fractures

 The thigh bone is the largest bone in the body, and has a  femoral artery beside it. Damage to the femoral artery is likely to cause massive internal bleeding, so it is a major emergency; Call EMS immediately. Try to maintain as much immobilization as possible and monitor ABCs until EMS arrives.

Dislocated joint may be:

  • Accompanied by numbness or tingling at the joint or beyond it.
  • Very painful
  • Limited in movement
  • Swollen or bruised
  • Visibly out of place and discolored

Treatment Review

  1. Call 911 before you begin treating someone who may have a dislocation or injury potentially life-threatening.
  2. If there has been a serious injury, check the victim’s ABC’s.
  3.  If necessary, begin rescue breathing, CPR, or bleeding control.
  4. Do not move the person if you think that the head, back, or leg has been injured.
  5. If the skin is broken, take steps to prevent infection.  Rinse the area gently with sterile water to remove obvious dirt, but do not scrub or probe. Cover the area with sterile dressings before immobilizing the injury.
  6. Splint or sling the injury in the position in which you found it. Do not move the joint. Be sure to immobilize the area above and below the injured joint.
  7. Check the person’s blood circulation around the injury by pressing firmly on the skin in the affected area. It should blanch white, and then regain color within a couple of seconds. If the skin has been broken, don’t do this.
  8. Remember R.I.C.E.
  9. Take steps to prevent shock. Unless there is a head, leg, or back injury, lay the victim flat, elevate the feet about 12 inches, and cover the person with a coat or blanket.


  • Do NOT move the person unless you must and the injury has been immobilized.
  • Do NOT move a person with an injured hip, pelvis, or upper leg unless it is absolutely necessary. If you are the only rescuer and the person must be moved away from danger, drag him or her by the clothing.



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