Learn essential first aid for broken bones .Broken bones and fractures are serious injuries that can happen in the wilderness due to falls, accidents, or other unexpected events. Immediate medical attention is the best course of action for treating broken bones, but that may not always be available in remote locations. Here is a guide to stabilizing and providing initial treatment for bone fractures when medical help is not readily available.
Identifying a Broken Bone or Fracture
Symptoms often include:
- Intense pain
- Swelling and bruising
- Deformity or unnatural movement
- Inability to move or put weight on the limb
- Grating noise or feeling
Immediate Steps
- Assess the Situation: Make sure you and the injured person are safe from further harm. This could mean moving away from a precarious ledge or ensuring that you’re visible to any oncoming traffic.
- Call for Help if Possible: If you have a means of communication, call for emergency assistance immediately.
- Comfort and Calm the Injured Person: Reassure the individual, keep them warm with a blanket or clothing, and elevate the injured area to reduce swelling, if possible.
Stabilizing the Fracture
- Immobilization: Use items like clothing, backpack straps, or sticks to immobilize the limb. Make sure to secure the joints above and below the fracture.
- Padding: Place padding (like clothing or foam) between the splint and the skin to reduce pressure points.
- Secure the Splint: Use ropes, belts, or adhesive tape to tie the splint securely, but not so tight that it cuts off circulation.
- Check Circulation: Make sure you can still feel a pulse below the area where you’ve applied the splint. Check periodically for signs of swelling, numbness, or bluish skin.
Open Fractures (Broken Skin)
- Control Bleeding: Use a clean cloth, gauze, or even a sanitary pad to apply gentle pressure around the wound to control bleeding. Do not press directly on the bone protruding through the skin.
- Cover the Wound: Cover the wound with sterile gauze or clean cloth to minimize infection risk.
- Follow Closed Fracture Protocol: After controlling bleeding and covering the wound, follow the closed fracture immobilization steps above.
Additional Steps
- Hydration and Nutrition: Keep the injured person hydrated and nourished, but avoid giving them anything that could lead to dehydration like coffee or alcohol.
- Pain Management: Over-the-counter pain medications like ibuprofen can help manage pain, but avoid those that could exacerbate bleeding, like aspirin.
- Monitor for Shock: Keep an eye out for symptoms of shock, such as rapid breathing, weak pulse, and pale or bluish skin. Keep the individual warm and elevate the legs if possible.
- Plan Your Evacuation: Decide on the best course of action for getting the injured person to professional medical help as quickly as possible, whether that means self-evacuating or waiting for rescue.
Types of Fractures
Understanding the type of fracture can help in providing the most appropriate first aid:
- Basic Fracture: The bone is fractured, yet the skin remains unbroken
- Compound Fracture: Bone is broken and protruding through the skin.
- Greenstick Fracture: Bone is cracked but not completely broken, common in children.
- Comminuted Fracture: Bone is broken into multiple pieces.
Evaluating for Further Complications
- Nerve Damage: Look for signs like tingling, numbness, or complete lack of sensation beyond the fracture site.
- Vascular Compromise: Check the pulse below the fracture site. A weak or absent pulse could indicate compromised blood flow.
- Infection: Particularly relevant in the case of open fractures. Signs include increased pain, pus, redness, and fever.
Additional Immobilization Techniques
- Arm Sling: For fractures of the forearm or wrist, creating a sling using a shirt or bandana can help keep the arm immobilized.
- Leg Traction: For fractures in the lower leg, applying gentle traction can sometimes help align the bones, but only attempt this if you have been trained in first aid.
Transporting the Injured Person
- Walking: If the fracture is minor and in the lower extremity, you may be able to make a temporary walking stick or crutch to aid in self-evacuation.
- Stretcher: In more serious cases, you might have to construct a makeshift stretcher using jackets and strong tree limbs.
Reevaluating and Adjusting
- Regular Checks: Continuously monitor the injured area for changes in color, swelling, or sensation.
- Adjusting Splints: As swelling subsides, splints and bindings may become loose and may need to be readjusted.
Mental Health Consideration
- Pain and Panic: The injured person is likely to be in severe pain, possibly even shock. Talking to them in a calming voice can help reduce panic.
- Keep Engaged: Keep the person engaged in simple tasks or conversations to keep their mind off the injury.
A Note on Children and the Senior
- Children: Their bones are more flexible but also less able to handle stress. The psychological aspect of care is essential.
- Senior: Their bones are more brittle, and comorbidities can complicate treatment.
Snow or Cold Weather
- Prevent Hypothermia: Make sure the injured person is insulated from the ground and covered to maintain body heat.
- Snow Splints: In a pinch, packed snow can be used as a makeshift splint for stabilization, though it’s not ideal.
- Weather-Proofing: Use a waterproof layer to protect the splint and any dressings from getting wet.
In Wet or Rainy Conditions
- Keep Dry: Use tarps or rain covers to keep the injured person and their dressings dry.
- Slip Prevention: Be extra cautious when moving, as wet conditions are more conducive to slips and further injury.
In Hot and Arid Climates
- Hydration: Dehydration can complicate any medical situation. Make sure both the injured person and caregivers are well-hydrated.
- Sun Protection: Avoid direct sunlight on the injured area to prevent burns or further discomfort.
When Alone or With Limited Help
- Self-Splinting: If you’re alone and sustain a fracture, you’ll need to splint the injury yourself, using trekking poles, tree branches, or even your other limbs for stabilization.
- Signaling for Help: Use signal mirrors, flares, or even creating ground signals with rocks or logs to attract attention if you cannot move.
- Energy Conservation: Whether alone or with limited help, it’s crucial to conserve energy. Plan your actions carefully to avoid unnecessary expenditure of effort.
Children and Pets
- Children: They may not understand the severity of the situation. Keep them calm and engaged in a task or game to distract them from the pain or stress.
- Pets: If a pet suffers a fracture, the same basic principles apply—immobilize the limb and seek veterinary care as soon as possible.
Technology and Tools
- GPS and Satellite Phones: These can be invaluable for both navigation and calling for help, especially in areas without cell service.
- First Aid Apps: Several apps provide comprehensive first aid guides, including how to handle fractures and other severe injuries.
- Personal Locator Beacons: In dire situations, activating a personal locator beacon can alert authorities to your precise location for rescue.
Mental Resilience
- Maintaining Morale: Encouragement and positive outlook can go a long way in keeping the injured person’s spirits up, which in turn can positively affect their physical condition.
- Mindfulness and Breathing: Simple mindfulness techniques and deep-breathing exercises can help manage pain and stress for both the injured person and caregivers.
Post-Evacuation
- Follow-Up Care: After successful evacuation and immediate medical treatment, further medical follow-up will usually be necessary, often including rehabilitation exercises or surgery.
- Learn and Adapt: After the incident, take time to review what happened. Were there any preventive steps that could have been implemented? How could you be better prepared for next time?
Conclusion
When you’re in a remote setting, dealing with broken bones and fractures can be incredibly challenging. Although the immediate objective is to stabilize the injury and control pain, getting to a medical facility for proper treatment is crucial. These guidelines are not a substitute for formal training or professional medical advice. When it comes to fractures, the sooner proper medical care is administered, the better the outcome will be. Therefore, your ultimate goal should be to get professional medical help as soon as possible.
