First aid for broken bones and sprains

1. Keep the person as still and calm as you can, and check for other injuries. If there is heavy bleeding, press a clean pad on the wound.
2. If a bone is sticking out, do not push it back or touch it. Cover the wound with a clean cloth or dressing and press around the wound, not on the bone.
3. Do not move the injured part. Support it as you found it, holding the joints above and below the injury, and pad around it with folded clothes or a blanket.
4. A towel or scarf can be used as a sling to support an injured arm.
5. Take off rings, watches and anything tight on the injured arm or hand before it swells.
6. A cold pack, or ice wrapped in a cloth, can ease pain and swelling. Keep it on for up to 20 minutes at a time and never put ice straight on the skin.
7. Give nothing to eat or drink, in case the person needs an operation.
8. Arrange medical help, as explained below. Stay with the person and watch the limb. If it turns pale, cold, blue or numb, tell the ambulance operator.

What not to do:

• Do not try to straighten a bent limb or push a bone back into place.
• Do not ask the person to test it by moving it or standing on it.
• Do not move someone who may have a back, neck, head, hip or thigh injury unless they are in danger.
• Do not let anyone pull or massage the limb to set it.
• Do not drive yourself to hospital if the injury is to your own arm or leg.

Suspect a spine injury after a bad fall, crash or blow if the person has pain in the neck or back, a twist in the line of the spine, weak or no movement in the arms or legs, tingling or loss of feeling, loss of control of the bladder or bowels, or trouble breathing.

• Call for an ambulance, or ask someone to.
• Do not move them, and do not tell them to move, unless they are in immediate danger, for example from fire or traffic.
• Keep the head, neck and back in a straight line. Kneel behind the head and hold it still with a hand on each side, without covering the ears.
• Keep checking their breathing and how they respond. If they stop breathing, start CPR.

A smaller bone, such as a finger, wrist or ankle, still needs an X-ray at a hospital emergency department. Ask someone to take you rather than driving yourself. A young child who will not use an arm or leg, or will not put weight on it, after a fall should be checked too, even if nothing looks wrong.

A sprain is a stretched or torn ligament at a joint, and a strain is a pulled muscle or tendon. For the first 2 to 3 days:

• Rest it. Stop using the joint and avoid putting weight on it.
• Ice it. Use a cold pack or a bag of frozen vegetables wrapped in a cloth, for up to 20 minutes at a time.
• Support it with a bandage wrapped firmly but not tightly.
• Raise it on pillows as much as you can.
• Avoid heat, alcohol and massage for the first couple of days, because they can increase swelling.
• Pain relief such as paracetamol can ease the pain.

It can be hard to tell a bad sprain from a break without an X-ray. If you heard a crack, the part has changed shape or sits at an odd angle, it is numb or tingling, or the skin is blue, grey or cold, treat it as a break and go to hospital. See a doctor if the pain is severe or getting worse, the swelling is large or growing, you cannot put weight on it, or it is not improving.