Fracture First Aid: Immediate Steps to Reduce Harm

Suspected Fracture – First Aid Protocol

Goal: prevent further injury, control pain, prepare for definitive care.

1. Control Bleeding

• Direct pressure with sterile gauze/clean cloth.
• Do not probe or irrigate open fractures.

2. Immobilize

• Splint the joint above AND below the fracture site.
• Use rigid splint (SAM, board, rolled magazine) or sling/swath for clavicle/shoulder.
• Pad voids; check capillary refill before/after.

3. Elevate

• Extremity above heart level (if no spinal/pelvic injury).
• Reduces swelling & pain.

4. Ice

• Ice pack wrapped in towel – 15‑20 min on, 20 min off.
• Never direct ice on skin.

5. Pain Management

• OTC: ibuprofen 400‑600 mg q6h or acetaminophen 1000 mg q6h (if no contraindications).
• Do not give aspirin to children.

6. Seek Professional Care

• Urgent care for stable distal fractures.
• ED for: open fracture, neurovascular compromise, deformity, femur/hip, pelvic, spinal, multiple injuries.
• Call 911 if: uncontrolled bleeding, absent pulse, paralysis, altered mental status.

Do NOT

• Attempt reduction (re‑alignment) – except trained provider for obvious angulated distal radius with neurovascular compromise and >1 hr transport.
• Apply traction splint to femur without training.
• Give anything by mouth (NPO for possible surgery).