Falls: bones, sprains and head injuries
Support a suspected broken bone as you find it, cool a sprain, and know the warning signs after a knock to the head that mean getting help fast.
IF IN DOUBT
You can't tell a break from a sprain by looking
A broken bone (fracture) and a sprain share their signs: pain, swelling, bruising, and not being able to use the arm or leg normally. Only an X-ray tells for sure. So the rule is simple: if in doubt, treat it as a fracture. Call the emergency number if there's an obvious deformity, bone through the skin (an open fracture), a grating feeling, or an injury to the leg, hip or pelvis.
Parisa twists her ankle stepping off a curb. It's swollen and she can't stand on it. It might be a sprain; she treats it as a possible break and gets it X-rayed.
A suspected broken bone
- Don't move them
Unless they're in danger where they are. Let them stay in the position that hurts least.
- Support the injured part as you found it
Hold it with your hands, or pad around it with rolled-up clothing. For an arm, a sling if it's comfortable for them.
- Don't try to straighten it
And never try to push a dislocated joint back in. Both can damage blood vessels and nerves.
- Open fracture: cover the wound
A clean dressing over it, and press around the bone to control bleeding, never on it.
- Watch for shock, nothing to eat or drink
Pale, cold, clammy skin and fast breathing mean shock (lesson 7). No food or drink, in case they need surgery.
Check yourself
Daniyal falls off his bike. His forearm is bent at an odd angle and he's holding it against his chest. What do you do?
- Gently pull the arm straight so the bone lines up again
- Support it the way he's holding it, don't straighten it, and get him to hospital or call for help
- Ask him to move his fingers and wrist a few times to check it's broken
- Rub it firmly to bring the swelling down
Show the answer
Support it the way he's holding it, don't straighten it, and get him to hospital or call for help
Right. An odd angle means treat it as a fracture: keep it still as found, support it, and get professional help. Straightening is a job for hospital.
A sprain or strain
- Rest it
Stop the game or the walk. Carrying on makes it worse.
- Cold pack, wrapped in a cloth
An ice pack or a bag of frozen peas wrapped in a thin towel, for up to about 20 minutes. Never put ice straight on the skin.
- Support it, and raise it if comfortable
Rest the leg on a cushion or a chair, or support the arm.
- Get it checked if
They can't put weight on it, the pain is severe, or it isn't getting better.
Check yourself
For the fastest results, hold ice directly on a sprained ankle for as long as possible.
Show the answer
False
False. Ice straight on the skin can cause a cold injury. Wrap the cold pack in a cloth and use it for up to about 20 minutes at a time.
A KNOCK TO THE HEAD
Most head bumps are minor. Watch anyway.
A bump and a headache after hitting your head on a cupboard door is common, and usually settles. A cold compress wrapped in a cloth on the bump, rest, and someone keeping an eye on them is often enough. The danger is the rarer injury inside the skull, which can show itself hours later. That's why the watching matters more than the bump.
Maryam's grandfather slips in the bathroom and hits his head. He seems fine. Because he's older, the family has a lower threshold for getting him checked, and they do.
After a head injury, get urgent help if there is
- Any loss of consciousness, even brief, or confusion or drowsiness.
- Vomiting, especially more than once, or a headache that gets worse.
- A seizure, or clear fluid or blood from the ears or nose.
- Unequal pupils, weakness, slurred speech, vision problems or memory loss.
- A fall from height or a high-speed impact, or they take blood thinners. Older people and young children: get help sooner.
Check yourself
An adult has knocked their head. Sort each sign.
- Has vomited twice since the fall
- A small bump that's sore to touch
- Getting drowsy and hard to keep awake
- A mild headache that's easing
- Clear fluid dripping from the nose
- Can't remember how they got to the kitchen
Show the answer
Get urgent help: Has vomited twice since the fall, Getting drowsy and hard to keep awake, Clear fluid dripping from the nose, Can't remember how they got to the kitchen
Rest, with someone watching: A small bump that's sore to touch, A mild headache that's easing
Check yourself
Kian takes an elbow to the head in a futsal game. He's dazed for a minute, then says he's fine and wants to go back on. What should happen?
- He goes back on if he can tell you the score
- He rests five minutes with a cold drink, then plays
- He stops for the day, gets checked, and someone stays with him and watches for warning signs
- He drives himself home and sleeps it off
Show the answer
He stops for the day, gets checked, and someone stays with him and watches for warning signs
Right. Being dazed after a knock can mean a concussion, so no more play that day. He gets checked, and someone stays with him in case a warning sign appears.
NECK AND BACK
A possible spinal injury
Suspect one after a fall from height, a diving accident or a road crash, or if they have neck or back pain, tingling, or weakness in their arms or legs. If they're awake and breathing: keep their head and neck still and in line with your hands, don't move them unless they're in danger, and call the emergency number. But breathing comes first: if they're unresponsive and not breathing normally, start CPR.
Kneel behind their head and hold it gently on both sides, keeping it in line with the body, until help takes over.
Check yourself
Maryam's father falls from a ladder while cleaning windows. He's awake, breathing normally, and says his neck hurts and his hands are tingling. What do you do?
- Keep his head and neck still and in line, don't move him, and call 115
- Help him sit up slowly so he can breathe more easily
- Roll him into the recovery position straight away
- Help him walk to the sofa so he's more comfortable
Show the answer
Keep his head and neck still and in line, don't move him, and call 115
Right. Neck pain and tingling after a fall from height mean a possible spinal injury. He's breathing normally, so the job is to keep him still, head in line, until help arrives.
Lesson recap
- A break and a sprain look alike. If in doubt, treat it as a fracture.
- Suspected fracture: don't move them, support the injury as you found it, don't straighten it, and nothing to eat or drink. Cover an open fracture and press around the bone.
- Sprain: rest, a cold pack wrapped in cloth for up to about 20 minutes, support, and raise it if comfortable.
- After a head knock, get urgent help for loss of consciousness, confusion, drowsiness, repeated vomiting, a worsening headache, a seizure or fluid from the ears or nose. Someone stays with them for about 24 hours.
- Possible spinal injury: keep the head and neck still and in line and call. But if they aren't breathing normally, CPR comes first.
- This is general education; a certified hands-on course is where you practise it.