When attending a casualty with a fracture of the leg or hip it is important that an ambulance is summoned as soon as possible. The casualty should not be moved unless medical assistance cannot be summoned or you have to remove him or her from a situation of potential danger. Fractures of the hip and thigh bone are often characterized by shortening and outward rotation of the injured limb. Should you need to move the casualty?
1. Gently lay the casualty on his back, supporting the injured limb with your hand, and make him as comfortable as possible. Arrange for an ambulance to attend as soon as possible.
2. If the lower limb is being bent in a position that prevents it from being immobilized, it may be necessary to apply gentle traction. Pull the limb gradually in a straight line, in line with the bone. Do not persist if the casualty experiences too much pain and distress.
3. Immobilize the limb, maintaining traction throughout this process. Tie the feet together at the ankles with a narrow bandage in a figure of eight. Place plenty of soft padding between the legs, from the groin to the ankle. Apply broad bandages above and below the fracture site but not directly on it. Gently position bandages round both legs, below the knees and at the knees. Tie the bandages in place with the knots tied on the uninjured limb and the ends of the knots tucked in.
4. If you are required to transport the casualty any distance then the leg will require greater support. Place a long straight board or branch as a splint from the armpit to the foot on the affected side of the body. Place padding between the body and the splint and then secure it in place with broad bandages above and below the fracture site, at the ankles, the knees, the pelvis and the chest.
5. Once the limbs are immobilized, if possible raise them a little to reduce the swelling. Check the ankles for signs of a pulse and the toes for numbness; loosen the bandages a little if necessary.
6. Observe the casualty for shock and ensure that he or she is kept warm and as comfortable as possible