A broken arm involves a crack or break in one of the three bones: the humerus in the upper arm, or the radius and ulna in the forearm. This common injury often results from a fall onto an outstretched hand or significant direct trauma. While a fracture is not usually life-threatening, it requires prompt medical attention to ensure proper healing and prevent complications. This guidance outlines the immediate, non-professional first aid steps to take while prioritizing safety until medical professionals arrive.
Identifying Signs of a Fracture
A person who has broken their arm will experience severe pain that typically intensifies with any attempt to move the limb. Visual inspection of the injured area may reveal swelling and bruising, which can appear almost immediately after the injury occurs. A highly visible sign is an obvious deformity, such as an unnatural bend or a limb that appears shorter compared to the uninjured arm.
A distinct physical sensation pointing strongly to a fracture is crepitus, a grating or crunching sensation that occurs when bone fragments rub against each other. This sound can sometimes be heard as a crackling noise. The person may also have difficulty rotating their arm and will likely experience tenderness when the fracture site is gently touched.
In some severe cases, the broken bone may puncture the skin, creating an open or compound fracture, which significantly increases the risk of infection. Numbness or tingling in the fingers or a cold, pale hand are serious signs that a nerve or major blood vessel may be damaged, requiring immediate emergency attention.
Immediate First Aid and Stabilization
The first priority is to ensure the safety of both the injured person and the rescuer by moving away from any ongoing hazard, such as a busy road or unstable ground. If there is visible, heavy bleeding from an open wound, direct pressure must be applied to the site using a clean cloth or sterile dressing to control the blood loss. Never attempt to clean a deep wound or remove any foreign objects, as this could cause further damage.
The injured limb must be immobilized exactly as it is found. A primary rule is never to attempt to straighten or realign the arm, even if it appears severely deformed. Immobilization involves stabilizing the joints both above and below the fracture site, meaning the shoulder, elbow, and wrist joints should all be secured.
To create a temporary splint, use rigid materials like rolled newspapers, magazines, or thin pieces of wood, and secure them with strips of cloth, a belt, or a tie. The splinting material should be padded with soft items like towels or clothing to reduce discomfort. After securing the splint, the arm should be placed in a comfortable position, often across the chest, and supported with a sling.
A temporary sling can be fashioned from a triangular bandage, scarf, or a piece of clothing to support the weight of the arm and keep it elevated. The sling should keep the hand slightly higher than the elbow to help minimize swelling in the hand. Once the arm is stabilized, check the circulation in the hand by observing the color and temperature of the fingers and assessing their ability to move and feel sensation.
To manage pain and reduce swelling, a cold compress or an ice pack can be applied to the injured area. Always wrap the cold source in a towel or cloth to prevent skin damage, as ice should never be placed directly on the skin. Continue to monitor the injured person for signs of shock, such as pale skin or rapid breathing, and keep them calm and warm while awaiting medical assistance.
Seeking Definitive Medical Treatment
Once first aid stabilization is complete, the next step is to get the injured person to a hospital emergency department. If the person has an open fracture with the bone visible, is experiencing heavy bleeding, or shows signs of nerve or blood vessel damage like numbness or a cold, pale hand, emergency services (911) should be called immediately. For less severe, closed fractures, the person can be transported to the emergency room by car, provided they are safely secured and the arm remains immobilized.
At the hospital, the arm will be diagnosed, typically starting with an X-ray to determine the exact location and type of fracture. The treatment approach depends on whether the bone fragments are properly aligned or displaced. If the bone pieces are misaligned, a physician will perform a procedure called reduction to set the bone back into its correct anatomical position.
A closed reduction involves external manipulation of the bone without a surgical incision, often performed using sedation or anesthesia to manage pain. If the fracture is severe, displaced, or involves multiple fragments, an open reduction may be necessary. This surgical procedure often includes internal fixation, where the bone is stabilized with metal implants like plates, screws, or rods.
Following reduction, the arm is immobilized with a cast or splint. Follow-up care, including physical therapy, will be needed to restore full function once the bone has healed.