First Aid Care
- If the person is unconscious and/or not breathing or moving, call 911 for medical help and begin CPR.
- Stop any bleeding. Apply pressure to the wound with a sterile bandage, a clean cloth, or a clean piece of clothing.
- While waiting for medical care, give first aid treatment for shock if the victim has symptoms such as dizziness, weakness, pale and clammy skin, shortness of breath, and increased heart rate. The person should lie quietly with the feet elevated about 12 inches. Cover him or her with a blanket to maintain body warmth.
- Immobilize the injured area if you will be moving the victim. Do not move them if there is a back or neck injury. Make a splint by folding a piece of cardboard or newspaper or a magazine, then placing it gently under the limb. Carefully tie the splint to the injured area with pieces of cloth.
- Apply a cold compress or ice in a plastic bag to the injured area. Make sure to place a cloth between the skin and the ice so you don’t damage the skin
Fractures or Dislocations Treatment
- Call 108
- 1. Stop Bleeding, if Necessary
- 2. Splint the Area, if Possible
- 3. Reduce Swelling and Prevent Injury
- 4. Manage Pain and Inflammation
- 5. Get Medical Help As Soon as Possible
- 6. Follow Up
- The person is seriously injured.
- You suspect injury to the person's head, neck, or back.
- Bone is sticking out of the skin.
- Bleeding doesn't stop after several minutes of firm pressure.
- Blood spurts from the wound.
- Experience loss of feeling at the injured site
- Experience loss of warmth beyond the injured area.
1. Stop Bleeding, if Necessary
- Apply firm pressure to wound with clean cloth until bleeding stops.
- If bone is pushing through skin, do not touch it or try to put it back in place.
2. Splint the Area, if Possible
The purpose of the splint is to hold still and protect a wounded body part from further damage.
- Cut away clothing if it cannot be removed without moving the injured body part.
- Gently tape the dislocated area or fracture to a rolled-up newspaper, ruler, stick, or a rolled-up piece of clothing with first aid tape. In general, try to include the joint above and below the injury in the splint. As much as possible, avoid moving the injured limb, and never force it or try to twist it back into place.
3. Reduce Swelling and Prevent Injury
- Apply an ice pack wrapped in cloth or a cold compress.
- Elevate the injured area if possible.
4. Manage Pain and Inflammation
- For pain, give ibuprofen (Advil, Motrin), acetaminophen (Tylenol), ornaproxen (Aleve, Naprosyn). Do not give aspirin to anyone under age 18.
5. Get Medical Help As Soon as Possible
6. Follow Up
- The doctor will X-ray the dislocation or fracture and may realign and set it.
- The doctor may apply a splint or cast, or surgery may be required.
Broken bones and fractures
A break or crack in a bone is called a fracture.
In most cases the damage to the bone will be under the skin, which is called a closed fracture, but sometimes bits of the bone can puncture through the skin to become an open fracture.
In both cases you'll need to treat the casualty for shock. Even if you can't see any blood, the break might have caused some internal bleeding.
To break a fully grown bone, a huge amount of force is needed. But bones that are still growing are supple and can split, crack or bend quite easily, a bit like a twig.
What to look for - Broken bones and fractures
The seven things to look for are:
- Swelling
- Difficulty moving
- Movement in an unnatural direction
- A limb that looks shorter, twisted or bent
- A grating noise or feeling
- Loss of strength
- Shock
What you need to do - Broken bones and fractures
• If it is an open fracture, cover the wound with a sterile dressing and secure it with a bandage. Apply pressure around the wound to control any bleeding.
• Support the injured body part to stop it from moving. This should ease any pain and prevent any further damage.
• Once you’ve done this, call 999 or 112 for medical help. While waiting for help to arrive, don’t move them unless they’re in immediate danger.
Waiting for medical help to arrive
Protect the injured area by using bandages to secure it to an uninjured part of the body to stop it from moving. For example, fractures on the arm can be secured with a sling, and a leg with a fracture can be tied to the uninjured leg.
Keep checking the casualty for signs of shock. This does not mean emotional shock, but is a life-threatening condition, often caused by losing blood.
If they lose consciousness at any point, open their airway, check their breathing and prepare to treat someone who’s become unconscious.
Schools
First aid gives young people something amazing – the confidence to do the right thing when it really counts.
You can help us teach a generation first aid – through using our teaching resources, inviting a St John Ambulance trainer to teach first aid at your school, or taking part in the Big First Aid Lesson.
We’re incredibly proud to say our schools programme is supported by the Department for Education’s Character Grant, because it meets their criteria of developing: perseverance, confidence, motivation, neighbourliness, tolerance, honesty and conscientiousness.
We’ll be using the grant to hire more schools trainers, train 600 school first aid champions, give 100,000 young people first aid skills and give 31,500 young people in-depth first aid training. We’ll also be creating 100 new Cadet units.
Big First Aid Lesson
The Big First Aid Lessons are a series of short first aid programmes presented by St John Ambulance trainers. Each lesson covers different first aid topics, in real life scenarios with easy-to-follow first aid demonstrations. In the space of just 20 minutes, students can learn first aid skills which could stay with them for a lifetime.
You can download a new lesson every term to watch with your class. You can also finish the school year with our annual live event, The Big First Aid Lesson Live.
The Big First Aid Lesson Live returns 17 June 2016! Register now to watch with your class.
Free first aid teaching resources
Our free, downloadable teaching resources offer you first aid training that’s tailor-made to meet the needs of your group.
Our first aid lesson plans provide teachers and youth leaders with the tools to pass on life saving skills to students aged between 7 and 16 years old, whether you’re teaching in the classroom or helping a youth group earn their first aid badge.
Specialist schools trainers
St John Ambulance’s experienced schools trainers are always available to provide you with help and support. They can help familiarise you with our teaching resources, and can also be booked to teach first aid to your students.
A-Z of first aid teaching courses
Our modular first aid courses offer a practical framework for teachers and youth leaders to provide first aid training to their students.
Each course contains a carefully chosen variety of first aid scenarios for students to learn. Alternatively,browse all first aid modules to see the full list.
We’ve created a range of courses suitable for schools:
This course covers all our first aid modules, split into three levels to be taught over consecutive school years.
Teach young people the life saving skill of resuscitation. This course covers adult, child and infant CPR.
This course contains every module we offer – ideal for after school clubs or those who have more time to spend on first aid.
This course includes modules which are required for PE students.
This course includes modules which are required for science students.
This course includes modules which are required in the PSHE curriculum.
This course includes modules which are required in the childcare curriculum.
A dislocation is where a bone has been displaced from its normal position at a joint. A fracture is when a bone has been broken.
A fracture is termed:
- closed where there is no break in the skin;
- open where the bone end has broken the skin or a wound is present with the fracture.
Fractures The fractured or dislocated part should not be moved and first aid should be confined to providing soft padding and support in the position chosen by the patient.
In a remote area, or where ambulance or medical care is likely to be delayed for an hour or more, the first aider may use simple immobilisation techniques to reduce pain and spasm. In such cases it is the first aider’s responsibility to monitor the circulation in any affected limb to ensure that the immobilisation has not stopped blood flow or affected the nerve supply to an extremity.
Dislocation Symptoms and signs – Not all may be present
- pain
- swelling
- deformity of the injured area (when compared with the uninjured side of the body)
- loss of normal function of the injured part
- discolouration of the skin (i.e. blueness) or bruising
- a wound if it is an open fracture
- altered sensation – e.g. ‘pins and needles’ – if a nerve is under pressure
- a grating sensation if injured bone ends are rubbing together
- patient may have heard/felt the bone break
How you can help
1. Control any bleeding
- If a wound is present, check for any significant bleeding; and if bleeding, apply direct pressure around any exposed bones.
- Apply padding around the wound, or above and below the wound.Apply a clean dressing loosely over the injured part.
Call 111 for an ambulance.
2. Immobilise the injured part
- Reduce the pain and the risk of further injury by supporting and immobilising the injured area. Usually this simply means supporting the injured part in a comfortable position.
3. Make the patient comfortable
- Help the patient into the position of greatest comfort without any unnecessary movement. Use blankets, pillows or clothing for general comfort and support.
- Place generous padding around the injured area and in the nearby hollows of the body, using soft towels, clothing, pillows or blankets, etc.
- Where an ambulance is likely to be delayed for more than 1 hour immobilise the injured part. Specific immobilisation techniques for various injuries are outlined on the following pages.
DO NOT move the patient or any injured part unnecessarily.
Make the patient comfortable
Fractures and dislocations that need special care
Fracture of the face or jaw
Fractures of the face and jaw have the potential to be serious. Injuries to the face may be associated with a head injury or with a serious eye injury. A fractured or dislocated jaw may cause a risk of serious airway complications because of the loss of the ability to swallow or bleeding within the mouth.
- If unconscious but breathing normally, place the patient on their side in a supported position.
Call 111 for an ambulance.
- If conscious, allow the patient to rest in the position of greatest comfort, generally half-sitting or lying down with the head tilted to the injured side. Provide a clean pad or some tissues for the patient to mop up any blood, saliva or mucus.
- If the jaw appears broken or dislocated, allow the patient to support the injured part with one or both hands.
Fracture of the collarbone or dislocation of the shoulder joint
A dislocated shoulder and fractured collarbone are managed in a similar way because both injuries disrupt the shoulder joint, and the weight of the arm on the injured side needs to be supported. Usually the patient will be supporting the arm on the injured side and the shoulder will be lower than the uninjured side, with the patient’s head tilted towards the injury. The patient is usually in severe pain and any unnecessary movement should be avoided.
- Use a pillow or folded clothing to allow the patient to support the weight of the arm in the most comfortable position.
Call 111 for an ambulance.
- If ambulance transport is likely to be delayed, carefully immobilise the arm with padding under the armpit and apply either an elevation sling or an arm sling depending on the patient’s preferred position of greatest comfort.
Use a pillow or folded clothing to allow the patient to support the weight of the arm in the most comfortable position. 
Apply either an elevation sling, or an arm sling. Fracture of the ribs
The injury may involve a single broken rib or several broken ribs. A rib fracture is always associated with pain, especially when breathing in or coughing. Sometimes an abnormal movement can be seen where one part of the chest moves outwards when the corresponding part on the opposite side moves inwards. In a severe injury where the underlying lung has been damaged, the patient may have breathing
- Assist the patient into a position of greatest comfort.
Call 111 for an ambulance.
- If severe pain is present, the first aider should apply improvised padding over the injured area and a broad-fold triangular bandage as a binder to secure the arm to the chest wall over the padding. This will stabilise the moving segment internal injury. An elevation sling is used to support the arm on the injured side.
Fracture of the upper arm
The patient usually supports the weight of the elbow and lower arm to reduce the pain of the injury. This fracture can be very serious because of the risk of pressure on major nerves and blood vessels, especially those close to the shoulder and elbow joints.
- Assist the patient into a position of greatest comfort, generally sitting in a chair or halfsitting with support.
- Allow the patient to support the arm on the injured side on a pillow or folded clothing.
Call 111 for an ambulance.
- If the ambulance is likely to be delayed apply an elevation sling with the minimum of movement of the injured arm.
Fracture of the lower arm or wrist
These injuries are very common, especially in children and the older adult. The wrist is often injured when a person falls onto an outstretched hand. Normally the patient can support theinjured arm using the other arm, but additional immobilisation may be required during transport to a doctor or hospital.
- Assist the patient into the position of greatest comfort, usually sitting down supporting the weight of the injured limb against the body with the other hand. A pillow or rolled-up clothing may be placed on the lap to provide a soft support for the patient to use to rest the weight of the arm.
- The patient needs to be taken to a hospital. If ambulance transport is not used it is necessary to immobilise the arm to avoid more pain and muscle spasm.
- Apply a splint under the injured limb usinga firmly rolled newspaper folded into a gutter shape.
- Hold the splint in place with a narrow-fold bandage applied above and below the injury site, with an additional bandage if necessary.
- Apply an arm sling for additional support and stability.
Fracture of the hand and fracture or dislocation of a finger
Injuries of the hand and fingers are common in some sports. Although it is tempting to replace a dislocated finger to relieve the pain and muscle spasm, there is a risk that a small nerve or blood vessel may be trapped and lead to a permanently numb or ‘dead’ finger. Replacement should be done only by a doctor or physiotherapist.
- Apply generous soft padding around the hand or injured finger(s).
- Apply an elevation sling, taking care to avoid touching the hand or fingers when tying the knot.
The patient needs to be taken to a hospital.
Fracture or dislocation of the ankle, foot or toes
It is often difficult to decide whether an ankle joint is fractured or sprained, and whenever there is any doubt, the injury should be managed as a potential fracture. The foot and toes can be crushed by a heavy object, which results in a very painful and disabling injury.
- Assist the patient to lie down and try to raise the injured foot and ankle on soft padding as soon as possible to reduce pain and slow the onset of swelling.
Unless you suspect an open wound on the foot or toes, leave a well-fitting shoe in place because removal may further complicate the injury.
- If immobilisation is needed, use a soft pillow or rolled blanket around the foot and ankle. Apply two narrow-fold bandages to hold the padding in place.
- Arrange for a prompt medical assessment. Or,
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