Being able to assess an injury correctly is the key to providing excellent first aid care. When evaluating any injured patient, it is essential to start with the basics; assessing for dangers that could pose a further risk to yourself or the victim, followed by determining the response of the victim. Only when you are happy that there is no immediate life-threatening injury to the victim should you then go on to assess extremity injuries such as a broken arm.
Once you are confident that the broken arm is an isolated injury or you have already dealt with more pressing concerns you can assess the arm injury.
Begin by asking the victim how they injured the arm; this may tell you a great deal about the type of injury you may be dealing with. For example, an elderly patient falling on to an outstretched arm often sustains a wrist fracture. Ask the victim which part of the arm is painful and how painful it is. Ask the victim if they can move the arm at all and whether they have any other symptoms such as tingling or numbness in the hands or fingers. Ascertain if the victim is right or left handed.
You can now proceed to examine the arm if the victim is happy for you to do so. Avoid moving the injured arm as you do not want to cause further pain or damage.
1. Look for any visible deformity, swelling or bruising.
A broken arm may look bent and angulated, especially if the fracture is severe. Children commonly sustain fractures of the forearm which can look very bent and are sometimes described as “banana arms.” An elderly patient’s wrist fracture may have the appearance of a dinner fork.
2. Look for any wound or bone protruding from the skin.
A severe fracture may result in a piece of bone sticking out of the skin. This is referred to as an open fracture. There may be associated bleeding with this type of injury, and if the bleeding is a severe urgent treatment to control the bleeding will be necessary. The bone may have pierced the skin at the moment of impact, but no longer be sticking out. There will be a wound present that may indicate this.
3. Assess for any tenderness.
A healthcare professional or first aider assessing an injured arm will examine for the presence of tenderness around the area. This will allow a decision to be made as to whether an x-ray is needed to further assess for a fracture.
4. Assess blood supply and nerve function in the arm.
Any fracture can cause damage to surrounding structures. In the case of a broken arm, this could mean permanent damage if the arm does not get the immediate care it needs.