Broken Bones, Sprains, and Strains

Article Translations: (Spanish)

A broken bone requires emergency medical care. Your child might have a broken (fractured) bone if he or she heard or felt a bone snap, has difficulty moving the injured part, or if the injured part moves in an unnatural way or is very painful to the touch.

A sprain occurs when the ligaments, which hold bones together, are overstretched and partially torn. A strain is when a muscle or tendon is overstretched or torn. Sprains and strains generally cause swelling and pain, and there may be bruises around the injured area. Most sprains and strains, after proper medical evaluation, can be treated at home.

What to Do:

For a Suspected Broken Bone:

• Do not move a child whose injury involves the neck or back, unless he or she is in imminent danger. Movement can cause serious nerve damage. Phone for emergency medical help. If the child must be moved, the neck and back must be completely immobilized first, ideally with at least one other person assisting you. Keeping the head, neck, and back in alignment, move the child together as a unit.
• If a child has an open break (bone protrudes through the skin) call 911 immediately. If there is severe bleeding, apply pressure on the bleeding area with a gauze pad or a clean piece of clothing or other material. Do not wash the wound or try to push back any part of the bone that may be sticking out.
• If the child must be moved, apply splints around the injured limb to prevent further injury. Leave the limb in the position you find it. The splints should be applied in that position. Splints can be made by using boards, brooms, a stack of newspapers, cardboard, or anything firm, and can be padded with pillows, shirts, towels, or anything soft. Splints must be long enough to extend beyond the joints above and below the fracture.
• Place cold packs or a bag of ice wrapped in cloth on the injured area.
• Keep the child lying down until medical help arrives. If he or she gets lightheaded, try to position the head at a slightly lower level than the chest, and if you can, lift the legs.

For a Suspected Sprain or Strain:

• If the injury involves the neck or back (even if there is no pain), do not move the child unless in imminent danger. Movement can cause serious nerve damage. Phone for emergency medical help. If the child must be moved, the neck and back must be completely immobilized first, ideally with at least one other person assisting you. Keeping the head, neck, and back in alignment, move the child together as a unit.
• It may be difficult to tell the difference between a sprain and a break. If there is any doubt whatsoever, phone your doctor or take your child to the nearest hospital emergency department. An X-ray can determine whether a bone is broken.
• First aid for sprains and strains includes rest, ice, compression, and elevation (known as RICE).
  • Rest: for at least 24 hours, rest the injured part of the body.
  • Ice packs (or cold compresses): apply for up to 10-15 minutes at a time every few hours for the first 2 days to prevent swelling.
  • Compression: wear an elastic bandage (such as an ACE bandage) for at least 2 days to reduce swelling.
  • Elevation: keep the injured part above heart level as much as possible to ease swelling.

• Do not apply heat in any form for at least 24 hours after an injury. Heat increases swelling and pain.
• Your doctor may recommend an over-the-counter pain reliever, such as acetaminophen or ibuprofen.

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