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Fractures, sprains and strains
What is fractures & sprains?
Fractures are breaks in bones that may be open (with a wound) or closed, and can range from simple cracks to complex, unstable injuries; sprains involve stretching or tearing of ligaments, while strains affect muscles or tendons. Typical signs include pain, swelling, bruising, deformity, difficulty moving or bearing weight, and in open fractures, visible bone or deep wounds.
Although many sprains and simple fractures are not immediately life‑threatening, first aiders play a key role in preventing further damage, relieving pain and identifying red flags such as open fractures, severe deformity, loss of circulation or suspected neck and back injuries that require emergency care. Good handling, support and timely referral also reduce long‑term disability and complaints.
Sprains and strains are among the most common minor injuries seen in A&E and urgent care, while fractures account for a significant proportion of trauma attendances, especially in older adults after falls.
Who needs this skill?
Health & Social Care
In health and social care, staff frequently encounter fractures and soft‑tissue injuries from falls, manual handling incidents and seizures; they must combine first aid with safeguarding and falls‑risk review, particularly in frail or osteoporotic patients. Immobilisation and careful handling are especially important when there is possible hip, pelvic or spinal injury.Licensed venues & nightlife
In nightlife and licensed venues, slips, trips and assaults can cause fractures and soft‑tissue injuries; staff should avoid moving people with severe pain, deformity or suspected head or spinal involvement, support injured limbs and arrange ambulance transfer rather than simply escorting casualties off the premises.Schools
Sports, play and trips mean schools see frequent limb injuries; staff who can distinguish likely sprains from more serious fractures can make better decisions about on-site care versus urgent referral.Workplaces
In workplaces, first aiders need to manage injuries ranging from ankle sprains on stairs to crush injuries from machinery, using principles of rest, ice, compression and elevation (RICE) for minor sprains, and immobilisation and 999 activation for suspected fractures or severe injuries. Employers should ensure manual handling and safety controls are robust to prevent repeat incidents.How to manage fractures & sprains
- 1Recognise signs of fracture, sprain or strainAssess for pain, swelling, bruising, deformity, loss of normal movement, inability to bear weight and, for open fractures, wounds with possible bone visible. Compare with the uninjured side and check for altered sensation or colour in hands or feet beyond the injury.Treat obvious deformity, open fractures, severe pain, loss of pulse, numbness or suspected neck/back injury as requiring urgent hospital assessment and often 999 activation.
- 2Support and immobilise the injured areaAdvise the casualty to keep the injured limb still, support it in the position found using soft padding, bandages, slings or improvised supports, and avoid straightening or pushing bones back into place.Immobilising the joints above and below a suspected fracture reduces pain and the risk of further tissue damage while you wait for help.
- 3Apply RICE for minor sprains and strains if appropriateFor injuries that appear minor, with no deformity or red flags, use Rest, Ice, comfortable Compression and Elevation to reduce pain and swelling, and advise the casualty to seek NHS 111 or GP advice if symptoms do not improve.Avoid applying ice directly to skin or compressing so tightly that circulation is impaired; recheck sensation and colour after bandaging.
- 4Monitor circulation and comfortRegularly check colour, warmth and sensation in fingers or toes beyond the injury, and loosen bandages or splints if they become tight or if pain worsens significantly.Record observations and escalate promptly if circulation is compromised or pain becomes uncontrollable despite support.
- 5Arrange appropriate transport and follow‑upCall 999 for open fractures, major deformities, suspected neck, back, pelvic or femur fractures, suspected compartment syndrome or if you are otherwise seriously concerned; for less severe injuries, arrange urgent care or A&E if weight‑bearing is impossible or pain remains severe.Ensure incidents are documented and that contributing factors such as environmental hazards or safeguarding concerns are followed up.
This guide is a learning reference only. It does not replace attended, assessed first aid training.
Qualifying courses
Qualsafe Level 3 Award in Paediatric First Aid (RQF)
2 days
3 years
Common questions
Practical answers for employers, venue managers, and healthcare teams about fractures & sprains training.
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Within workplace and basic first aid, you should generally not administer medicines unless explicitly allowed by policy; instead, advise casualties who are conscious and able to swallow to take their own usual over‑the‑counter pain relief if appropriate. In clinical and FREC settings, follow local pain management protocols.