Yeah a broken femur is very serious. It's seriousness though is whether or not the femoral artery has been ruptured. Your femur is under alot of tension. Your quads are constantly pulling on your femur. If it breaks your thigh muscles will collapse the two halfs of the femur grinding it against itself. When this happens the jagged broken end, as well as bone shards, can sever your femoral artery.
Now your femoral is as big around as your thumb. Passes alot of blood. If it's totally severed, you'll die in a few short minutes. Seconds maybe, and I'm not kidding either. You'd best hope the painfull break was so agonizing you passed out. Patients often go into shock, their heart racing, they bleed out in seconds.
If the artery has infact been severed, it will often retract into the pelvis. If the rupture happened near the knee, it will still retract deep and high into the thigh musculature. If it's in the pelvis he'll soon be dead. In the thigh and you may gain a couple minutes by applying a turnicate high on the thigh and close to the pelvis.
You can't "first-aid" a patient bleeding out of a broken femur. Most cases like this I deal with are ballistic in nature. Ummm...shrapnel, bullets and the like...You have to stop the bleeding at it's source. What we do is put our hands into the patients leg, if it means making an incision big enough for our hands to fit. Following the path of the foriegn object we carefully feel for the patients pulse. Basically his heart beating blood into our open hand. Follow the pulse to the artery and clamp that bitch.
An ordinary person isn't going to do this...
So this is a quick list of things anybody can and should perform if this were to happen to a friend of yours.
1. Is his hurt leg shorter then the other *yes*
2. Take his pants off.
3. Check for a pulse below the suspected break. (good place is on the foot)
4. If weak or no pulse immediately apply ternicate to upper thigh.
5. If strong pulse felt splint leg as is. *IMPORTANT* If he's got a pulse you don't want the broken bones rattling around trying to sever the artery.
6. If you splinted the leg check the pulse again once you've finished.
7. Elevate leg, loosen restrictive clothing, keep patient cool and comfortable. (you want the patients heart rate as calm and steady as possible.)
Massive swelling will begin to take place. Patient triage doesn't end at step 7. You must continually monitor patient as loosening more clothing may be nessecary due to swelling. That's way you raise the broken leg, helps keep swelling down, and may also help a slow a bleeder if that's the case.
Of course notifying higher treatment personel has got to be done as well. But have somebody else do the calling. If this isn't done first. You might as well dig a hole and burry him right there.
Not all femur breaks cause loss of blood, I've seen one in eight or nine breaks. And not all breaks that rupture the femoral will bleed out in seconds. But it CAN happen quite easily. So if you don't take immediate action and treat the patient...you won't have time to say any last words.
Whew...Ranger First-Responder 101. So who wants to go riding?!
