Broken Femur First Aid: Why 999 Comes Before Splinting
A broken femur (thigh bone) is one of the most serious injuries you can face outdoors. It’s not just a painful fracture – it’s a life-threatening emergency that can cause massive internal bleeding and shock. It can kill you, the casualty needs to be in hospital ASAP, with safe, expedient evacuation. Not an orange survival bag, six rocks, a broom handle and a wish and a prayer.
So what should a first aider actually do? Do you call 999 and wait, or do you try and splint the leg with sticks and bandages?
I can remember early in my career, outdoor courses making improvised traction splints, it was a laugh and we thought it was cool. Three decades down the line and having attended serious fractures of the pelvis and femur, it is not a laughing matter.
It is not as easy in real life as it is in a classroom, it is incredible painful and the risks are high if you cock it up. Add to that, we will have to take everything off to put proper splints in place. More movement, more pain, more time wasted.
Let’s break it down.
(These images are taken from an Advanced Outdoor First Aid Course and an artists impression of a photo I saw on Facebook, which somone had posted from a recent outdoor first aid course.)
The Everyday UK First Aid Response
For workplace first aiders, teachers, outdoor instructors, parents, or members of the public in the UK, Europe, USA anywhere with a dedicated medical/rescue service:
✅ Call 999 immediately – this is non-negotiable.
A femoral fracture can bleed up to 1–2 litres internally.
The casualty may quickly deteriorate.
✅ Reassure and keep the casualty still – moving the leg makes things worse.
✅ Control visible bleeding – apply direct pressure or use a haemostatic dressing if trained.
✅ Treat for shock – lay the person flat (if possible), keep them warm, and keep monitoring.
❌ Don’t try to straighten the leg – leave it as found.
❌ Don’t attempt traction splints or improvised splints – unless you’re trained, properly equipped, and evacuation will be severely delayed.
Bottom line: For most UK scenarios, you don’t try to splint a broken femur. You call 999 and focus on good casualty care until professionals arrive.
The Remote or Expedition Context
Things change if you’re in the on an expedition, or overseas in a wilderness setting where help might be hours away. It's all on you.
Here, advanced planning makes the difference:
Teams should carry a traction splint and a pelvic binder.
Leaders need training to use this kit safely (plus refresher training).
Splinting in these contexts isn’t about “sticks and bandages” – it’s about professional-grade equipment designed for high-risk trauma.
You need to be thinking about evacuation. You're on the clock.
This is why many expedition medics, Mountain Rescue teams, and military medics train specifically for these injuries.
Why This Distinction Matters
One of the biggest risks in first aid is trying to do too much without the right skills. An unskilled attempt at traction or splinting can cause more harm than good. Keep things simple, focus on what you can do, it is all about evacuation and definitive professional care.
That’s why in our courses, we emphasise:
Local/urban settings → Call 999. Focus on bleeding, shock, reassurance.
Remote/adventurous settings → Carry the right kit, and get the training to use it.
Be Adventure Ready
At Invenio Training, we don’t just tick boxes. We teach real-world, research-led first aid designed for the environments you actually operate in. Whether you’re a school leading overseas expeditions, or an individual heading into the hills, we’ll give you the confidence, competence and compassion to deal with emergencies.
Because when it comes to a femoral fracture, knowing when not to act is just as important as knowing what to do.
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