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. 

 

 

You’re halfway through a group walk when someone missteps on a loose rock. They go down hard, and you hear those classic words: 

 

“I think I’ve just twisted it. I’ll walk it off.” 

 

As an EMT, I’ve learned never to underestimate soft tissue injuries. Out here, even a “minor sprain” can turn into a major problem if not managed properly. 

 

You’re an hour into a coastal hike. It’s roasting. One of your group sits down suddenly, looking pale, sweaty, and just not quite right. “I’m fine,” they say. But are they? 

 

As an EMT, I’ve treated more than a few heat-related emergencies — on city streets, at music festivals, and the uplands of the UK where help is hours away. The key to managing heat illness is catching it early, acting fast, and knowing when ‘just hot’ becomes dangerous.