Chapter 16 Splinting Extremities
Splinting • Reduces pain • Prevents further damage to muscles, nerves, and blood vessels • Prevents closed fracture from becoming open fracture • Reduces bleeding and swelling
Rigid splint Self-splint (anatomic splint) Soft splint Types of Splints
Splinting Guidelines (1 of 3) • Cover open wounds with dry dressing before applying splint. • Check CSM in the extremity. • Splint only if it won’t cause further pain. • Splint in position found. • Warn victim of pain. • Use splint that will extend beyond joints above and below injury. • Apply firmly, but do not affect circulation.
Splinting Guidelines (2 of 3) • When possible, splint on both sides of injury. • Check CSM periodically. • Elevate extremity after splinting. • Apply ice pack. • If possible spine injury, victim should not move. • Stabilize spine with rolled blankets on each side of neck and torso.
Splinting Guidelines (3 of 3) • Seek medical care if: • Extremity has no pulse • Open fracture • Dislocation • Swollen, hot, tender, or painful joint • Deformity, tenderness, swelling over bone • Victim unable to walk • Snap, crackle, pop was heard • Uncertain whether bone was broken • Lack of rapid improvement
Slings • Open triangular bandage = sling • Folded triangular bandage = cravat/swathe
Applying a Sling to Upper Arm, Forearm, or Hand/Wrist(1 of 2) • Hold victim’s arm away from chest. • Place triangular bandage between forearm and chest with point toward elbow. • Stretch bandage beyond elbow. • Pull upper end of bandage over uninjured shoulder. • Bring lower end of bandage over forearm.
Applying a Sling to Upper Arm, Forearm, or Hand/Wrist(2 of 2) • Bring end of bandage around neck to uninjured side. • Tie other end at hollow above clavicle on uninjured side. • Place swathe around upper arm and body. • Place padding underneath both knots. • Adjust sling to support hand and wrist.
Applying a Sling to Clavicle/Shoulder (1 of 2) • Hold victim’s arm away from chest. • Place triangular bandage between forearm and chest with point toward elbow. • Stretch bandage beyond elbow. • Pull upper end over uninjured shoulder.
Applying a Sling to Clavicle/Shoulder (2 of 2) • Bring lower end of bandage over forearm. • Tuck under armpit on uninjured side. • Bring lower end around back. • Tie to upper end. • Place swathe around chest and forearm.
Improvised Slings • Place hand inside buttoned jacket. • Use belt, necktie, or other item looped around neck and injured arm. • Pin sleeve of shirt or jacket to clothing. • Turn up lower edge of shirt or jacket over uninjured arm. • Pin to upper part of shirt or jacket.
Shoulder Splinting (1 of 2) • Support injured arm away from chest. • Place open triangular bandage between forearm and chest. • Stretch point beyond elbow. • Pull upper end over shoulder on uninjured side.
Shoulder Splinting (2 of 2) • Bring lower end over forearm, under armpit on injured side, around back. • Tie upper and lower ends. • Check pulse and nail color.
Humerus Splinting • Place injured arm across chest. • If available, tie rigid splint to outside of arm. • Place arm in sling. • Secure arm to chest with swathe.
Elbow Splinting • Splint in position found. • If straight, tie rigid splint onto arm with cravat bandages. • Place arm in sling. • Check CSM.
Forearm Splinting • Use one rigid splint from palm past elbow. • Use second rigid splint on opposite side of arm. • Secure splint with roller bandage or cravats. • Put arm in sling. • Keep thumb upright. • Secure with swathe around body.
Wrist, Hand, and Finger Splinting • Three methods: • Place injured hand in position of function. • Attach rigid splint extending past fingertips. • Place hand in position of function. • Place arm in sling and swathe with thumb upright. • Tape fingers together with gauze separating fingers.
Pelvis and Hip Splinting • Stabilize victim in position found. • Treat for shock. • Do not lift legs. • Wait for EMS.
Femur Splinting • Traction splint required. • Available only on ambulances. • Two first aid methods: • Place folded blanket between victim’s legs. • Place board between legs from groin to foot.
Knee Splinting (1 of 2) • Stabilize in position found. • To splint straight knee: • Lift injured leg. • Place rigid splint under leg, from buttocks to beyond foot. • Place cravats under splint. • Place padding under knee and ankle. • Tie cravats. Do not tie over injured area.
Knee Splinting (2 of 2) • To splint bent knee: • Place rigid splint against injured leg. • Do not place against knee. • Tie cravat around splint and lower leg. • Tie cravat around splint and thigh. • Tie knots over splint, not over leg.
Lower Leg Splinting (1 of 2) • Self-splint method: • Pad between legs. • Push cravats under leg with thin board. • Tie legs together. • Tie knots between legs, over padding.
Lower Leg Splinting (2 of 2) • Using rigid splints: • Place rigid splint on outside and inside. • Push cravats under leg and splints with thin board. • Tie splints and leg together with cravats. • Tie knots on top of splint.
Ankle and Foot Splinting • Use RICE. • Wrap pillow or folded blanket around ankle and foot. • Tie with cravats.