Chapter 16 Splinting Extremeties
- 2. Splinting Extremities • Injured extremities should be stabilized by splinting the extremity in the position in which it was found. • To stabilize means to minimize further injury by holding a body part to prevent movement. • All fractures should be stabilized before a victim is moved.
- 3. Reasons for Splinting • Reduce pain. • Prevent damage to muscles, nerves, and blood vessels. • Prevent a closed fracture from becoming an open fracture. • Reduce bleeding and swelling. • Prevent a fractured bone from moving into soft tissues.
- 4. Types of Splints (1 of 3) Rigid splint: • Inflexible device used to maintain stability • Must be long enough to be secured above and below fracture site
- 5. Types of Splints (2 of 3) Soft splint: • Pillow • Useful for lower leg • Useful for forearm
- 6. Types of Splints (3 of 3) Self-splint, or anatomic splint: • Uses the body • Injured extremity tied to an uninjured part
- 7. To Apply a Splint (1 of 4) • All fractures and dislocations should be stabilized before the victim is moved. • Cover open wounds with sterile dressing. • Check circulation, sensation, and movement (CSM). • If pulses are absent: • Gently line up a fracture or dislocation. • Do not force anything into position. • Warn the victim.
- 8. To Apply a Splint (2 of 4) • Use the rule of thirds. • If the injury is located in the upper or lower third of a bone: • Assume the nearest joint is injured. • Extend the splint above and below the joint. • If the injury is located in the middle third: • Stabilize the joints above and below the fracture. • Place an injured arm in a sling and swathe.
- 9. To Apply a Splint (3 of 4) • If two first aiders are present: • One should support the injury site. • The other does the splinting. • When possible, place splint materials on both sides of the injured part. • With rigid splints, use extra padding.
- 10. To Apply a Splint (4 of 4) • Apply splints firmly, but do not restrict blood flow. • Check CSM. • Use RICE (rest, ice, compression, and elevation). • Elevate. • Do not apply ice packs if pulse is absent.
- 11. Splinting Guidelines (1 of 3) Possible spinal injuries take precedence. •Tell the victim not to move. •Place rolled blankets on each side of neck and torso. •It is usually best to wait for emergency medical services (EMS) personnel.
- 12. Splinting Guidelines (2 of 3) • Seek medical care for: • Extremity without a pulse • Open fracture • Dislocation • Joint injury with moderate or severe swelling • Deformity, tenderness, or swelling over the bone
- 13. Splinting Guidelines (3 of 3) • Seek medical care for (cont’d): • Victims unable to walk or bear weight • Snaps, crackles, or pops • Hot, tender, swollen, or painful injured areas, especially a joint • Uncertainty whether a bone was broken • Lack of rapid improvement
- 14. Slings • An open triangular bandage can be used as a sling. • A folded triangular bandage, known as a cravat, can be used as a swathe in conjunction with a sling.
- 15. Applying a Sling to Upper Arm, Forearm, or Hand/Wrist (1 of 4) • Hold victim’s arm slightly away from chest with wrist and hand slightly higher than tip of elbow. • Place a triangular bandage between forearm and chest. • Pull upper end of bandage over uninjured shoulder.
- 16. Applying a Sling to Upper Arm, Forearm, or Hand/Wrist (2 of 4) • Bring the lower end of the bandage over the forearm.
- 17. Applying a Sling to Upper Arm, Forearm, or Hand/Wrist (3 of 4) • Bring end of bandage around neck to the uninjured side. • Tie the other end at the hollow above the clavicle. • Secure point of the bandage at the elbow.
- 18. Applying a Sling to Upper Arm, Forearm, or Hand/Wrist (4 of 4) • Place a swathe around the upper arm and body. • Thumb-up position • Place padding underneath both knots. • Adjust the sling. • Only the fingers should be exposed.
- 19. Applying a Sling to Clavicle/Shoulder (1 of 3) • Hold arm away from the chest. • Place bandage between forearm and chest. • Pull the upper end over the uninjured shoulder. • Bring other end over the forearm.
- 20. Applying a Sling to Clavicle/Shoulder (2 of 3) • Continue bringing the lower end of the bandage around the victim’s back.
- 21. Applying a Sling to Clavicle/Shoulder (3 of 3) • Place a swathe around the chest and forearm. • Center should be placed over forearm. • Thumb-up position, slightly above elbow
- 22. When Bandages or Other Resources Are Unavailable (1 of 2) • Place the hand inside a buttoned jacket. • Use a belt, necktie, etc. around the neck and injured arm.
- 23. When Bandages or Other Resources Are Unavailable (2 of 2) • Pin the sleeve of the shirt or jacket to the clothing. • Turn up lower edge of victim’s jacket or shirt over injured arm.
- 24. Shoulder and Upper Arm Sling (1 of 2) • Support injured arm away from the chest. • Place bandage between forearm and the chest. • Pull upper end over the uninjured shoulder.
- 25. Shoulder and Upper-Arm Sling (2 of 2) • Bring lower end of bandage over forearm, under armpit, and around the back. • Tie ends. • Check pulse and nail color. • The hand should be in a thumb-up position.
- 26. Humerus Splinting (1 of 2) Stabilize with a rigid splint. • Place the injured arm across the chest. • If available, tie a rigid splint to outside of arm.
- 27. Humerus Splinting (2 of 2) • Loop a cravat or strap around wrist and neck. • Secure the arm to the chest with a swathe.
- 28. Splinting an Elbow in the Bent Position (1 of 2) • Place a rigid splint from the upper arm to the wrist. • Tie a rigid splint onto the arm with cravat bandages.
- 29. Splinting an Elbow in the Bent Position (2 of 2) • Place the arm in a sling. • Check CSM.
- 30. Splinting an Elbow in the Straight Position (1 of 2) • Place a rigid splint along the inside of the arm from the hand to the armpit.
- 31. Splinting an Elbow in the Straight Position (2 of 2) • Secure with a roller bandage or several cravat bandages. • Check CSM.
- 32. Forearm Splinting (1 of 3) • Use one rigid splint from palm past the elbow. • Use a second rigid splint on opposite side of arm.
- 33. Forearm Splinting (2 of 3) • Place splints on both sides of forearm. • Secure with a cravat or roller bandage.
- 34. Forearm Splinting (3 of 3) • Place arm in a sling. • A binder or swathe around the body is recommended. • Keep the thumb in the upright position.
- 35. Wrist, Hand, and Finger Splinting (1 of 2) • Three methods: • Place a rolled pair of socks or a roller bandage in palm. • Attach a rigid splint.
- 36. Wrist, Hand, and Finger Splinting (2 of 2) • Three methods (cont’d): • Mold a pillow around hand and forearm. • Tie with cravats or roller bandage. • Buddy tape fingers together.
- 37. Pelvis and Hip Splinting • Stabilize victim in position found. • Treat for shock. • Do not lift legs. • Wait for EMS. • Use a long backboard.
- 38. Femur Splinting (1 of 2) • Best splinted with a traction splint • Two methods: • Place a folded blanket between victim’s legs. • Tie the injured leg to the uninjured leg with several cravats or bandages.
- 39. Femur Splinting (2 of 2) • Two methods (cont’d): • Place one board between the victim’s legs. • Place another board along the victim’s side. • The boards must be well padded. • Tie the boards to the leg and body securely.
- 40. Splinting a Knee • Always stabilize an injured knee in the position in which you found it.
- 41. Splinting a Knee in the Straight Position (1 of 3) • Lift the injured leg and place a rigid splint under the leg that extends from the buttocks to beyond the foot.
- 42. Splinting a Knee in the Straight Position (2 of 3) • Place cravat bandages under the rigid splint. • Place soft padding under the knee and ankle.
- 43. Splinting a Knee in the Straight Position (3 of 3) • Tie the cravat bandages. • Do not tie the knots over the injured area.
- 44. Splinting a Knee in the Bent Position (1 of 2) • Place a rigid splint against injured leg. • Tie a cravat bandage around the splint and lower leg.
- 45. Splinting a Knee in the Bent Position (2 of 2) • Tie a cravat bandage around the splint and thigh. • Tie knots over the splint.
- 46. Splinting the Lower Leg • There are two methods of splinting.
- 47. Splinting the Lower Leg Self-Splint Method (1 of 2) • Place padding between the legs. • Push the cravat bandages under the leg with a thin board.
- 48. Splinting the Lower Leg Self-Splint Method (2 of 2) • Tie the legs together. • Tie knots between the legs, over the padding.
- 49. Splinting the Lower Leg Rigid Splint Method (1 of 2) • Place one rigid splint on the outside and another inside. • Push the cravat bandages under the leg with a thin board.
- 50. Splinting the Lower Leg Rigid Splint Method (2 of 2) • Tie both splints and leg together with cravat bandages. • Tie knots on top of the splint.
- 51. Ankle and Foot Splinting • Treat ankle and foot injuries with RICE procedures. • To further stabilize an ankle, wrap a pillow or folded blanket around the ankle and foot, and tie with cravats.