Chapter 16Splinting Extremities

Splinting• Reduces pain• Prevents further damage to muscles,

nerves, and blood vessels• Prevents closed fracture from

becoming open fracture• Reduces bleeding and swelling

Types of Splints

• Rigid splint

• Self-splint (anatomic splint)

• Soft splint

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 pulseOpen fractureDislocationSwollen, hot, tender, or painful jointDeformity, tenderness, swelling over boneVictim unable to walkSnap, crackle, pop was heardUncertain whether bone was brokenLack 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.