Chapter 16Splinting Extremities

Splinting Extremities

• Injured extremities should be stabilized by splinting the extremity in the position in which it was found.

• Stabilize: minimize further injury by holding a body part to prevent movement.

• All fractures should be stabilized before a person is moved.

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.

Types of Splints

• Rigid splint– Inflexible device

used to maintain stability

– Must be long enough to be secured above and below fracture site

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Types of Splints

• Soft splint– Pillow– Useful for lower leg– Useful for forearm

© American Academy of Orthopaedic Surgeons.

Types of Splints

• Self-splint, or anatomic splint– Uses the body– Injured extremity tied to an uninjured part

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To Apply a Splint

• All fractures and dislocations should be stabilized before the person is moved.– Cover open wounds with sterile dressing.– Check circulation, sensation, and movement.– If pulses are absent:

• Gently line up a fracture or dislocation.• Do not force anything into position.• Warn the person.

To Apply a Splint

• Use the rule of thirds.– If the injury is located in the upper or lower

third of a bone:• 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.

To Apply a Splint

• If two first aid providers are present:– One should support the injury site.– Minimize movement of the extremity.

• When possible, place splint materials on both sides of the injured part.

To Apply a Splint

• Apply splints firmly, but do not restrict blood flow.

• Use the RICE procedure.– Elevate.– Do not apply ice packs if pulse is absent.

Seek Medical Care For…

• Open fracture• Dislocation• Joint injury with moderate or severe

swelling• Deformity, tenderness, or swelling • Person is unable to walk or bear weight

Seek Medical Care For…

• Snaps, crackles, or pops• Hot, tender, swollen, or painful areas• Uncertainty whether a bone was broken• Lack of rapid improvement

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.

Applying a Sling to Upper Arm, Forearm, or Hand/Wrist

• Place a triangular bandage between forearm and chest.– Pull upper end over

uninjured shoulder.– Bring lower end

over the forearm.

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Applying a Sling to Upper Arm, Forearm, or Hand/Wrist

• Bring end of bandage around neck to the uninjured side.– Tie other end above the clavicle.

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Applying a Sling to Upper Arm, Forearm, or Hand/Wrist

• Secure point of bandage at the elbow.• Place a swathe around the upper arm and

body.

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When Bandages or Other Resources Are Unavailable

• Place the hand inside a buttoned jacket.• Use a belt, necktie, etc. around the neck

and injured arm.

© American Academy of Orthopaedic Surgeons.

© American Academy of Orthopaedic Surgeons.

When Bandages or Other Resources Are Unavailable

• Pin the sleeve of the shirt or jacket to the clothing.

• Turn up lower edge of person’s jacket or shirt over injured arm.

© American Academy of Orthopaedic Surgeons.

© American Academy of Orthopaedic Surgeons.

Shoulder and UpperArm Sling

• Support injured arm away from chest.• Place bandage between forearm and

chest.• Pull upper end over uninjured shoulder.• Bring lower end of bandage over forearm

and around neck to uninjured side.

Shoulder and UpperArm Sling

• Tie ends.• Check pulse and nail color.• The hand should be in a thumb-up

position.

Humerus Splinting

• Gently place the injured arm across the chest.

• If available, tie a rigid splint to outside of arm.

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Humerus Splinting

• Loop a cravat or strap around wrist and neck.

• Secure the arm to the chest with a swathe.

© Jones & Bartlett Learning. © Jones & Bartlett Learning.

Splinting an Elbow in the Bent Position

• Place a rigid splint from the upper arm to the wrist.

• Tie the splint with cravat bandages.

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Splinting an Elbow in the Bent Position

• Place the arm in a sling.• Check CSM.

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Splinting an Elbow in the Straight Position

• Place a rigid splint along the inside of the arm from the hand to the armpit.

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Splinting an Elbow in the Straight Position

• Secure with a roller bandage or several cravat bandages.

• Check CSM.

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Forearm Splinting:Rigid Splint

• Place a rigid splint on the forearm.

• Secure with either a roller bandage or folded triangular bandages.

• Place arm in a sling with a binder.

© Jones & Bartlett Learning. Courtesy of MIEMSS.

© Jones & Bartlett Learning. Courtesy of MIEMSS.

Forearm Splinting:Soft Splint

• Wrap a pillow or folded blanket around the forearm.

• Secure with folded triangular bandages or cloth bands.

• Place the arm in a sling with a binder.

© Jones & Bartlett Learning.

© Jones & Bartlett Learning.

Wrist, Hand, and FingerSplinting

• Three methods:– Place a rolled pair

of socks or a roller bandage in palm.

• Attach a rigid splint.

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Wrist, Hand, and FingerSplinting

• Three methods (cont’d):– Mold a pillow around hand and forearm.

• Tie with cravats or roller bandage.– Buddy tape fingers together.

Pelvis and Hip Splinting

• Treat for shock.• Do not lift legs.• Wait for EMS.• Long backboard is required.

Femur Splinting

• Best splinted with a traction splint• Call 9-1-1 immediately.• Tell the person not to move.• Apply an ice pack while waiting for EMS.

Splinting a Knee

• Always stabilize an injured knee in the position in which you find it.

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Splinting a Knee in the Straight Position

• Place a rigid splint under the leg that extends from the buttocks to beyond the foot.

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Splinting a Knee in the Straight Position

• Place cravat bandages under the rigid splint.

• Place soft padding under the knee and ankle.

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Splinting a Knee in the Straight Position

• Tie the cravat bandages.• Do not tie the knots over the injured area.

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Splinting a Knee in the Bent Position

• Place a rigid splint against injured leg.• Tie a cravat bandage around the splint and

lower leg.

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Splinting a Knee in the Bent Position

• Tie a cravat bandage around the splint and thigh.

• Tie knots over the splint.

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Splinting the Lower Leg: Self Splint Method

• Place padding between the legs.

• Push the cravat bandages under the leg with a thin board.

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Splinting the Lower Leg: Self Splint Method

• Tie the legs together.• Tie knots between the legs, over the

padding.

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Splinting the Lower Leg: Rigid Splint Method

• Place one rigid splint on the outside and another inside.

• Push the cravat bandages under the leg with a thin board.

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Splinting the Lower Leg: Rigid Splint Method

• Tie both splints and leg together with cravat bandages.

• Tie knots on top of the splint.

© Jones & Bartlett Learning. Courtesy of MIEMSS.

Ankle and Foot Splinting

• Treat with RICE procedure.

• To further stabilize, wrap a pillow or folded blanket around the ankle and foot, and tie with cravats.

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