Splinting Extremities

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Chapter 16

• Splinting Extremities

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Splinting

• Reduces pain
• Prevents further damage to muscles, nerves, and
  blood vessels
• Prevents closed fracture from becoming open
  fracture
• Reduces bleeding and swelling

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Types of Splints

• Rigid splint
• Self-splint (anatomic splint)

• Soft splint

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Splinting Guidelines (1 of 3)

• Cover open wounds with dry dressing before
  applying splint.
• Check CSM in the extremity.
• Splint only if it wont 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.

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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.

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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

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Slings

• Open triangular bandage sling
• Folded triangular bandage cravat/swathe

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Applying a Sling to Upper Arm, Forearm, or
Hand/Wrist (1 of 2)

• Hold victims 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.

9
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.

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Applying a Sling to Clavicle/Shoulder (1 of 2)

• Hold victims 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.

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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.

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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.

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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.

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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.

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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.

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Elbow Splinting

• Splint in position found.
• If straight, tie rigid splint onto arm with
  cravat bandages.
• Place arm in sling.
• Check CSM.

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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.

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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.

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Pelvis and Hip Splinting

• Stabilize victim in position found.
• Treat for shock.
• Do not lift legs.
• Wait for EMS.

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Femur Splinting

• Traction splint required.
• Available only on ambulances.
• Two first aid methods
• Place folded blanket between victims legs.
• Place board between legs from groin to foot.

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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.

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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.

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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.

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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.

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Ankle and Foot Splinting

• Use RICE.
• Wrap pillow or folded blanket around ankle and
  foot.
• Tie with cravats.