Extremity 3

1. Chapter 16
Splinting Extremities

2. 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.

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
• Rigid splint
– Inflexible device
used to maintain
stability
– Must be long
enough to be
secured above and
below fracture site
© SAM® Medical.

5. Types of Splints
• Soft splint
– Pillow
– Useful for lower leg
– Useful for forearm
© American Academy of Orthopaedic Surgeons.

6. Types of Splints
• Self-splint, or anatomic splint
– Uses the body
– Injured extremity tied to an uninjured part
© Jones & Bartlett Learning.

7. 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.

8. 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.

9. 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.

10. 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.

11. 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

12. Seek Medical Care For…
• Snaps, crackles, or pops
• Hot, tender, swollen, or painful areas
• Uncertainty whether a bone was broken
• Lack of rapid improvement

13. 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.

14. 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.
© Jones & Bartlett Learning.

15. 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.
© Jones & Bartlett Learning.

16. 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.
© Jones & Bartlett Learning.

17. 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.

18. 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.

19. Shoulder and Upper
Arm 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.

20. Shoulder and Upper
Arm Sling
• Tie ends.
• Check pulse and nail color.
• The hand should be in a thumb-up
position.

21. Humerus Splinting
• Gently place the
injured arm across
the chest.
• If available, tie a rigid
splint to outside of
arm.
© Jones & Bartlett Learning.

22. 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.

23. Splinting an Elbow in the Bent
Position
• Place a rigid splint from the upper arm to
the wrist.
• Tie the splint with cravat bandages.
© Jones & Bartlett Learning. Courtesy of MIEMSS. © Jones & Bartlett Learning. Courtesy of MIEMSS.

24. Splinting an Elbow in the Bent
Position
• Place the arm in a sling.
• Check CSM.
© Jones & Bartlett Learning. Courtesy of MIEMSS.

25. Splinting an Elbow in the
Straight Position
• Place a rigid splint along the inside of the
arm from the hand to the armpit.
© Jones & Bartlett Learning. Courtesy of MIEMSS.

26. Splinting an Elbow in the
Straight Position
• Secure with a roller bandage or several
cravat bandages.
• Check CSM.
© Jones & Bartlett Learning. Courtesy of MIEMSS. © Jones & Bartlett Learning. Courtesy of MIEMSS.

27. 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.

28. 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.

29. Wrist, Hand, and Finger
Splinting
• Three methods:
– Place a rolled pair
of socks or a roller
bandage in palm.
• Attach a rigid splint.
© Jones & Bartlett Learning.

30. Wrist, Hand, and Finger
Splinting
• Three methods (cont’d):
– Mold a pillow around hand and forearm.
• Tie with cravats or roller bandage.
– Buddy tape fingers together.

31. Pelvis and Hip Splinting
• Treat for shock.
• Do not lift legs.
• Wait for EMS.
• Long backboard is required.

32. 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.

33. Splinting a Knee
• Always stabilize an injured knee in the
position in which you find it.
© Jones & Bartlett Learning. © Jones & Bartlett Learning.

34. Splinting a Knee in the
Straight Position
• Place a rigid splint under the leg that
extends from the buttocks to beyond the
foot.
© Jones & Bartlett Learning.

35. Splinting a Knee in the
Straight Position
• Place cravat bandages under the rigid
splint.
• Place soft padding under the knee and
ankle.
© Jones & Bartlett Learning.

36. Splinting a Knee in the
Straight Position
• Tie the cravat bandages.
• Do not tie the knots over the injured area.
© Jones & Bartlett Learning.

37. Splinting a Knee in the
Bent Position
• Place a rigid splint against injured leg.
• Tie a cravat bandage around the splint and
lower leg.
© Jones & Bartlett Learning. Courtesy of MIEMSS. © Jones & Bartlett Learning. Courtesy of MIEMSS.

38. Splinting a Knee in the
Bent Position
• Tie a cravat bandage around the splint and
thigh.
• Tie knots over the splint.
© Jones & Bartlett Learning. Courtesy of MIEMSS. © Jones & Bartlett Learning. Courtesy of MIEMSS.

39. Splinting the Lower Leg:
Self Splint Method
• Place padding
between the legs.
• Push the cravat
bandages under
the leg with a thin
board.
© Jones & Bartlett Learning. Courtesy of MIEMSS.

40. Splinting the Lower Leg:
Self Splint Method
• Tie the legs together.
• Tie knots between the legs, over the
padding.
© Jones & Bartlett Learning. Courtesy of MIEMSS. © Jones & Bartlett Learning. Courtesy of MIEMSS.

41. 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.
© Jones & Bartlett Learning. Courtesy of MIEMSS.

42. 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.

43. 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.
© Jones & Bartlett Learning.