This document provides guidance on splinting injured extremities in the field. It describes stabilizing fractures and dislocations before moving patients, as well as the reasons for splinting like reducing pain and preventing further injury. Common types of splints are described as rigid, soft, or self-splints. Instructions are provided on applying splints and slings to different parts of the body like the shoulder, arm, elbow, forearm, wrist, hand, pelvis, hip, knee, lower leg, ankle and foot. Guidance is also given on when to seek medical care after splinting.

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.