This document provides guidance on splinting various extremities for injuries. It describes the reasons for splinting, types of splints including rigid, soft, and self-splints. Instructions are given for applying splints to the upper arm, forearm, wrist, hand, fingers, pelvis, hip, femur, knee, lower leg, and ankle. Slings are also described for supporting injured arms. The goal of splinting is to stabilize injuries, reduce pain, prevent further damage, and allow for safe transport to medical care.

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.
• To stabilize means to minimize further
injury by holding a body part to prevent
movement.
• All fractures should be stabilized before
a victim 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 (1 of 3)
Rigid splint:
• Inflexible device used
to maintain stability
• Must be long enough to
be secured above and
below fracture site

5. Types of Splints (2 of 3)
Soft splint:
• Pillow
• Useful for lower leg
• Useful for forearm

6. Types of Splints (3 of 3)
Self-splint, or
anatomic splint:
• Uses the body
• Injured extremity tied
to an uninjured part

7. To Apply a Splint (1 of 4)
• All fractures and dislocations should be
stabilized before the victim is moved.
• Cover open wounds with sterile dressing.
• Check circulation, sensation, and movement
(CSM).
• If pulses are absent:
• Gently line up a fracture or dislocation.
• Do not force anything into position.
• Warn the victim.

8. To Apply a Splint (2 of 4)
• Use the rule of thirds.
• If the injury is located in the upper or lower third
of a bone:
• Assume the nearest joint is injured.
• 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 (3 of 4)
• If two first aiders are present:
• One should support the injury site.
• The other does the splinting.
• When possible, place splint materials on
both sides of the injured part.
• With rigid splints, use extra padding.

10. To Apply a Splint (4 of 4)
• Apply splints firmly, but do not restrict
blood flow.
• Check CSM.
• Use RICE (rest, ice, compression, and
elevation).
• Elevate.
• Do not apply ice packs if pulse is absent.

11. Splinting Guidelines (1 of 3)
Possible spinal injuries take precedence.
•Tell the victim not to move.
•Place rolled blankets on each side of neck
and torso.
•It is usually best to wait for emergency
medical services (EMS) personnel.

12. Splinting Guidelines (2 of 3)
• Seek medical care for:
• Extremity without a pulse
• Open fracture
• Dislocation
• Joint injury with moderate or severe swelling
• Deformity, tenderness, or swelling over the
bone

13. Splinting Guidelines (3 of 3)
• Seek medical care for (cont’d):
• Victims unable to walk or bear weight
• Snaps, crackles, or pops
• Hot, tender, swollen, or painful injured areas,
especially a joint
• Uncertainty whether a bone was broken
• Lack of rapid improvement

14. 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.

15. Applying a Sling to Upper Arm,
Forearm, or Hand/Wrist (1 of 4)
• Hold victim’s arm slightly
away from chest with
wrist and hand slightly
higher than tip of elbow.
• Place a triangular
bandage between
forearm and chest.
• Pull upper end of
bandage over uninjured
shoulder.

16. Applying a Sling to Upper Arm,
Forearm, or Hand/Wrist (2 of 4)
• Bring the lower end
of the bandage over
the forearm.

17. Applying a Sling to Upper Arm,
Forearm, or Hand/Wrist (3 of 4)
• Bring end of bandage
around neck to the
uninjured side.
• Tie the other end at
the hollow above the
clavicle.
• Secure point of the
bandage at the elbow.

18. Applying a Sling to Upper Arm,
Forearm, or Hand/Wrist (4 of 4)
• Place a swathe around
the upper arm and body.
• Thumb-up position
• Place padding
underneath both knots.
• Adjust the sling.
• Only the fingers should
be exposed.

19. Applying a Sling to Clavicle/Shoulder
(1 of 3)
• Hold arm away from
the chest.
• Place bandage
between forearm and
chest.
• Pull the upper end
over the uninjured
shoulder.
• Bring other end over
the forearm.

20. Applying a Sling to Clavicle/Shoulder
(2 of 3)
• Continue bringing
the lower end of the
bandage around
the victim’s back.

21. Applying a Sling to Clavicle/Shoulder
(3 of 3)
• Place a swathe around the chest and
forearm.
• Center should be placed over forearm.
• Thumb-up position, slightly above elbow

22. When Bandages or Other Resources
Are Unavailable (1 of 2)
• Place the hand
inside a buttoned
jacket.
• Use a belt, necktie,
etc. around the
neck and injured
arm.

23. When Bandages or Other Resources
Are Unavailable (2 of 2)
• Pin the sleeve of
the shirt or jacket
to the clothing.
• Turn up lower
edge of victim’s
jacket or shirt over
injured arm.

24. Shoulder and Upper Arm Sling (1 of 2)
• Support injured arm
away from the chest.
• Place bandage
between forearm and
the chest.
• Pull upper end over the
uninjured shoulder.

25. Shoulder and Upper-Arm Sling (2 of 2)
• Bring lower end of
bandage over forearm,
under armpit, and around
the back.
• Tie ends.
• Check pulse and nail
color.
• The hand should be in a
thumb-up position.

26. Humerus Splinting (1 of 2)
Stabilize with a rigid
splint.
• Place the injured arm
across the chest.
• If available, tie a rigid
splint to outside of
arm.

27. Humerus Splinting (2 of 2)
• Loop a cravat or strap around wrist and
neck.
• Secure the arm to the chest with a swathe.

28. Splinting an Elbow in the
Bent Position (1 of 2)
• Place a rigid splint
from the upper arm
to the wrist.
• Tie a rigid splint
onto the arm with
cravat bandages.

29. Splinting an Elbow in the
Bent Position (2 of 2)
• Place the arm in a
sling.
• Check CSM.

30. Splinting an Elbow in the
Straight Position (1 of 2)
• Place a rigid splint
along the inside of
the arm from the
hand to the armpit.

31. Splinting an Elbow in the
Straight Position (2 of 2)
• Secure with a roller bandage or several
cravat bandages.
• Check CSM.

32. Forearm Splinting (1 of 3)
• Use one rigid splint from palm past the
elbow.
• Use a second rigid splint on opposite
side of arm.

33. Forearm Splinting (2 of 3)
• Place splints on both
sides of forearm.
• Secure with a cravat
or roller bandage.

34. Forearm Splinting (3 of 3)
• Place arm in a sling.
• A binder or swathe
around the body is
recommended.
• Keep the thumb in
the upright position.

35. Wrist, Hand, and Finger Splinting
(1 of 2)
• Three methods:
• Place a rolled pair
of socks or a roller
bandage in palm.
• Attach a rigid splint.

36. Wrist, Hand, and Finger Splinting
(2 of 2)
• Three methods
(cont’d):
• Mold a pillow
around hand and
forearm.
• Tie with cravats or
roller bandage.
• Buddy tape fingers
together.

37. Pelvis and Hip Splinting
• Stabilize victim in
position found.
• Treat for shock.
• Do not lift legs.
• Wait for EMS.
• Use a long backboard.

38. Femur Splinting (1 of 2)
• Best splinted with a traction splint
• Two methods:
• Place a folded blanket between victim’s legs.
• Tie the injured leg to the uninjured leg with several
cravats or bandages.

39. Femur Splinting (2 of 2)
• Two methods (cont’d):
• Place one board
between the victim’s
legs.
• Place another board
along the victim’s side.
• The boards must be well
padded.
• Tie the boards to the leg
and body securely.

40. Splinting a Knee
• Always stabilize an
injured knee in the
position in which you
found it.

41. Splinting a Knee in the
Straight Position (1 of 3)
• Lift the injured leg and place a rigid splint
under the leg that extends from the buttocks
to beyond the foot.

42. Splinting a Knee in the
Straight Position (2 of 3)
• Place cravat bandages under the rigid
splint.
• Place soft padding under the knee and
ankle.

43. Splinting a Knee in the
Straight Position (3 of 3)
• Tie the cravat bandages.
• Do not tie the knots over the injured
area.

44. Splinting a Knee in the Bent Position
(1 of 2)
• Place a rigid splint
against injured leg.
• Tie a cravat bandage
around the splint and
lower leg.

45. Splinting a Knee in the Bent Position
(2 of 2)
• Tie a cravat
bandage around
the splint and thigh.
• Tie knots over the
splint.

46. Splinting the Lower Leg
• There are two methods of splinting.

47. Splinting the Lower Leg
Self-Splint Method (1 of 2)
• Place padding
between the legs.
• Push the cravat
bandages under the
leg with a thin
board.

48. Splinting the Lower Leg
Self-Splint Method (2 of 2)
• Tie the legs together.
• Tie knots between the legs, over the
padding.

49. Splinting the Lower Leg
Rigid Splint Method (1 of 2)
• Place one rigid
splint on the outside
and another inside.
• Push the cravat
bandages under the
leg with a thin
board.

50. Splinting the Lower Leg
Rigid Splint Method (2 of 2)
• Tie both splints and leg together with
cravat bandages.
• Tie knots on top of the splint.

51. Ankle and Foot Splinting
• Treat ankle and foot
injuries with RICE
procedures.
• To further stabilize an
ankle, wrap a pillow or
folded blanket around
the ankle and foot,
and tie with cravats.