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Conditions: You see a casualty who has an arm or leg that you think
is broken.
The casualty has no more serious
wounds or conditions that have not been
treated.
Necessary materials and equipment:
splint materials (boards, poles, tree
branches), padding materials (clothing,
blanket, field dressing, leafy vegetation),
and tie materials (strips of cloth, belts).
Standards:
Splinted the suspected broken arm or leg so
the arm or leg did not move and circulation
was not impaired.
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Performance
Steps
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1. Prepare the casualty for splinting.
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a.
Reassure the casualty if
he is conscious and able to
understand.
Tell the casualty you will be
taking care of him.
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b.
Loosen any tight or
binding clothing.
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WARNING
Do
not remove any protective clothing or
boots in a chemical environment.
Apply the splint over the
clothing.
WARNING
Do
not remove boots from the casualty
unless they are needed to stabilize a
neck injury or there is actual
bleeding from the foot.
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c.
Remove all jewelry from
the affected limb and place it in
the casualty’s pocket.
Tell the casualty that you
are doing this to prevent further
injury if swelling occurs later.
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2. Get splinting materials.
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a.
Get splints (wooden
boards, tree branches, poles, an
unloaded rifle) long enough to reach
beyond the joints above and below
the broken part.
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b.
Get materials to pad the
splints, such as a jacket, blanket,
poncho, shelter half, or leafy
vegetation.
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c.
Get tie materials, such
as strips of cloth or belts, to tie
the splints.
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Note. If
splinting materials are not available,
use the chest wall to immobilize a
suspected fracture of the arm and an
uninjured leg to immobilize the
fractured leg.
Continue with steps 7 and 8.
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3. Pad the splints.
Apply padding between the
splint and the bony areas of the body.
Suggested sites for padding:
wrist, elbow, ankle, knee,
crotch, and armpit.
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4. Check for signs of blood circulation problems below
the injury.
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a.
Check light-skinned
persons for color of skin (skin may
be pale, white, or a bluish gray
color).
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b.
Check dark-skinned
persons by depressing the toenail or
fingernail beds and seeing how fast
the color returns.
A slower return of color to
the injured side indicates a
circulation problem.
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c.
Check to see if the
injured arm or leg feels colder than
the uninjured one.
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d.
Ask the casualty about
the presence of numbness, tightness,
or a cold sensation.
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WARNING
If
there is a blood circulation problem,
evacuate the casualty as soon as
possible
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5. Put on a splint.
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WARNING
If
the fracture is open, do not attempt
to push bones back under the skin.
Apply a field dressing to
protect the area
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a.
Splint the broken arm or
leg in the position in which you
find it.
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Note. Do not try
to reposition or straighten the
fracture.
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b.
Place one splint on each
side of the arm or leg.
Make sure the splints reach
beyond the joints above and below
the fracture.
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c.
Tie the splints with
improvised (or actual) cravats.
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(1)
Gently place the
cravats at a minimum of two points
above and two points below the
fracture if possible.
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WARNING
Do
not tie any cravats directly over the
fracture
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(2)
Tie nonslip knots on
the splint away from the injury.
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6. Check the splint for tightness.
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a.
Make sure the cravats are
tight enough to hold the splinting
materials securely in place.
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b.
Recheck circulation below
the injury to make sure circulation
is not impaired.
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c.
Make any adjustments
without allowing the splint to
become ineffective.
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7. Apply sling if applicable.
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Note. A sling can
be used to further immobilize an arm
and to provide support by the
uninjured side.
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a.
Make a sling from any
nonstretching material such as a
strip of clothing or blanket,
poncho, shelter half, belt, or
shirttail.
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b.
Apply the sling so the
supporting pressure is on the
casualty’s uninjured side.
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c.
Make sure the hand of the
supported arm is slightly higher
than the elbow.
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8. Apply swathes if applicable.
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Note. Apply
swathes when the casualty has a
splinted, suspected fracture of the
elbow or leg, or when a suspected
fracture cannot be splinted. (Improvise swathes from large pieces of cloth or belts.) |
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WARNING
Place
swathes above and/or below the
fracture, not over it
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a.
Apply swathes to an
injured arm by wrapping the swathes
over the injured arm, around the
casualty’s back, and under the arm
on the uninjured side.
Tie the ends on the uninjured
side.
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b.
Apply swathes to an
injured leg by wrapping the swathes
around both legs and tying the
swathes on the uninjured side.
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Note. Watch the
casualty closely for life-threatening
conditions, check for other injuries,
and seek medical aid.
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Evaluation
Preparation:
Setup: You will need
another soldier to play the part of the
casualty. Have the casualty lie down or sit. Place splinting materials nearby. Have available splints, padding, and materials for ties,
slings, and swathes that are appropriate to
the fracture location on the arm or leg.
If available, have two or more pairs
of splints of varying lengths to help in
scoring step 1.
Brief
Soldier:
Tell the soldier that the casualty
has a suspected closed fracture and where it
is located (lower arm, elbow, upper leg,
lower leg). Tell the soldier to splint the
suspected fracture.
Do not evaluate step 8 in the
simulated mode.
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Performance
Measures
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GO
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NO
GO
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1. Used splints that reach beyond the joints above and
below the fracture.
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2. Checked blood circulation below the fracture before
and after applying the splints.
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3. Applied padding between the splints and all bony
areas.
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4. Used at least four ties (two above and two below
the fracture) to secure the splints,
if possible.
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5. Tied nonslip knots on the splint away from the
injury.
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6. Immobilized the splinted arm or leg using a sling
and/or swathes, as required, to
prevent easy movement.
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7. Checked the splint for tightness.
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8. Watched the casualty for life-threatening
conditions and checked for other
injuries.
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Evaluation
Guidance:
Score the soldier GO if all
performance measures are passed.
Score the soldier NO GO if any
performance measure is failed.
If the soldier scores NO GO, show
what was done wrong and how to do it
correctly.
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References
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Required
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Related
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FM
4-25.11
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