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At this time we urge you to verify the information below with the printed publication available through the U.S. Government Printing Office.
1. Prepare the casualty for splinting the suspected fracture.
a. Reassure the casualty if he or she is conscious and able to understand. Tell the casualty that you will be taking care of him or her.
| WARNING |
| DO NOT REMOVE ANY PROTECTIVE CLOTHING OR BOOTS IN A CHEMICAL ENVIRONMENT. APPLY THE SPLINT OVER THE CLOTHING. DO NOT REMOVE BOOTS FROM THE CASUALTY UNLESS THEY ARE NEEDED TO STABILIZE A NECK INJURY OR THERE IS ACTUAL BLEEDING FROM THE FOOT. |
b. Loosen any tight or binding clothing.
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.
2. Get splinting materials.
a. Get splints (boards, tree branches, poles, an unloaded rifle) long enough to reach beyond the joints above and below the broken part.
b. Get materials to pad the splints, such as a jacket, blanket, poncho, shelter half, or leafy vegetation.
c. Get things to tie the splints, such as strips of cloth or belts.
NOTE: If splinting materials are not available, the chest wall can be used to immobilize a suspected fracture of the arm and an uninjured leg can be used to immobilize the fractured leg. Continue with steps 7 and 8.
3. Pad the splints where they will touch any bony part of the body, such as the wrist, elbow, ankle, or knee. Also pad splints where they will touch the crotch or armpit.
| WARNING |
| IF BLOOD CIRCULATION PROBLEMS ARE FOUND, EVACUATE THE CASUALTY AS SOON AS POSSIBLE. |
4. Check for signs of blood circulation problems below the injury by performing the following checks as necessary.
a. Check light-skinned persons for skin which is pale, white, or a bluish gray color.
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.
c. Check to see if the injured arm or leg feels colder than the uninjured one.
d. Ask the casualty about the presence of numbness, tightness, or a cold sensation.
5. Put on the splint.
| WARNING |
| IF THE FRACTURE IS OPEN, DO NOT ATTEMPT TO PUSH BONES BACK UNDER THE SKIN. APPLY A FIELD DRESSING TO PROTECT THE AREA. (SEE THE TASK PUT ON A FIELD OR PRESSURE DRESSING, TASK NUMBER 081-831-1016.) |
a. Splint the broken arm or leg in the position you find it. Do not try to reposition or straighten the fracture.
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.
c. Tie the splints with improvised (or actual) cravats.
| WARNING |
| DO NOT TIE ANY CRAVATS DIRECTLY OVER THE FRACTURE. |
(1) Gently place the cravats at a minimum of two points above and two points below the fracture, if possible.
(2) Tie nonslip knots on the splint away from the injury.
6. Check the splint for tightness.
a. Make sure that the cravats are tight enough to securely hold the splinting materials in place.
b. Recheck circulation below the injury to make sure that circulation is not impaired.
c. Make any adjustments without allowing the splint to become ineffective.
7. Apply a sling, if applicable.
a. Make a sling from any nonstretching material, such as a strip of clothing or blanket, poncho, shelter half, belt, or shirttail.
b. Apply the sling so that the supporting pressure is on the casualty's uninjured side.
c. Make sure that the hand of the supported arm is slightly higher than the elbow.
8. Apply swathes, if applicable.
NOTE: Swathes should be applied when the casualty has a splinted suspected fracture of the elbow or leg or when a suspected fracture cannot be splinted. Swathes can be improvised from large pieces of cloth or belts. WARNING PLACE SWATHES ABOVE AND/OR BELOW THE FRACTURE--NOT OVER IT.
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, tying the ends on the uninjured side.
b. Apply swathes to an injured leg by wrapping the swathes around both legs, tying the swathes on the uninjured side.
9. Watch the casualty closely for life-threatening conditions and check for other injuries, if necessary. (See the task Evaluate A Casualty, task number 081-831-1000.)
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 7 in the simulated mode.
| Performance Measure | Results | |
|---|---|---|
1. Use splints that reach beyond the joints above and below the fracture. | P | F |
2. Check circulation below the fracture both before and after applying the splints. | P | F |
3. Apply padding between the splints and all bony areas. | P | F |
4. Use at least four ties (two above and two below the fracture) to secure the splints, if possible. | P | F |
5. Tie nonslip knots on the splint which is away from the injury. | P | F |
6. Immobilize the splinted arm or leg using a sling and/or swathes, as required, so that it does not move easily. | P | F |
7. Watch the casualty closely for life-threatening conditions and check for other injuries, if necessary. (See the task Evaluate A Casualty, task number 081-831-1000.) | P | F |