Before beginning first aid treatment for a fracture, gather whatever
splinting materials are available. Materials may consist of splints,
such as wooden boards, branches, or poles. Other splinting materials
include padding, improvised cravats, and/or bandages. Ensure that
splints are long enough to immobilize the joint above and below
the suspected fracture. If possible, use at least four ties (two
above and two below the fracture) to secure the splints. The
ties should be nonslip knots and should be tied away from the
body on the splint.
*a. Evaluate the Casualty (081-831-1000). Be prepared
to perform any necessary lifesaving measures. Monitor the casualty
for development of conditions which may require you to perform
necessary basic lifesaving measures. These measures include clearing
the airway, rescue breathing, preventing shock, and/or bleeding
Unless there is immediate life-threatening danger, such as
a fire or an explosion, DO
NOT move the casualty with a suspected
back or neck injury. Improper movement
may cause permanent paralysis
In a chemical environment, DO NOT remove any protective clothing.
Apply the dressing/splint over the clothing.
b. Locate the Site of the Suspected Fracture. Ask the
casualty for the location of the injury. Does he have any
pain? Where is it tender? Can he move the extremity?
Look for an unnatural position of the extremity. Look for a bone
sticking out (protruding).
c. Prepare the Casualty for Splinting the Suspected Fracture
(1) Reassure the casualty. Tell him that you will be taking care
of him and that medical aid is on the way.
(2) Loosen any tight or binding clothing.
(3) Remove all the jewelry from the casualty and place it in the
casualty's pocket. Tell the casualty you are doing this because
if the jewelry is not removed at this time and swelling occurs
later, further bodily injury can occur.
Boots should not be removed from the casualty unless they
are needed to stabilize a
neck injury, or there is actual bleeding
from the foot.
d. Gather Splinting Materials (081-831-1034). If standard
splinting materials (splints, padding, cravats, and so forth)
are not available, gather improvised materials. Splints can be
improvised from wooden boards, tree branches, poles, rolled newspapers
or magazines Splints should be long enough to reach beyond the
joints above and below the suspected fracture site. Improvised
padding, such as a jacket blanket, poncho, shelter half, or leafy
vegetation may be used. A cravat can be improvised from a piece
of cloth, a large bandage, a shirt, or a towel. Also, to immobilize
a suspected fracture of an arm or a leg, parts of the casualty's
body may be used. For example, the chest wall may be used to immobilize
an arm; and the uninjured leg may be used to immobilize the injured
If splinting material is not available and suspected fracture
CANNOT be splinted,
then swathes, or a combination of swathes
and slings can be used to immobilize an
e. Pad the Splints (081-831-1034). Pad the splints where
they touch any bony part of the body, such as the elbow, wrist,
knee, ankle, crotch, or armpit. Padding prevents excessive pressure
to the area.
f. Check the Circulation Below the Site of the Injury (081-831-1034).
(1) Note any pale, white, or bluish-gray color of the skin which
may indicate impaired circulation. Circulation can also be checked
by depressing the toe/fingernail beds and observing how quickly
the color returns. A slower return of pink color to the injured
side when compared with the uninjured side indicates a problem
with circulation. Depressing the toe/fingernail beds is a method
to use to check the circulation in a dark-skinned casualty.
(2) Check the temperature of the injured extremity. Use your hand
to compare the temperature of the injured side with the uninjured
side of the body. The body area below the injury may be colder
to the touch indicating poor circulation.
(3) Question the casualty about the presence of numbness, tightness,
cold, or tingling sensations.
Casualties with fractures to the extremities may show impaired
circulation, such as numbness, tingling, cold and/or pale to blue
skin. These casualties should be
evacuated by medical personnel
and treated as soon as possible. Prompt medical
prevent possible loss of the limb.
If it is an open fracture (skin is broken; bone(s) may be
sticking out), DO NOT
ATTEMPT TO PUSH BONE(S) BACK UNDER THE SKIN.
Apply a field
dressing to protect the area. See Task 081-831-1016,
Put on a Field or Pressure
g. Apply the Splint in Place (081-831-1034).
(1) Splint the fracture(s) in the position found. DO NOT attempt
to reposition or straighten the injury. If it is an open fracture,
stop the bleeding and protect the wound. (See Chapter 2, Section II, for detailed information.) Cover all wounds with field dressings
before applying a splint. Remember to use the casualty's field
dressing, not your own. If bones are protruding (sticking out),
DO NOT attempt to push them back under the skin. Apply dressings
to protect the area.
(2) Place one splint on each side of the arm or leg. Make sure
that the splints reach, if possible, beyond the joints above and
below the fracture.
(3) Tie the splints. Secure each splint in place above
and below the fracture site with improvised (or actual)
cravats. Improvised cravats, such as strips of cloth, belts, or
whatever else you have, may be used. With minimal motion to the
injured areas, place and tie the splints with the bandages. Push
cravats through and under the natural body curvatures (spaces),
and then gently position improvised cravats and tie in place.
Use nonslip knots. Tie all knots on the splint away from the casualty
(Figure 4-2). DO NOT tie cravats directly
over suspected fracture/dislocation site.