Splinting is the technique
to secure the part of the body that is injured to
decrease further damage or injury to that part of
the body, and to make the individual more comfortable
until treatment can be initiated. There are many forms
of splinting. Many outdoorsmen have been very creative
in the past. Many items can be used, from sticks to
ski poles to dismantled barrels of shotguns, to dismantled
arrows, bark of trees, anything that is stable and
can be used to wrap around an extremity or an injured
part of the body. For the most part, splinting has
very few drawbacks. One of the most common is putting
the extremity in a splint and wrapping it too tightly,
thereby cutting off circulation. Other than that,
it is very difficult to cause more harm with splinting.
With any injury, one should assume that the injured
party has a fracture, and go ahead and splint until
one can be transported to a healthcare provider. All
dislocations, sprains, strains, and assumed fractures
should be splinted. It is important to assess color
of the skin farthest from the injured area, as well
as feeling farthest from the injured area. This will
give you some indication of the possible seriousness
of the injury, which will help when reporting this
to a healthcare provider. All injured extremities
should be elevated to decrease swelling.
When using sticks in the outdoors for
splinting fingers, arms, ankles, it is important to
use fresh green limbs as opposed to dead dry ones
for the obvious reason of the dry limbs breaking (A).
It is important to remember that when using any bark
or limbs, to make sure there are no insects under
the bark, for example ants and termites. It has not
been uncommon for individual in a rush to splint an
injured party member on a camping expedition and after
a few minutes to an hour, the ants then start to come
out and numerous bites are inflicted on that part
of the extremity. As you can see in the picture to
the right, these are willow branches that are used
to splint a finger, which work very well when using
duct tape to make a hammock, if you will, for the
finger to lie in. (B, C, D)
One of the most useful inventions, developed
by Sam Scheinberg, M.D., is the SAM splint. This splint
has been around for a while and has been used on Mt.
Everest expeditions, as well as on the space shuttle.
It is extremely lightweight, very malleable, as well
as very durable. As you will see in the photos, these
splints can be put into position to splint a variety
of joints, as well as appendages. This splint can
also be cut with a pair of scissors to shorten or
mold along certain area of the body. These splints
can be reused over and over again, and are invaluable
when on any outdoor expedition. In sustaining any
falls, for example out of a tree stand when deer hunting,
or when rock climbing, head injuries are not uncommon.
Subsequently, one has to worry about a cervical fracture,
which would be a fracture of the neck. The SAM splint
can easily be used for a cervical collar, which can
immobilize the neck and prevent further problems.
Please see photo to the right. (E)
The ankle is also very frequently injured
in the outdoors, whether from running, camping or
rock climbing. Severe sprains and fractures are not
uncommon. There are two technique used when employing
the SAM splint with a sprained or fractured ankle.
One is the Ice Tong Technique, where the SAM splint
is used to go under the bottom of the foot and up
onto each side of the ankle and then wrapped (F,
G, H, I), as well as the Forward and Back Wrap,
which is also a very secure method of splinting an
ankle. All of these SAM splints should be secured
with either an Ace wrap (which can be carried in your
backpack), a belt can be used or even a torn shirt,
to secure the SAM splint to the appendage. Dislocations
and fractures of the wrist as well as the elbow also
commonly occur. The SAM splint can be placed on the
palm side of the arm as seen in the picture to the
right, and wrapped with Ace wrap to secure the wrist
or the elbow. (J, K)
When an individual needs to have a more
secure splint, or it will not move, it is important
to take the SAM splint and bevel it before you apply
it, by bending it with a ridge on the bottom of the
splint. This splint will be in the shape of an I-beam
for example, which makes the splint almost impossible
to bend after it is molded. (L,
M)
This is especially useful when transporting
on long distances, with concerns that the extremity
is fractured, and you do not want any movement with
that extremity. Again, it is important to mention
to keep the injured extremity elevated if possible,
to decrease any swelling to the injured area. Splinting
remains one of the quickest and easiest mechanisms
of first line treatment in the outdoors which, when
used effectively, can actually save limbs from further
injury, as well as preserve function of the limbs
for years to come. |
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