a. Immobilize the Fracture.

Make the casualty comfortable and keep him as still as possible. Apply a sling and swathe to the arm on the injured side (figure 3-9).

The sling and swathe help to immobilize the injured side as much as possible. There is a danger the rib may be broken in two places. If so, a rib segment is free of the sternum and spine and the segment may “float.” The sharp end of the rib segment could puncture the lung or damage the heart or major blood vessels. Sub course MD0533, Treating Fractures in the Field, describes the procedures for applying slings and swathes.

CAUTION: Do not tape, strap, or bind the chest since these actions could interfere with the casualty’s breathing. The swathe should not be tight enough to compress the casualty’s chest.

b. Monitor and Evacuate Casualty.

Monitor the casualty’s breathing.

Encourage the casualty to take deep breaths to inflate his lungs. If the casualty has difficulty breathing, establish and maintain an open airway. Administer oxygen if it is needed and is available. Observe the casualty for signs and symptoms of tension pneumothorax and hemothorax. Evacuate the casualty when possible.