Treating Fractures in the Field
Lesson 5: Fractures of the Upper Extremities
5-3
5-3. IMMOBILIZE A FRACTURED HUMERUS WITH A SAM SPLINT
a. Unroll the SAM splint and flatten it.
b. Fold the SAM splint into an irregular (uneven) "V" shape with one side of the V about four to six inches longer than the other.
c. Bend the edges of the splint so the sides of the splint are U-shaped and generally conform to the shape of the limb being splinted.
d. Check the casualty's pulse below the fracture site. If no pulse is found, evacuate the casualty as soon as possible after the upper arm is splinted.
e. Position the casualty's forearm so it is across his chest with the wrist slightly higher than the elbow.
f. Apply the SAM splint to the upper arm. The upper part of the forearm (where it joins the elbow) should rest in the bottom of the "V," the short side of the "V" is on the inside of the upper arm (but not pressing on the arm pit), and the long side is on the outside of the upper arm with the end extending to or past the shoulder.
g. Adjust the shape of the SAM splint to conform to the limb, if needed.
h. Secure the splint using at least two cravats (see figure 5-5).
Figure 5-5. Upper arm immobilized using a SAM splint.
(1) Apply at least one cravat above the fracture site and at least one cravat below the fracture site. If possible, apply two cravats above the fracture site and two cravats below the fracture site. Do not apply a cravat over the fracture site.
(2) Tie the tails of the cravats in a non-slip knot on the outside of the splint. Tuck the ends of the tails into the cravat to prevent accidental entanglement when the casualty is moved.
(3) Check the casualty's pulse after each cravat is applied. If the pulse can no longer be detected, loosen the cravat and apply it again. If this does not restore circulation, evacuate the casualty as soon as possible.
(4) If cravats are not available, use tape or a roller bandage to secure the SAM splint.
i. Apply a sling and a swathe to further immobilize the casualty's arm. If possible, apply two swathes--one above the fracture site and one below the fracture site.
