Treating Fractures in the Field
Lesson 5: Fractures of the Upper Extremities
5-4
5-4. IMMOBILIZE A FRACTURED HUMERUS WITH AN IMPROVISED SPLINT
Wire ladder splints, SAM splints, and pneumatic splints are used to immobilize a fracture of the upper extremity. If these splints are not available, a splint can be made from improvised rigid objects and securing materials. Basswood boards, tree limbs, broken poles, boards, or rolled newspaper can be used as rigid objects. If a rigid object cannot be readily found, the casualty's chest can be used as the rigid object. Cravats, slings, and swathes are normally made from triangular bandages (paragraph 2-4c). If muslin bandages or other materials are not available to make triangular bandages, strips of torn cloth, belts, or similar objects can be used. Wire, shoestrings, and other very narrow materials should not be used. General procedures for applying an improvised splint to a fractured humerus are given in the following paragraphs.
a. Gather two rigid objects, securing materials, and padding.
b. Pad the rigid objects.
c. Check the casualty's pulse below the fracture site. If no pulse is found, evacuate the casualty as soon as possible after the splint is applied.
d. Place the rigid objects on each side of the upper arm. Make sure the inside rigid object is not pressing on the axilla (armpit).
e. Secure the rigid objects with cravats or other securing material.
(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 outer rigid object and tuck in the tails.
(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.
f. 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.
