Treating Fractures in the Field
Lesson 5: Fractures of the Upper Extremities
5-10
5-10. IMMOBILIZE A FOREARM USING A PNEUMATIC SPLINT
A pneumatic (air) is normally used to immobilize a fracture of the forearm or lower leg. A pneumatic splint can be applied quickly and easily. Since they are transparent, the injury can be observed through the splint. Pneumatic splints, however, also have disadvantages. A pneumatic splint cannot be used with an open fracture since the pressure from the splint would force the bone back into the arm. The splint can also be rendered useless if it is torn or punctured. The pressure may need to be adjusted periodically, especially if the casualty is evacuated by air. The procedures below give the general steps for applying a pneumatic splint to a fractured forearm with the casualty lying on the ground.
a. Inspect Splint. Check the splint for cuts, tears, and punctures. Check the air valve and the zipper to make sure they function properly.
b. Check Pulse. Check the casualty's pulse distal to the suspected fracture. If no pulse is found, evacuate the casualty as soon as possible after the injury is splinted.
c. Apply Splint.
(1) Unzip the splint and lay it flat next to the injured forearm. The splint should be flat (not inflated).
(2) Gently lift the casualty's forearm. Support the elbow with your hand and cradle his arm in your arm..
(3) With your other hand, move the splint beneath the injured forearm. The splint should be as high on the injured forearm as possible.
(4) Gently lower the forearm onto the splint.
(5) Gently place the splint around the forearm and close the zipper completely.
d. Inflate the Splint.
(1) Open the air valve. This is usually done by turning the valve counterclockwise. A pneumatic (air) splint is normally used to immobilize a fracture of the forearm or lower leg. A pneumatic splint can be applied quickly and easily. Since they are transparent, the injury can be monitored easily.
(2) Inflate the splint by blowing into the air valve.
(a) Always inflate the splint by mouth. Do not use an air pump. It is easy to over inflate a splint when a pump is used. As the air pressure inside the splint increases, so does the pressure caused by the splint on the injured limb. Too much pressure can result in impaired circulation in the limb.
(b) When the splint is properly inflated, you will be able to make a small indentation in the splint by pressing on it with your finger or thumb.
(3) Close the air valve. This is usually done by turning the valve clockwise.
(4) Check the casualty's pulse distal to the splint. If the casualty had a pulse previously but a pulse can no longer be found, decrease the air pressure in the splint and recheck the pulse. If a pulse still cannot be felt, evacuate the casualty as soon as possible.
e. Monitor the Splint.
(1) Since the splint depends upon air pressure to remain rigid, continue to check the splint to make sure no leaks have developed.
(2) Observe for impaired circulation.
(a) Monitor the casualty's pulse and the color and temperature of the limb distal to the splint. Also ask the casualty about numbness or tingling sensations if he is responsive. Lower the air pressure if the splint is impairing circulation.
(b) Partially deflate the splint every 20 to 30 minutes to reestablish peripheral circulation in the forearm and hand; then inflate the splint again to its normal
rigidity.
(3) Adjust for changes in environment by increasing or decreasing the amount of air in the splint.
(a) Changes in the weather and temperature can affect the air pressure inside the splint.
(b) Decrease the air pressure in the splint if the casualty is to be evacuated by air.
