First aid: Limb injuries 3 – Fixation

Fractures, sprains, dislocations, contusions, stretched or torn ligaments. These are all common and unfortunately serious limb injuries. And what if they happen in places where medical help is not available, for example in the mountains or somewhere in the wilderness? In this article, we will show you how to fix the limb and create a functional improvised splint.

In the previous two articles on stable and unstable limb injuries (the injured limb can/cannot be weight-bearing), we explained why it is better not to try to determine the exact diagnosis and why to respond instead according to the severity of the situation and the availability of medical care. We also discussed how to proceed with treatment and what to do until the ambulance arrives in case of serious injuries.

But what if the injury occurs in places where EMS is not within reach, e.g. in the mountains or somewhere "in the wilderness" far from civilization? In that case we will have to rely on ourselves. After treatment, it will be necessary to fix the injured limb, i.e. create a functional splint from what we have or find around us, and prepare the injured for transport.

So today we will discuss how to properly create a splint. We will talk about the transport of the injured in the following article from the first aid section…

When to splint and when not to splint

The injured limb needs to be fixed in case of severe limb injuries. It is an unstable injury, i.e. one when it is not possible to put weight on the limb, the range of motion is not normal, and there are problems with innervation or blood supply to the end parts (peripheries).

ATTENTION: Splint only in situations where EMS is not within reach and you will have to transport the injured person yourself, e.g. in the mountains or far from civilization. If the EMS is within reach, call 155 or 112 or use the Záchranka application.

What criteria must the splint meet?

Creating a splint with which you can transport the injured person to safety is not easy. To really work as it should, it must meet several important criteria:

• Rigid to prevent movement of the injured limb.
  

• Comfortable - the injured person will have to stay in it for a longer time and manage the transport.

• It must always be possible to control the fingers. Check the fingers before splinting, after it and continuously during transport.
  

• In case of joint injury: over two bones.
  

• In case of bone injury: over two joints.
  

Material for making a splint

To make a splint, you can use tools that you may have in your first aid kit - for example, a SAM Splint or a three-pointed scarf. Or improvise and create a fixation from materials and equipment you have with you or find around you.

What can be used for an improvised splint:

• A mat (even an inflatable one).
  

• A trekking pole.

• An isothermal foil.

• A detachable backpack waist belt (in the case of a broken pelvis - handle the injured person very carefully and only if necessary!)
  

• Branches.

• A flat loop.

• Bandages, fabrics (including clothing or pieces thereof).

• A kinesiology tape.

• For strengthening: Duct tape, paracord…

...and more.

A few tips for splinting:

• Try to use mainly the injured person's material. After handing over the patient to the doctors, you might not be reunited with your belongings.
  

• Because the splint you create will have to survive transport and last for a long time, take real care in its preparation!

We have a splint! And what next?

Have you created the perfect splint? Great! But it doesn't end there. Even with the splint on and continuously during transport:

• Check the state of consciousness of the injured.

• Control their fingers.

• Maintain their thermal comfort.

Examples of improvised splints

Improvised neck collar

Improvised neck collar using a SAM splint. You can also use, for example, a rolled mat.

Collarbone injury

In case of a collarbone injury, you create a "bow tie" that helps pull the fragments apart slightly. Use, for example, a flat loop, an elastic bandage or a piece of clothing.

Injury of the lower limb

Left leg: inflatable mat fixed with duct tape. Right leg: SAM splint fixed with elastic bandages.

A limb fixed with a trekking pole.

Injury of the upper limb

To increase comfort when fixing the arm, include the wrist in the splint.

Pelvic injury

In the case of a pelvic injury, handle the injured person very carefully.

<!DOCTYPE html>

ZDrSEM – HORAL course

This 5.5 day outdoor first aid course will teach you how to react in places where professional help is available within hours or not at all and you will have to rely on yourself. More at www.zdrsem.cz/horal.

The article was created in collaboration with Dita Voltr Podhadská, ZDrSEM first aid instructor and HORAL outdoor first aid course guarantor.