c. Apply Padding. Place padding between the rigid objects and the body part
to be splinted. The padding helps prevent excessive pressure on the limb which could
interfere with blood circulation. Extra padding should be used at bony body areas such
as the elbow, wrist, knee, or ankle and extra-sensitive areas such as the groin and
As a general rule, fractures are splinted
in the position they are found
("splint them as they lie"). However, if there is no circulation below the fracture site or if
the limb is so grossly angulated that you cannot effectively splint it, you may need to
gently realign the limb. With one hand supporting the fracture site, use the other hand
to grasp the part of the limb farthest from the fracture site and gently pull in the direction
of the long axis of the bone, like extending a telescope. The realignment of the limb
may help to restore blood circulation.
d. Secure Rigid Objects and Padding. Wrap the securing materials around
the rigid objects and limb so that the rigid objects immobilize the limb. Tie the ends
(tails) of each securing cravat in a nonslip knot on the outer rigid object and away from
the casualty. (The knots are tied on the outer rather than the inner rigid object to make
loosening and retying the cravats easier should that procedure become necessary.)
The securing material should be tight enough to hold the rigid objects and padding
securely in place, but not tight enough to interfere with blood circulation. Properly
secured splints cannot be moved easily.
(1) Secure the rigid objects above and below the fracture site (normally, two
cravats above the fracture site and two cravats below the fracture site). Normally, the
joint above the fracture site and the joint below the fracture site are immobilized.
(2) If a joint is fractured, apply the splint to the bone above the joint and to
the bone below the joint so the joint is immobilized.
Pad the splint at the joints and at sensitive areas to prevent local
(4) If possible, immobilize the joint above the fracture site and the joint
below the fracture site.
Minimize movement of the limb until it has been splinted.