e. Recheck Circulation. Observe the limb below the cravats for signs of
impaired circulation as you secure the splints. After the splint has been secured,
recheck the limb's circulation to ensure that the cravats or rigid objects have not
interfered with blood circulation. Check the color and temperature of the limb and ask
the casualty how the limb feels. If your check before splinting the fracture showed
normal circulation and your check now shows poor circulation (weak or no pulse, bluish
skin, slow return of color to nail bed, coolness, a numb or tingling sensation in the limb,
etc.), take the following measures to restore circulation.
Loosen the securing strip/cravat closest to the heart (above the fracture
(2) If the end of the rigid object is pressing against the casualty's body
(especially under the arm or inside the thigh), reposition the rigid object and/or add
(3) Retie the securing materials using nonslip knots on the outer rigid object.
Make sure that the securing materials keep the rigid objects from slipping, but are not
tight enough to interfere with blood circulation.
(4) Recheck the circulation. If the limb still has poor circulation, repeat
steps (1) through (4) for the next cravat/securing strip (one distal to the previous cravat)
until circulation is restored or until all of the securing materials have been loosened and
(5) If all of the securing materials have been loosened and retied and the
circulation has not been restored, evacuate the casualty as soon as possible.
APPLYING A SLING TO A FOREARM
A sling is used to support and immobilize the forearm. It also serves to
immobilize the elbow and upper arm. A sling is normally made from a triangular
bandage (see Lesson 5), but other slings can be improvised. A swathe is normally
applied to further immobilize the casualty's injured arm.
a Insert the triangular bandage (figure 6-13 A) between the injured arm and the
casualty's chest so the arm is in the center, the apex of the sling is beyond the elbow,
and the top corner of the material is over the shoulder of the injured side (figure 6-13 B).
b. Position the forearm so the hand is slightly higher than the elbow (about a 10
c. Fold the material along the base (the long side opposite the apex) back to the
casualty's fingers, forming a cuff.