6-6.
PREPARING TO SPLINT A FRACTURE OF AN EXTREMITY
Once you have located the site of the fracture, you must splint the injured arm or
leg. If the fractured bone is not splinted, the sharp end of the broken bone could move
and injure surrounding muscles, blood vessels, and nerves. Before applying the splint,
however, you should prepare the casualty.
a. Reassure the Casualty. Tell the casualty that you are taking care of him. If
you must leave the casualty to obtain materials for a splint, be sure to tell him that you
will return quickly. Talk to the casualty even if he appears to be unconscious.
b. Loosen Clothing and Expose Wound. Loosen any clothing that is tight or
which binds the casualty. Gently move clothing to expose the injury and to determine
the site of the fracture.
CAUTION:
In a chemical environment, do not loosen or remove any protective
clothing. Apply any needed dressings over the casualty's clothing.
c. Locate the Site of the Fracture. If the fracture is open, the wound (with or
without visible bone) usually identifies the site of the fracture. In a closed fracture, pain,
point tenderness, bruising, swelling, deformity, and crepitation may be used to locate
the site of the fracture.
d. Remove Jewelry. Remove any jewelry that is on the casualty's injured limb
and put the jewelry into his pocket. Jewelry is removed because the limb may swell and
cause the jewelry to interfere with blood circulation. If this happens, the jewelry may
have to be cut off to restore adequate blood circulation. Be sure to tell the casualty
what you are doing and why.
e. Check Circulation Below the Fracture Site. Evaluate the casualty's blood
circulation in the limb below the fracture site. A person with poor circulation should be
evacuated as soon as possible after the limb is splinted to prevent the loss of the limb.
(1) Check pulse. Palpate a pulse site below the fracture site. If no pulse or
a weak pulse is found, the fracture may be putting pressure on the artery or may have
damaged the artery. A weak pulse can be determined by comparing the pulse felt
below the fracture with the pulse felt at the same location on the uninjured limb. A
casualty with no pulse below the fracture site should be evacuated as soon as the limb
is splinted.
(2) Check capillary refill. If the fractured limb is an arm, press on the
casualty's fingernail, then release. If normal color does not return within two seconds,
the limb may have impaired circulation. This is also called the blanch test.
IS0877
6-7
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