Any serious injury in a wilderness setting can be alarming in the extreme, but panic will help no-one. If you are faced with a broken or seriously injured limb, the answer is to ensure that the limb is thoroughly immobilized whilst you seek further professional medical help. Since you are in the wilderness, you will not have access to any fancy kit, but there should be something around you that will allow you to do a capable job in creating a splint.
Why do you need to splint an injured limb?
The basic reason to splint an injured limb is to immobilize it. If a bone is broken, every time that bone moves it will cause excruciating pain, so immobilizing the limb will make the evacuation of the injured person much more comfortable.
Where do I start?
ABC of First Aid.
The very first thing that you need to do is ensure that the broken limb is the only injury you are dealing with. Remember your ABC of First Aid; airway, breathing, and circulation. First, check that the patient is breathing normally and that nothing is blocking their airway. Now check for any bleeding and make sure that you deal with open wounds before starting to splint the limb.
What do I need to make a splint?
Essentially, you will need at least two strong supports, something to pad them with and something with which to tie and secure them to the injured limb.
Let’s take these one at a time, starting with the supports. You can use mostly anything as a support for an injured limb. Look for something that is long enough to support the limb from above the joint above the injury to the lower side of the joint below the injury. For example, if you have an injured forearm, you must splint from above the elbow to below the wrist. In this way, you can be sure that the limb will not move.
Try to make the splint approximately the correct size. Using ski poles to splint a forearm is going to make moving the patient very difficult as the weight of the poles will make moving the arm painful as well as extremely cumbersome. In this case, try to find two pieces of a tree branch that will fit. Look at using the rigid interior of your backpack or perhaps a tent pole. If you are splinting an arm or a leg and cannot find anything like tree branches, then take a pair of trousers and stuff the legs with clothing and foam sleeping pads, packing them as tightly as possible. This will make a fairly stout emergency splint.
Next, consider the padding. If you are using hard materials such as tree branches, ski poles, paddles, etc., then you will need to pad the splint before tying it on. This will stop abrasion of the skin by the hard materials. Wrap clothing, towels or any soft material around the hard splint before applying it. In an emergency, you can take a shirt and place grass inside the sleeve thus making a very effective pad for a splint.
Lastly, you need something to tie the splint to the injured limb. Ideally, a bandage of some kind would be nice, but in the wilderness, you may not have access to this. Here I suspect someone will have to sacrifice their clothing! Cut long strips of material that is at least two or three inches wide. You can also use webbing, duct tape, straps, gauze or anything that will wrap and tie off securely.
What if there is a bone sticking out
This is known as a compound fracture, and it can be very frightening. Make absolutely no attempt to do anything with the bone. If you have bandages, make them into a long sausage and bend it into a circular pad. Place it around the injury, then cover the top of the bone with a further pad of material and gently tie or stick the entire dressing down. If you have no bandages, use clean shirts or trousers to make the circular pad.
Applying the splint
Place one of your rigid supports on one side of the limb and carefully place the padding in between the limb and the support. Repeat this on the other side of the limb. Under no circumstances should you attempt to relocate the broken bones. This can only be done by a medical professional when you arrive at a medical facility.
Get someone to hold the two supports in place and start tying the supports onto the limb. NEVER tie over the point of the break! Tie above and below and try to get the splints secured in such a way as to provide support and to stop the limb moving.
Be very careful to not cut off the blood circulation to the limb. Before starting to move, check that the blood supply to the limb is good, the extremity should be warm and normal in color. If it has changed color or is cold, or the patient says it is tingling, loosen the ties as you could well have cut off the blood supply.
Moving the patient
Be gentle with your patient. Remember that they may well go into a state of shock so be prepared to treat for shock, too. Also, if you have to transport the patient over some distance before getting to medical assistance, stop on a regular basis to check that the injured limb is not swelling to the point that your ties are now cutting off the blood supply. You can expect the broken limb to swell so keep a careful eye on the ties.
As with all First Aid that you may have to undertake in a wilderness setting, keeping yourself, your patient and the others in your party calm will be your first priority. Panic has been the death of many people, so keep calm, assess the situation and then take action. Remember your ABC and work methodically through the task. You will be amazed at how much you can achieve with a limited range of materials.
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