Skill:

1. Skill: Splinting a Forearm

2. Support arm. Check circulation.

3. Position arm on rigid splint.

4. Secure splint.

5. Check circulation.

6. Wrist Injuries Sprains Fractures

7. Splinting Wrist Injuries Goal is to stabilize from forearm to hand Soft splint and sling often sufficient Rigid splint provides more support Assess circulation, sensation, movement in hand and fingers

8. Wrist Injuries • Apply rigid splint on palm side of arm from forearm past fingertips • Tie above and below wrist • Leave fingers uncovered • Support forearm and wrist with sling and apply binder around upper arm and chest

9. Hand Injuries May be injured by direct blow Fractures occur when patient punches something with closed fist

10. Splinting Hand Injuries • Goal is immobilization of hand • Use soft or rigid splint • Place roll of gauze in palm • Bandage entire hand • Place rigid splint on palm side of hand. Pad between hand and splint • Support further with sling and swathe

11. Finger Injuries Fractures and dislocations Often splint not required Use rigid splint or anatomic splint

12. Splinting Finger Injuries Use soft splint if finger cannot be straightened without pain Don’t manipulate finger into normal position Use rigid splint, secured with tape Tape finger to adjoining finger with gauze in between

13. Lower Extremity Injuries • Larger forces are typically involved • Forces may also cause spinal injury • Assess patient, without moving extremity • Femur fracture can damage femoral artery

14. Hip and Pelvis Injuries • Fractures and dislocations • A hip fracture = fracture of top part of femur • Fractures more common in elderly • Bleeding and pain may be severe • Dislocations occur at any age • Falls • Vehicular crashes • Blows to body

15. Hip Injuries Do not move patient Immobilize leg and hip in position found Pad between legs and bandage together (unless this causes more pain) Treat for shock but do not elevate legs

16. Upper Leg Injuries Femur fractures serious Severe pain/shock may occur Keep patient from moving Use rigid splint if lying down with leg supported by ground Use folded blankets/coats to immobilize leg in position found

17. Splinting Upper Leg Injuries Anatomic splint Rigid splints

18. Splinting Upper Leg Injuries continued • Check circulation and sensation in foot and toes • Put rigid splint on each side of leg • Pad body areas and voids • Inside splint should extend from groin past foot • Outside splint should extend from armpit past foot

19. Traction Splint for Femur Fractures Traction splint maintains continual pull on femur to keep bone ends in normal position First Responders usually assist other EMS personnel

20. Knee Injuries Sprains Dislocations Caused by sports injuries, motor vehicle crashes, falls Femur, tibia or fibula fractures indistinguishable from knee injuries

21. Splinting Knee Injuries • Splint in position found • Apply soft splint by rolling blanket or placing pillow around knee • If knee straight, make anatomical splint

22. Splinting the Knee If possible, put rigid splint on both sides of leg Pad body areas and voids Check circulation and sensation in foot and toes first and periodically after splinting

23. Splinting the Knee If knee is straight apply two splints along both sides of knee If knee is bent, splint in position found Tie splints with cravats or bandages

24. Lower Leg Injuries Many causes Either or both bones of lower leg can be fractured

25. Lower Leg Injuries • Rigid splint applied the same as for knee injury • Three-sided cardboard splint can be used

26. Skill: Splinting the Leg (Anatomic)

27. Check circulation. Gently slide four to five strips of bandages under both legs.

28. Pad between legs.

29. Gently slide uninjured leg next to injured leg.

30. Tie bandages and Check circulation

31. Ankle Injuries Commonly a sprain occurring when foot forcefully twisted to one side Fractures or dislocations Often involve torn ligaments and nerve/blood vessel damage

32. Splinting Ankle Injuries Soft splint usually best Assess circulation, sensation, movement in toes

33. Foot Injuries Commonly caused by direct blows/falls Involve almost any bone/ligament of foot Treat same as ankle injuries Toe fractures can be very painful

34. Splinting Foot Injuries • Usually no splinting required • Use pillow splint as for ankle injury if: • toe is significantly bent • more than one toe involved • foot is very painful

35. Rib Fractures Typically caused by blunt trauma to chest More common in lower ribs and along side Cause severe pain, discoloration, swelling Pain often sharper upon breathing in Patient may breathe shallowly and hold/support area

36. Splinting Rib Injuries Goal is primarily supportive Have patient sit/stand in easy breathing position Support ribs with pillow or soft padding loosely bandaged over area and under arm Immobilize arm with sling and swathe Monitor breathing