Perform First Aid for a Suspected Fracture

Conditions: You see a casualty who has an arm or leg that you think is broken. The casualty has no more serious wounds or conditions that have not been treated. Necessary materials and equipment: splint materials (boards, poles, tree branches), padding materials (clothing, blanket, field dressing, leafy vegetation), and tie materials (strips of cloth, belts).

Standards: Splinted the suspected broken arm or leg so the arm or leg did not move and circulation was not impaired.

Performance Steps

1. Prepare the casualty for splinting.

   a. Reassure the casualty if he is conscious and able to understand.  Tell the casualty you will be taking care of him.

   b. Loosen any tight or binding clothing.

WARNING

Do not remove any protective clothing or boots in a chemical environment. Apply the splint over the clothing.

WARNING

Do not remove boots from the casualty unless they are needed to stabilize a neck injury or there is actual bleeding from the foot.

   c. Remove all jewelry from the affected limb and place it in the casualty's pocket.  Tell the casualty that you are doing this to prevent further injury if swelling occurs later.

2. Get splinting materials.

   a. Get splints (wooden boards, tree branches, poles, an unloaded rifle) long enough to reach beyond the joints above and below the broken part.

   b. Get materials to pad the splints, such as a jacket, blanket, poncho, shelter half, or leafy vegetation.

   c. Get tie materials, such as strips of cloth or belts, to tie the splints.

Note. If splinting materials are not available, use the chest wall to immobilize a suspected fracture of the arm and an uninjured leg to immobilize the fractured leg. Continue with steps 7 and 8.

3. Pad the splints. Apply padding between the splint and the bony areas of the body. Suggested sites for padding: wrist, elbow, ankle, knee, crotch, and armpit.

4. Check for signs of blood circulation problems below the injury.

   a. Check light-skinned persons for color of skin (skin may be pale, white, or a bluish gray color).

   b. Check dark-skinned persons by depressing the toenail or fingernail beds and seeing how fast the color returns.  A slower return of color to the injured side indicates a circulation problem.

   c. Check to see if the injured arm or leg feels colder than the uninjured one.

   d. Ask the casualty about the presence of numbness, tightness, or a cold sensation.

WARNING

If there is a blood circulation problem, evacuate the casualty as soon as possible

5. Put on a splint.

WARNING

If the fracture is open, do not attempt to push bones back under the skin. Apply a field dressing to protect the area

   a. Splint the broken arm or leg in the position in which you find it.

Note. Do not try to reposition or straighten the fracture.

   b. Place one splint on each side of the arm or leg.  Make sure the splints reach beyond the joints above and below the fracture.

   c. Tie the splints with improvised (or actual) cravats.

       (1)  Gently place the cravats at a minimum of two points above and two points below the fracture if possible.

WARNING

Do not tie any cravats directly over the fracture

       (2)  Tie nonslip knots on the splint away from the injury.

6. Check the splint for tightness.

   a. Make sure the cravats are tight enough to hold the splinting materials securely in place.

   b. Recheck circulation below the injury to make sure circulation is not impaired.

   c. Make any adjustments without allowing the splint to become ineffective.

7. Apply sling if applicable.

Note. A sling can be used to further immobilize an arm and to provide support by the uninjured side.

   a. Make a sling from any nonstretching material such as a strip of clothing or blanket, poncho, shelter half, belt, or shirttail.

   b. Apply the sling so the supporting pressure is on the casualty's uninjured side.

   c. Make sure the hand of the supported arm is slightly higher than the elbow.

8. Apply swathes if applicable.

Note. Apply swathes when the casualty has a splinted, suspected fracture of the elbow or leg, or when a suspected fracture cannot be splinted. (Improvise swathes from large pieces of cloth or belts.)

WARNING

Place swathes above and/or below the fracture, not over it

   a. Apply swathes to an injured arm by wrapping the swathes over the injured arm, around the casualty's back, and under the arm on the uninjured side.  Tie the ends on the uninjured side.

   b. Apply swathes to an injured leg by wrapping the swathes around both legs and tying the swathes on the uninjured side.

Note. Watch the casualty closely for life-threatening conditions, check for other injuries, and seek medical aid.