Improvised Inflatable Splint

This article should be taken in context with recent relevent training and does not, on it's own, constitute instruction for treatment.

In many circumstances, splinting is not necessary for bone or joint injuries, certainly in an urban or domestic setting where professional help can arrive within the hour.  

Splinting and bandaging is almost impossible to do without causing movement which, in turn, can cause further damage and pain.   In many cases the casualty may be 'guarding' or holding the limb in a comfortable position so supporting the limb in that position is often all that is needed.

Unconscious casualties are least likely to move their limb and may not even be responsive to the pain; their priority is management of the airway.

But sometimes, there is benefit in splinting.

Indications - when you would

  • Extended time between the incident and professional care

  • A need to move or transport the casualty

  • Extreme pain may be relived by splinting

Contraindications - when you would not

  • Less than one hour until professional help

  • The casualty is not in need of being moved

  • The casualty has manageable pain

The following method is intended as an improvised solution for remote environments.

You will need:  Duck Tape, Stretch Wrap a 3/4 length self-inflating mattress (e.g. Therm-a-Rest or Alpkit)

Step 1

The most important thing in any treatment is to 'set your stall out';  gather everything you need before you need it so that you do not have to leave the casualty.  Having everything to hand will also prevent any delay in the process.

Lay out the mattress, without inflating it, alongside the injured limb.  The valve must be closed and importantly, at the foot of the casualty.

Step 2

Elevate the limb to slide the mattress underneath - do not lower the limb if it can be helped; while elevating the limb may cause pain or discomfort, repeated lifting and lowering may cause more pain.  If an assistant is available they should apply gentle traction throughout the lifting and - if needed - support under the site of the injury.

Tell the casualty that it will hurt but you will do your best to minimise pain and you will work as fast as you can.   Never tell a casualty it will not hurt if you know that it will!

Once the mattress is under the limb, quickly tape it around with a few long strips of Duck Tape.   The tape does not provide any support in the finished article, it is merely there to hold the mattress in place during Step 3.

Step 3

Again, working quickly with minimum movement on the limb and the assistant applying continual gentle traction, wrap the mattress in  Stretch Wrap.   The mattress should be covered along the whole length of the limb.   The limb can now be gently lowered.

Step 4

Being thankful that you remembered to position the mattress with the valve at the foot of the casualty, not their groin, undo the valve and inflate.  The casualty will immediately notice constant, supportive pressure evenly along the length of the limb.

As with all procedures which involve wrapping or positioning a limb, check the Colour, Sensation and Movement at the foot of the limb before and after the process and in both cases compare with the uninjured limb.   If there are signs of impairment following the application, release some air from the mattress and reassess.

Further Reading - musculoskeletal injuries

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