An arm sling is a simple, effective device used to support and immobilize an injured upper limb. In an emergency, its primary function is to stabilize the arm, wrist, or shoulder in a comfortable position, providing immediate relief from movement-induced pain. Stabilization is a foundational principle of first aid. Creating a makeshift sling is a temporary measure intended only to secure the limb until professional medical assessment and treatment can be obtained.
When and Why to Use a Sling
A makeshift sling is appropriate when a person has sustained an injury to the forearm, wrist, or hand, and movement causes significant distress. This includes suspected fractures, dislocations, or severe sprains where the integrity of the bone or joint is compromised. The core objective of using a sling is immobilization, which prevents involuntary movement of the injured area. By restricting motion, the sling helps mitigate pain and guards against further damage while awaiting medical transport. Ultimately, a sling is a supportive mechanism for transport, not a definitive treatment.
Essential Materials and Preparation
The most effective material for an emergency sling is a broad piece of cloth, ideally a triangular bandage. If a dedicated first aid bandage is unavailable, a large square scarf, a clean pillowcase, or a section of a t-shirt can be adapted for the task. The material must be robust enough not to stretch significantly under the arm’s weight. Before applying the sling, instruct the injured person to support their forearm across their chest with their uninjured hand, positioning the elbow at roughly a 90-degree angle. This position is the most comfortable and functional for the injured arm.
Step-by-Step Construction and Application
Positioning the Fabric
To begin, slide the improvised triangular bandage gently underneath the injured arm, ensuring the point of the triangle extends slightly past the elbow. The longest edge of the fabric should run vertically, aligned with the person’s body, while the arm remains bent across the chest. Bring the upper end of the bandage over the shoulder on the uninjured side of the body; this section serves as the primary neck strap.
Tying the Knot
Bring the lower end of the triangular fabric up and over the forearm, crossing the chest to meet the other end at the shoulder of the injured side. The ends of the bandage must be tied together securely using a square knot (reef knot). The knot should be positioned to the side of the neck, resting above the collarbone on the uninjured side. This placement prevents pressure on the spine or the back of the neck.
Final Adjustments
Adjust the sling until the forearm is fully supported by the fabric, ensuring the hand is slightly elevated above the level of the elbow. This slight elevation assists in reducing potential swelling by promoting venous return from the hand. The front edge of the sling should extend to the base of the little finger, providing complete support to the wrist and hand. Secure the excess fabric at the elbow by twisting the material and tucking it into the sling, or by using a safety pin to hold the point of the triangle snugly around the elbow.
Checking for Proper Fit and Safety
Once the sling is in place, confirm the proper fit to ensure comfort and safety. The arm should rest comfortably against the chest, with the elbow bent at a right angle and the wrist fully supported by the fabric. The fingertips must remain exposed to allow for continuous monitoring of circulation.
A check for adequate blood flow must be performed immediately after application and rechecked every ten minutes. Gently press on a fingernail until the color drains, then release; the pink color should return within two seconds (capillary refill). If the fingers appear pale, feel cold, or if the injured person reports numbness, tingling, or increased pain, the sling is likely too tight. The knot must be loosened and the sling immediately readjusted to prevent neurovascular compromise.