An arm sling is a medical device designed to provide support and immobilization for an injured arm, shoulder, or collarbone. It is commonly used to reduce movement and offer comfort while an injury is healing or while awaiting professional medical treatment. Proper application is paramount for effective healing and patient safety, ensuring the injured limb is correctly positioned and secured. An improperly fitted sling can impede recovery or cause complications like nerve damage or restricted blood flow. The mechanical support offered by a well-applied sling protects the injured area from accidental movements.
Preparing the Arm and Materials
Before application, the injured arm requires careful preparation. The arm should be gently positioned across the chest, aiming for an approximately 90-degree bend at the elbow. This angle is the optimal resting position for the elbow joint, helping to prevent stiffness and strain. The fingers of the injured hand should point toward the opposite shoulder, maintaining a neutral, relaxed posture.
Any open wounds must be cleaned and appropriately dressed before the sling material is introduced. Materials can range from a commercially manufactured sling with adjustable straps to an improvised sling created from a large triangular bandage. The material must be wide enough to support the entire forearm and hand, ensuring the wrist joint is not left dangling unsupported.
Step-by-Step Application
The application process begins by positioning the sling material carefully beneath the injured arm and across the chest. If using a triangular bandage, the base should be aligned parallel to the body, with the point of the triangle positioned near the elbow. One end of the bandage is draped over the uninjured shoulder, while the other end hangs down in front of the chest.
The forearm is gently brought across the chest and over the bandage, with the elbow settling snugly into the corner of the material. The hanging end is then brought up and over the injured shoulder, meeting the first end behind the neck. Secure the sling by tying the two ends together using a square knot or a reef knot.
The knot must be placed on the side of the neck corresponding to the uninjured shoulder. This prevents pressure from resting directly on the cervical spine or a potentially fractured collarbone. Once secured, any excess material at the elbow (the apex) should be twisted and tucked in to create a supportive pocket. This pocket ensures the elbow remains cradled and prevents the arm from slipping out.
Ensuring Proper Fit and Circulation
Once the sling is secured, a thorough check of the fit and the wearer’s circulation is necessary. The hand should be positioned so that the fingertips are visible, and the wrist is slightly elevated above the level of the elbow. This elevation helps reduce swelling and fluid accumulation in the wrist and hand. If the arm hangs too low or the elbow is too straight, the sling is too loose and must be adjusted to maintain the approximately 90-degree bend.
To assess circulation, perform the capillary refill test on the exposed fingertips. Press the soft pad of one finger firmly for about five seconds until the skin turns pale. Upon release, the normal pink color should return within three seconds. A refill time exceeding three seconds suggests compromised blood flow, indicating the sling is too tight and requires immediate adjustment or repositioning.
The wearer should also be asked about any sensations of numbness, tingling, or increased pain in the hand or fingers. These symptoms, along with a change in finger color to blue or abnormal coldness, are signs of potential nerve compression or vascular restriction. Any indication of impaired circulation warrants immediate adjustment or professional medical evaluation to prevent tissue damage. The shoulder should remain in a neutral position, avoiding unnatural elevation or drooping.
Practical Considerations While Wearing
Managing daily life with a sling requires adjustments to maintain hygiene and comfort without compromising immobilization. When bathing or showering, the sling can typically be removed, but the injured arm must be kept close to the body and supported to prevent accidental movement. Waterproof covers or a simple plastic bag can protect dressings or casts from water exposure. It is also helpful to use a toweling bathrobe for drying, as maneuvering a regular towel with one arm can be difficult.
The sling should generally be worn throughout the night for the duration recommended by a doctor. Many people find it more comfortable to sleep on their back or the uninjured side, often propped up by pillows. Placing a pillow under the injured arm provides cushioning and support, preventing the arm from rolling or being accidentally compressed.
For dressing, select loose-fitting clothing that opens in the front, such as a button-up shirt. Always dress the injured arm first, sliding it gently into the sleeve before maneuvering the garment onto the uninjured side. The sling should only be removed for specific, gentle exercises if explicitly recommended by a medical professional to prevent joint stiffness. The overall duration of wear depends on the specific injury and should be determined through consultation with a healthcare provider.