An arm sling is a simple medical device designed to support and temporarily immobilize an injury, most commonly affecting the arm, wrist, or hand. Its primary function is to reduce movement and alleviate gravitational pressure on the injured limb, which helps manage pain and prevent further soft tissue damage. Applying a sling correctly is a practical step in immediate first aid, stabilizing the limb until professional medical assessment can occur. This article provides instructions for effectively applying an arm sling using common materials.
Preparing the Arm and Choosing Materials
Before applying any support, gently position the injured arm across the body, with the elbow bent to approximately a 90-degree angle. This resting position helps maintain the anatomical alignment of the radius and ulna bones in the forearm. While commercial slings offer convenience, a standard triangular bandage or a large square of non-stretchy cloth, like a scarf or shirt, can be improvised effectively. The material chosen should be wide enough to support the entire forearm and must not be elastic, as this might compromise circulation.
Step-by-Step Application of the Sling
To begin the application using a triangular bandage, lay the material out flat, with the longest edge (the base) pointing away from the body. Gently slide the bandage underneath the injured arm, ensuring the center of the material is positioned near the elbow, and the top point rests against the shoulder of the injured side. The base of the triangle should extend past the hand toward the opposite side of the body. Next, bring the top point of the bandage up over the shoulder of the injured arm, crossing the chest slightly.
This secures the initial support for the elbow and posterior aspect of the forearm. Take the bottom corner of the material and bring it up over the forearm and across the chest, passing it over the shoulder on the uninjured side. The two ends of the bandage should meet at the side of the neck, slightly offset from the central spine. Tying the knot here, rather than directly behind the neck, prevents pressure on the cervical vertebrae and improves comfort.
The knot should be a secure square knot, ensuring the two ends are firmly pulled to hold the arm in place without causing discomfort. After the knot is tied, the excess material around the elbow (the point of the triangle) can be folded or twisted and pinned to the main body of the sling. This fold creates a small pocket of support, preventing the elbow from slipping out and maintaining the necessary 90-degree bend for better immobilization.
Checking for Correct Alignment and Comfort
After securing the sling, several checks are necessary to ensure the support is both effective and safe. The first alignment check involves the hand position: the fingers should remain visible, and the hand should be slightly elevated compared to the elbow. Elevating the hand minimizes swelling by promoting venous return toward the torso, using gravity as an aid. Inspect the neck area to confirm that the knot is positioned to the side and not directly pressing on the neck or the spine.
A small amount of padding, such as a folded cloth, can be placed beneath the knot on the shoulder to distribute pressure evenly. The next check focuses on the angle of the forearm, which must be supported horizontally or at a slight upward incline across the chest. This positioning ensures the weight of the forearm is fully borne by the sling, not the shoulder muscles. Finally, assess circulation by briefly pressing on a fingernail of the injured hand. The color should return to the nail bed within two seconds, indicating adequate blood flow, and the fingers should remain warm and free of tingling or numbness.
Ongoing Monitoring and When to Seek Medical Help
Once the sling is correctly applied, ongoing monitoring of the patient’s condition and comfort is necessary until professional medical care is received. The sling may need periodic, gentle adjustment to maintain the correct arm elevation and prevent the material from bunching up uncomfortably. If directed by a healthcare professional, hygiene around the hand and wrist can be maintained by carefully exposing the area without completely removing the supporting sling. This helps prevent skin irritation underneath the material.
Patients must be aware of specific signs that require immediate medical attention, signaling a potential complication or worsening injury. If the circulation check reveals a delayed color return or if the fingers become cold, the sling must be immediately loosened and professional help sought. These signs include:
- A significant increase in pain that is not relieved by resting the arm.
- The onset of severe numbness or persistent tingling in the fingers.
- Noticeable swelling that extends beyond the initial injury site.
- Fingers becoming cold or a delayed color return during a circulation check.