An improvised splint is a temporary, emergency device created from readily available items to stabilize a suspected bone or joint injury. This first aid measure is not a substitute for professional medical treatment, but it prevents further damage during transport to a healthcare facility. The primary goal of splinting is to achieve immobilization of the injured site, reducing movement of broken bone fragments and lessening pain. Holding the limb steady minimizes the risk of a closed fracture becoming an open one or causing neurovascular damage.
Materials for Rigid Support
The structural component requires materials that are stiff and straight enough to provide stability. Select items long enough to extend past the joints both above and below the suspected injury for effective immobilization. Availability dictates selection, often grouping materials found in a vehicle, a home, or an outdoor setting.
Items commonly found in a car or home include rolled-up magazines, thick cardboard, or a lightweight umbrella. Rolled paper products must be tightly compacted for rigidity, and cardboard should be folded along its length to increase strength. In an outdoor environment, sturdy, straight sticks, small branches, trekking poles, or tent poles can be used effectively.
Two or more rigid supports are generally required to sandwich the injured limb, providing stability on multiple sides. For instance, a suspected forearm fracture benefits from two thin boards or rolled materials placed on the palm and back sides of the arm. The material’s strength and length must be assessed to ensure it can withstand movement during the patient’s transfer.
Materials for Securement and Padding
Once the rigid supports are in place, two distinct types of flexible materials are needed: one for cushioning the limb and one for securing the assembly. Padding is a mandatory step that protects the skin and soft tissues from the hard edges of the rigid material. Bony prominences, such as the wrist, ankle, or elbow, are particularly susceptible to pressure sores and must be thoroughly cushioned.
Soft materials for padding include socks, towels, bandanas, scarves, or pieces of clothing. These items should be rolled or folded and placed between the limb and the rigid supports, especially over angular parts of the body. Materials for securement bind the padding and rigid supports together. Belts, neckties, shoelaces, strips of torn cloth, or duct tape can be used as fasteners.
The securement straps should be applied both above and below the injury site, avoiding direct pressure on the injury itself and any bony areas. The straps must be fastened snugly enough to prevent movement of the fracture site, but not so tight as to restrict blood flow. Wide materials are preferable to thin cords for securement, as they distribute pressure more evenly across the limb.
Safety Precautions and Unsuitable Materials
The application of an improvised splint must always be approached with caution to avoid causing additional harm. Never attempt to straighten or reposition a visibly deformed limb, as this movement can cause sharp bone fragments to sever nerves or blood vessels. The limb should be splinted in the position in which it was found.
After the splint is secured, it is imperative to check the circulation of the limb distal to the injury (fingers or toes). This check involves assessing the color and warmth of the skin and ensuring the patient has normal sensation. Signs like paleness, numbness, or coldness indicate that the splint may be tied too tightly and must be immediately loosened.
Certain materials should never be used in an improvised splint due to the high risk they pose to the patient. Thin wire, fishing line, or any narrow, rough string should be avoided for securement, as they can easily cut the skin or act as a tourniquet, compromising circulation. Likewise, avoid using dirty, contaminated, or overly sharp objects for rigid support, even if well-padded, to prevent infection or further soft tissue damage.