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Fractures and slings
 

Management of fractures


If you are in a metropolitan area where ambulance assistance is readily available there is no need to splint a fracture. In this circumstance simply support the fracture in the position it was found and do not move the casualty unless it is necessary.

If the ambulance is going to be delayed, or you are in an isolated area, you may have to splint or sling the affected limb to stabilise it.

If it is necessary to move the casualty, follow these guidelines:

  • Seek medical aid — call Triple Zero (000) for an ambulance
  • Immobilise all fractures before moving a casualty
  • Immobilise the limb above and below the site of the fracture with padded splints and tie off on the uninjured side with triangular bandages or any other suitable item
  • Make sure that the ties holding the splint in position are firm but not too tight
  • Towels and/or blankets can be used as improvised splints if necessary
  • support the fracture
  • A sling may be used to do this?



Image above: Leg fracture immobilisation



Image above: Improvised splints


When in doubt, splint the injured limb as it is better to over-treat than not treat at all

  • Elevate the limb if possible.
  • When elevating the limb make sure it is well supported
  • Listen to the casualty, they feel the pain and are the best person to judge if they are in a comfortable position or not
  • Make sure that the ties are firm but not too tight
  • In the absence of other splints the body can be used as a splint

Severely angulated fractures should be straightened only if:

  • There is no circulation to the lower part of the limb that is broken
  • Medical aid is not available and you have to transport the casualty out of a remote location (e.g. placing a casualty with an angulated leg fracture onto a stretcher will be extremely difficult unless the leg is straightened)

If you have to straighten a limb, be careful to provide support above and below the fracture site:

  • You only want to achieve the return of circulation, so it is not necessary to attempt total realignment of the limb
  • Never straighten fractures at joints because it may cause damage to the many nerves and blood vessels that run through the joint
  • If you do use an improvised splint (such as a piece of wood), always ensure that the splint extends further than the length of the limb

Key points for leg fracture immobilisation:

  • With leg fractures it is important to provide adequate padding in the natural hollows found when you place the legs together
  • Always position all bandages before tying off
  • The key to immobilisation of a leg fracture is the figure 8 bandage that is placed around the feet - this is always tied off first

"Never attempt to place a dislocated joint back into the socket"


"Dislocations often look like fractures so, if in doubt, treat and splint as a fracture"