You’re halfway into a backpacking trip in Wyoming’s Wind River Range when a hiking partner slips on a wet scree slope, injuring her knee. She can bear weight but needs some support to hike out. She also injured her wrist as she tried to catch herself. Now what?
We’ve put together a three-part series of guidelines and techniques for constructing improvised splints. Today, we cover the principles, which apply to any improvised splint. Later, we’ll provide specific details on creating upper- and lower-limb splints.
We strongly urge you to take a wilderness first aid course. The techniques described below will be of little use without good assessment skills and sound judgment.
Basic Principles:
- Be creative. Almost anything can be used for making a splint: sticks, packs, pads, clothing, camp chairs, or anything else that can provide some support. For improvised splints, your motto should be, “What would MacGyver do?” which by the way, is a good mantra for all occasions. That said, there are a few items that will make your job easier.
- Something to tie stuff with. The old standby for this is a cravat (a large triangular piece of fabric). You can make them by cutting up clothing or any fabric you can spare. Cravats are fantastic for two reasons: they make sling and swaths much easier (see below), and they can be spread out over a large surface area, making the splint much more comfortable. If you think your patient isn’t worth the sacrifice of your precious Patagonia Capilene, there are alternatives. Spare webbing or cordage is always good, as is twisted duct or athletic tape.
- A semi-rigid sheet of … anything. Probably the single most useful piece of backcountry splinting material is a foam sleeping pad. In fact, they make more comfortable splints than beds. If you don’t have a foam pad, the framesheet of your pack will work, as will your self-inflating mattress, or even a sleeping bag (sleeping bags are especially good, though they tend to make the unlucky soul hot).
How many items do you see that you could use to make a splint?
- Splint in the position of function. Like many medical terms, position of function is a fancy name for a commonsense principle: splint the injury in a position that’s comfortable and natural. For an upper extremity injury, the injured person will generally be holding the injured arm in toward his chest, cradling it with the uninjured arm. You’ll be splinting the arm in this position. For a lower extremity injury, strive to make the splint as comfortable as possible and in line with the patient’s body.
- Use padding, then use a little more. In a backcountry scenario, your patient will probably be wearing the splint for a long, long time—in some cases, several days. In the backcountry, you’ll have loads of time. Take advantage of that time, and be anal. The entire splint should be well padded, especially if the splint involves a rigid component, like a stick or trekking pole.
- The splint should be adjustable. During a long evacuation, even the best splints need a little love once in a while. Use releasable knots (like you do with your shoelace) so they are easy to undo and retie if need be.
- Fingers and toes should be accessible. You don’t want to make an injury worse by cutting off circulation, sensation, or motion. Check the circulation in the toes or fingers by checking the pulse or, if you don’t know how do that, by observing skin temperature and color. Ask the patient to wiggle his or her fingers then to squeeze your hand. Ask her if she has any tingling or weird sensations. Apply the splint, then recheck everything mentioned. If anything changes for the worse, reevaluate your splint. Remember, evacuating an injured person in the backcountry takes a while. The extra ten minutes to make a quality splint is nothing compared to the multiple hours (or days) it will take to hike out. Take the time to do it right.
- Immobilize
- For injured joints (busted knees, elbows, ankles) immobilize bones above and below the injury.
- For long bone injuries (broken arms, legs), immobilize the joint above and below the injury.
Now that the rules are out of the way, stay tuned for Improvised Splints Part II and Part III to learn some techniques you can use to splint common injuries.
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Tags: backpacking, do-it-yourself, outdoor survival, safety, wilderness survival
[...] This is the second article of a three-part series. Check out Improvised Splints – Part I: Basic Principles. [...]
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[...] Splints, we’ll go over how to make splints for knee, lower leg, and ankle injuries. Check out Part I: Basic Principles of Splints if you don’t know what a cravats does, or check out Part II if you broke an [...]
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@admin: I just have to say your site is the first I’ve come across today that doesn’t have typos every other line. Thank you for taking the time to write something that doesn’t look like a 6th grader wrote. I apologize, just had to vent.
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sounds like a lot of work
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[...] Get yourself a serious first aid kit and keep it in your car. There are about a million ways to get jacked when you’re climbing, biking, hiking, or even chilling around camp. If someone gets a little sloppy with the firewood chopping, then you want to be able to deal with it quickly. Especially when you’re an hour from the closest town with zero chance at cell reception. It’s also well worth your time and money to take a Wilderness First Responder class so you can deal with anything that doesn’t require an emergency room. Or at the very least, know how to make an improvised splint. [...]
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