How to Splint a Lower - Time to Prepare

Torn tissue, broken bones and misaligned joints are common injuries for hikers. In a survival situation, splinting is essential to keeping the limb safe from further damage until it can heal on its own. Splints don’t have to be complicated or difficult to make- in fact, they can be made with just two materials: duct tape and a stick. Making this splint will help you prevent an otherwise potentially life-threatening injury when hiking.

The “how to splint an arm” is a survival technique that can be used if you are injured and need to stop the bleeding. It is done by wrapping a cloth around the lower arm, then putting pressure on it with your other hand.

Note from the editor: This is a guest article by Bruce A. West, a former Army medic.

You’re miles from civilization, sitting on a giant rock with a friend at a viewing point, admiring the magnificent autumn countryside, when your companion slips and falls to the earth. They’re clutching their leg and screaming in agony; their tibia (shin bone) is protruding from the flesh, and blood is dripping from the wound. You rush to their rescue and apply a makeshift tourniquet to stem the bleeding. Now you need to get them out of the woods as soon as possible, but you need to address the shattered leg first. So, what exactly do you do?

When you’re out in the woods, you may not always have all of the equipment you’ll need to save lives – let’s face it, few of us are strong enough to carry an ambulance’s worth of supplies on our backs. You don’t have any pre-made braces, crutches, or casting material on hand, and you’re unlikely to have the instruments necessary to correctly set a fractured bone. You only have a first-aid kit (maybe), a pocket knife, your clothing, and the forests surrounding you. This kit includes everything you’ll need to build a homemade splint that might save your life.

Forget about all the first-aid regulations you’ve studied and all the technological equipment you wish you possessed. All you have to do now is improvise. These procedures aren’t pre-made, and they aren’t very attractive. They’ve been handed down through the generations of battlefield medics, and they’ve been shown to save lives.

One of the simplest and most crucial improvised first aid skills you can acquire is how to cure a broken limb. Because various types of fractures need different treatments, we’ll solely concentrate on the lower leg (tibia and/or fibula) today. I’ll go into how to treat additional types of fractures in future posts (upper leg and arm). Lower leg fractures are rather frequent, and severe breaks may be fatal. I’ll walk you through every step you’ll need to accomplish this possibly life-saving method.

Your Lower-Leg Splinting Strategy

If you have any other companions, have them dial 911. Whether you’re alone with the victim, check to see if they’re breathing, heart is beating, and there’s no serious bleeding before calling 911.

If you’re in the middle of nowhere with no phone service, you’ll probably have to transfer your patient to get reception – and you may even have to travel to get to a location where rescuers can find you. However, you can’t move someone who has a badly broken limb that isn’t splinted. To brace their fractured leg, follow these steps:

Isolation of body substances and scene safety are the first two steps.

The safety of the rescuer is the most critical factor in military medical, civilian medicine, and basic first aid. If you’re in danger, don’t treat anybody. You’re no longer concerned about weapons and explosives, as in military medicine, but you need consider the following dangers: Are you in a position to fall? Your patient fractured their leg in a fall…are you in a position to fall? If you’re in danger, take care of yourself first, then the patient. In this situation, despite their injury or bleeding, you may need to move your patient to level ground before you can safely treat them. Then, before you do anything else, put on gloves to protect yourself from sickness (or even plastic bags).

Step 2: Assess the Patient and Expose the Wound

Before you can treat a patient, you must first examine them in order of most critical functions to least important functions, and then address them when issues arise. It’s critical to ensure that your patient is breathing and that their heart is pumping at all times. You may have taken a first-aid course and learnt the ABCs (Airway, Breathing, and Circulation). In a medical context, this is an excellent mnemonic device, but in a catastrophic trauma emergency, this sequence of treatments may cost a life. We learned an abbreviation called MARCH in the Army, which stood for:

Hemorrhage in the Majors
Airway
Respirations
Circulation
Hypothermia/Shock, Head Injuries, Minor Hemorrhaging

Always deal with heavy bleeding first; if they’re losing a lot of blood and you’re concerned about CPR, they’re already dead. Blood loss is a serious issue with open fractures (broken bones protruding through the skin). A tourniquet will be required. So, examine any serious bleeding and manage it, then perform your ABCs, or “-ARCH.”

Exposing your victim’s wounds is the best and only method to find out where they are. When dealing with serious trauma, don’t only concentrate on the areas you know are injured; there may be additional injuries that are hidden by clothes. “A cheerful trauma patient is a naked trauma patient,” says an ancient adage in medicine. You can’t cure something you don’t know about. I recommend completely undressing your patient (you can easily redress them afterwards if you don’t conceal any wounds).

Step 3: Stabilize the Fracture Manually

You aren’t a doctor (unless you are), and this isn’t a scene from a movie, therefore you won’t be putting your victim’s fractured bone back together. You must keep it immobile (to prevent more internal injury, such as cut arteries, ripped muscles, ligaments, and tendons) and leave it in the position you discovered it in. You’ll splint it, but it’s a good idea to physically support the fractured limb while you construct your handmade splint first.

Have someone hold the fractured limb in place if you aren’t alone with the victim. Manual stabilization is that straightforward; complex term, simple implementation. Because they’re in agony and may be moving about, have someone keep their limb motionless to avoid the injury from worsening. This is only possible if you have assistance; if it’s just you and the sufferer, limb immobilization will have to wait until the splint has been placed.

Step 4: Examine for PMS

You should examine their PMS before splinting the limb. This implies you should look for the following things underneath the fracture:

Pulse
Controlling the motors
Sensual Experience

Check for tibial pulses (on the inside of the ankle, just behind the bump that’s commonly referred to as the “ankle bone”) or a dorsal pedal pulse (on the top of the foot); have them wiggle their toes, and make sure they feel you touching their feet (pinch their pinky toe and ask them which toe you’re touching). Here’s a little video to show you how to find these pulses: You won’t discover a pulse below the injury if you applied a tourniquet on an exposed fracture, and there may be minimal motor control or sensation. Checking for PMS is helpful in less severe situations. If they had circulation, mobility, and feeling in their hands and feet before the splint was put on, you want them to have the same feelings afterward. As a result, you’ll need to repeat this step later.

Step 5: Choose a Splint

If you break your leg during a bartitsu match with another aristocratic gentlemen, have a buddy use your umbrella to splint it.

This is your chance to be inventive. You’ll have to make your own splint.

Anything stiff will suffice, such as thick sticks, a trekking pole or walking stick, the frame from inside a backpack, or an axe handle. To splint each side, all you need is two items, ideally the length of the limb (or at least the length of the damaged half) – for further support, extend a longer outer splint up to the victim’s armpit.

After that, you’ll need something to secure your braces to the limb. Get inventive once again. Belts, shirt sleeves/torn sections from a t-shirt, bandanas/handkerchiefs (another of its many applications! ), a shemagh/scarf, rope from a survival bracelet, and even a tie are all options. It’s not so much what you use as it is how you utilize it.

Step 6: Put the Splint in Place

Before you tighten it down, make sure everything is in position. Start by tying your knots beneath the limb — for a leg, gently slip the tying devices through the gap below the knee and ease them back and forth until they’re secure. One for the ankle, one for the fracture, one for below the knee, one for above the knee, and so on. Don’t put one directly on the knee, and don’t put one on top of the wound!

Place your splints on each side of the limb on top of the tying devices after you’ve got your ties in place.

Tie the splint to their leg from the bottom up, working your way up to their torso. If you have time and a long enough strap, wrap the ankle strap over the sufferer’s foot for more support; this immobilizes the foot, preventing the victim from causing needless agony by bending their ankle, which puts stress on the tibia and fibula. For added comfort, lay cushioning between the splint and the patient’s body (this can be in the form of torn cloth, acrylic sleeping bag stuffing, spare socks, etc.) However, if getting someone out of the woods as fast as possible is your main goal, you don’t need to spend time on it; their leg is already hurting.

Finally, the knots should be snug, but not too tight. The goal is to keep the braces on the leg while without cutting off circulation. Remember the rule of thumb: two fingers should be able to glide side by side between the ties and their limb.

Step 7: Assess and Treat Any Injuries That Remain

Great! The shattered limb of the sufferer is splinted! They’re not, however, waiting for powdered eggs in a warm and cozy hospital bed. There are additional factors to consider before they are fully safe, apart from transporting them to a hospital.

Check their afflicted limb once again to be sure they don’t have PMS. If they did previously but don’t now, you’ll probably need to reposition your splint (unless you’ve placed a tourniquet).

Next, check to see whether they have an open airway and if they are breathing. Do they have a heartbeat? Is there any blood? Are there any open wounds? Yes, in this situation! There are wounds that are visible. The sufferer has an open fracture, which means there is exposed bone and open skin, which may lead to serious infection. The tourniquet has already stopped the bleeding; now it’s time to cover the wound from the weather. If you have sterile gauze in your first-aid kit, use it immediately; if you don’t, use soft fabric from a shirt instead. Cover the wound completely and fasten it with a second homemade knot (making sure not to tie it too tightly so as not to cause pain).

It’s also a good opportunity to check for shock. Shock is highly probable in the case of such a serious fracture. Keep an eye out for:

Skin that is cold and clammy (moist, cool, and pale)
Cyanosis is a condition that affects people (blueing of skin)
Weakness
Confusion
Breathing quickly
Unconsciousness

Lay the person on their back and keep them warm to cure shock. Cover them with clothing, jackets, blankets, a sleeping bag, or even a mound of leaves or pine needles – anything you have.

Step 8: Seek assistance!

If you haven’t already dialed 911, do do immediately. If you’re still unable to dial 911, it’s time to relocate. It’s never a good idea to abandon a patient. Do it if they can hop on one foot as you assist them, but it may not be possible. In this instance, it’s time to channel your inner firefighter and carry that individual to safety.

Bruce A. West fought in the Iraq War as an Army medic. In a program called Combat Lifesaver, he taught over 500 troops how to save lives, and he’ll be sharing his experience here on AoM in a series on vital first aid/first responder skills that every guy should have. Bruce has also just launched Geared Magazine, an outdoor gear and educational website focusing on survival and preparedness.

The “types of splints with pictures” article is a great resource for people who have injured their lower limbs. It has a list of different types of splints, and the best way to use them.

Frequently Asked Questions

How do you splint lower leg?

What are 3 things you should not do while splinting?

A:
In order to splint a fracture without further damage, you should avoid the following actions.

How do you splint a fractured tibia?

A: Fractured tibia is a broken bone in the lower leg. You should take x-rays to confirm the fracture, then you will need to set up a splint for it and keep it iced on top of icing your foot as well.