How to splint a broken finger or dislocated elbow/shoulder?

ruby_jane, BSN, RN · Oct 4, 2018

See, situation by situation for me.
Average EMT response for me is ~6 minutes. If the kid has a break that warrants ASAP attention, is in safe location, as comfortable as they can be, I'm likely to hold off on a splint till they arrive.

Yes. ma'am. I am more likely to immobilize with even cardboard if I really think it's broken (as evidenced by something sticking our or gross deformity). I am less likely to provide an ace wrap for an ankle only because I've seen that student three days later, trailing the dirty ace wrap, and they never did get to the doctor.

Incidentally, our children's hospital says you can use a magazine (open so that the middle fold is parallel with the lateral surface of the arm) and tape instead of those triangle bandages....

stephrooth · Oct 4, 2018

I don't splint, wrap, or tape at school. Agree with immobilization and ice until EMS or parent arrives.

When you mean immobilization, you mean just leave it alone? eekkk idk I'm sorry

aprilmoss · Oct 4, 2018

Don't use triangular bandages anymore. Both me and the responding EMS guys use lots of kerlix.

Wuzzie · Oct 4, 2018

Incidentally, our children's hospital says you can use a magazine (open so that the middle fold is parallel with the lateral surface of the arm) and tape instead of those triangle bandages....

That would work fine as a splint but the sling made out of a t-bandage serves a different purpose. With a forearm fracture (most common peds fracture) a splint AND a sling would be applied as a first aid measure. However, if the child is able to secure the affected arm I would probably just stick with the splint alone and not worry about a sling. A sling alone would not be effective in immobilizing such a fracture.

OldDude · Oct 4, 2018

That would work fine as a splint but the sling made out of a t-bandage serves a different purpose. With a forearm fracture (most common peds fracture) a splint AND a sling would be applied as a first aid measure. However, if the child is able to secure the affected arm I would probably just stick with the splint alone and not worry about a sling. A sling alone would not be effective in immobilizing such a fracture.

I'd use anything I could find for immobilization if I was out and about, but otherwise I usually use the foam covered cardboards that you can cut to fit the area you're trying to immobilize. I too allow the child to hold the injured arm without a sling if it's more of a subjective assessment but I always apply a sling to any angulated or deformed arm fracture.

Wuzzie · Oct 4, 2018

I'd use anything I could find for immobilization if I was out and about, but otherwise I usually use the foam covered cardboards that you can cut to fit the area you're trying to immobilize. I too allow the child to hold the injured arm without a sling if it's more of a subjective assessment but I always apply a sling to any angulated or deformed arm fracture.

All good points. I am not a school nurse but have been a member of the National Ski Patrol for nigh onto 40 years. We use cardboard splints by the truckload. We are also pretty good at macgyvering splints from just about anything really. Ask me about making a traction splint from a sapling!

GdBSN, RN · Oct 4, 2018

Thank you all for the great triangle bandage tips. Just had to apply my first one, and I think it went pretty smoothly.

schoolnurse61 · Oct 4, 2018

I usually immobilize w a splint/ace in the position that is comfortable for the child if able, if not they remain as is until EMS arrives. My guidance counselor is my splint application assistant. She's awesome and will help me with anything. Never tried to use a triangular bandage cuz I don't know how! :)

AdobeRN · Oct 4, 2018

All good points. I am not a school nurse but have been a member of the National Ski Patrol for nigh onto 40 years. We use cardboard splints by the truckload. We are also pretty good at macgyvering splints from just about anything really. Ask me about making a traction splint from a sapling!

Did my first macgyver splint a couple of weeks ago - went to watch a friend practice at Roller Derby and one of the girls ended up with a fractured ankle - left her foot laced up in her skate and used hockey sticks taped to leg and skates to stabilize till she got to ER, we were quite proud of ourselves.

Wuzzie · Oct 4, 2018

Did my first macgyver splint a couple of weeks ago - went to watch a friend practice at Roller Derby and one of the girls ended up with a fractured ankle - left her foot laced up in her skate and used hockey sticks taped to leg and skates to stabilize till she got to ER, we were quite proud of ourselves.

Freaking Awesome!!!! :yeah:

OldDude · Oct 4, 2018

Freaking Awesome!!!!

Speaking of awesome...I want to hear more about the wooden traction splint.

broughden · Oct 5, 2018

From the student nurse but long time Wilderness First Responder instructor, I'd highly recommend taking a WFR course from NOLS-Wilderness Medical Institute. 8 days of splinting, triangle bandages, and reducing dislocations. And counts for CEU. Highly recommend it.