First Aid for Fractures: What to do when you don't have a splint

By Joel Dovenbarger, BSN and Frances Smith, MS, DMT, EMT-P
alternative splint idea for a fractured arm
alternative splint idea for a fractured arm
No splints in your first-aid kit? Improvise with a magazine, a t-shirt for padding, and some gauze or velcro strips.

Whether you purchase a prepackaged first-aid kit or create it yourself from a tool or tackle box, make sure your kit contains all the essential first-aid products and that you know how to use them. As a boater, you probably already have a sense of what your specific needs may be. It’s our job as your safety advisors to fill in any gaps.

This article represents the first in a new series in which we describe a member incident and explore the first-aid supplies and response necessary to address the incident. Each incident is selected because it represents one of the many common risks associated with boating and extended travel. Along the way, you'll also learn more about the benefits of DAN Boater membership.

Fractures Can Happen In A Split-Second

To celebrate their early retirement, DAN Boater members Jim and Ellen* embarked on their first extended sailing vacation to the smaller, more remote islands of the Bahamas. During an island hike, loose gravel and uneven ground caused an unexpected fall. Ellen thrust out both arms before she hit the ground, trying to lessen the impact of the fall. She knew immediately from the severe wrist pain and swelling, which were far greater than with a simple sprain, that she had a problem. The couple returned to their boat to retrieve their first-aid kit.

Jim had taken a first-aid course so he was comfortable using the contents of their customized kit. But when he opened the kit, he discovered it was missing the one thing he really needed: a splint to stabilize Ellen’s arm. Looking for advice on what to do next, he called the DAN Boater Emergency Hotline and was immediately transferred to a medic.

The DAN Boater medic provided instructions for improvising an arm splint using a folded magazine, a t-shirt for padding, and some Velcro ties they had onboard. Within minutes, Jim was able to stabilize his wife’s injured arm, helping to reduce the pain and protect against additional injury.

Standard treatment called for medical transport of the injured member to diagnostic medical care, so Ellen's medic arranged transportation to a hospital in Nassau. Unfortunately, bad weather prevented all fixed-wing flights in and out of the small local airstrip, so the couple was forced to wait for the storm front to pass before they could get to medical treatment. In the meantime, Ellen's medic provided pain-management advice and continued to monitor her situation.

The weather finally broke two days later and the runway was sufficient to provide the couple an airlift to Nassau. The hospital’s x-ray confirmed a fracture, which required only a hard cast to keep the bone immobile. Ellen and Jim returned to their boat, where she was able to recuperate.

Splints are a First-Aid Kit Necessity

It’s impossible to predict what may happen during a voyage, but preparing for the injuries and illnesses boaters commonly experience can make a huge difference in preventing and responding to emergencies. While this couple did a great job addressing initial care issues, they were missing an essential first-aid component.

A good first-aid kit for extended travel should contain at least one, preferably two, splints. The splint should be lightweight, reusable, padded and able to be formed or molded to fit the person’s injured limb. Splints are inexpensive and available online or at most pharmacies and medical supply houses. It’s also a good idea to add finger splints with similar flexibility and padding to your first-aid kit.

Along with your splint, you will need two additional first-aid items: a dressing to wrap around the splint and an arm sling to hold an injured arm close to the chest. Ideally, your kit will also have medicine for pain management. Initial pain from a fracture often lessens within a few hours, and over-the-counter pain medication and ice can make it much more bearable.

With these materials, you will be prepared to provide initial care for most fractures.

First-Aid for Arm Fractures: How to Splint

Regardless of whether you're using a commercial pre-formed splint, or one you fashioned yourself, your primary goal is to immobilize the joints above and below the injured area. With that in mind, follow these basic steps:

  1. If emergency transportation is needed, active EMS.
  2. Remove any jewelry or clothing that may prevent adquate visualization of the affected areas.
  3. Keep the injured limb in the position it was found, if possible. Do not attempt to straighten.
  4. Place splinting material either along or on each side of the injured limb. Place the splint so the joints both above and below the site of injury are immobilized.
  5. Use padding such as gauze, towels, or clothing to fill in voids under the splint and provide additional support to the injured limb.
  6. After the splint is in place, check circulation by squeezing the nail beds and looking for the pink color under the nails to return quickly after pressure is released. If color does not return in two seconds or less, loosen the bandage and rewrap.
  7. Continually reassess the injured person and monitor for signs of shock.

Explore more boater Health & Safety Resources.

*The couple's names were changed to respect their privacy.