Improvised Splints and Slings

A splint does one job: immobilize the injured area to prevent further damage during transport. It does NOT set bones. It does NOT fix the injury. It buys time until professional care can take over.

Two rules: (1) Splint in the position you FOUND it — never try to straighten a deformed limb unless circulation is cut off and you have no other option. (2) Immobilize the joint ABOVE and BELOW the injury to truly stop movement.

Splinting principles

• ☐ GOAL — stop movement of the injury, prevent further damage
• ☐ Splint in the position you found the injury
• ☐ Immobilize the joints ABOVE and BELOW the fracture
• ☐ Pad the splint well — pressure points become injuries
• ☐ Check circulation past the splint (skin warmth, pulse, color, sensation)
• ☐ Re-check circulation every 15 minutes — tight splints cut off blood flow
• ☐ NEVER try to push protruding bone back into the skin
• ☐ If circulation is lost, loosen the splint immediately

The ideal splint is a commercial SAM splint ($15, weighs nothing, moldable aluminum foam, works for any limb). Without one, you improvise from whatever is rigid, long enough, and wrappable.

Splint materials

• ☐ SAM splint — the gold standard, moldable aluminum foam, $15  → Buy
• ☐ Cardboard — fold into triangle cross-section for rigidity
• ☐ Rolled magazines or newspapers — surprisingly rigid when tight
• ☐ Broom handles, tent poles, hiking poles — natural rigid supports
• ☐ Canoe paddle — excellent for leg/arm splints
• ☐ Tree branches — green wood is stronger than dead
• ☐ Rolled clothing for padding
• ☐ Belt, paracord, bandana, torn cloth for securing
• ☐ Duct tape or Coban wrap for final securing  → Buy

Arm injuries are the most common — falls onto outstretched hands cause forearm fractures constantly. The splint needs to immobilize both the wrist and the elbow, then get supported with a sling to take weight off the injury.

Arm splint technique

• ☐ Support the forearm with rigid material from the hand to the elbow
• ☐ Pad between the splint and the arm
• ☐ Secure with 2-3 ties: one at wrist, one mid-forearm, one at elbow
• ☐ Check pulse at the wrist after securing
• ☐ Add a sling to support arm weight — triangle bandage or torn cloth
• ☐ Sling should hold the arm at 90° across the chest, hand slightly elevated above elbow
• ☐ Secure the sling with a knot behind the neck
• ☐ For a swathe (wrap around the body), add a second bandage to prevent shoulder movement

Leg splints are harder because legs bear weight and move more than arms. The goal is to prevent the patient from weight-bearing and to immobilize the injury during transport.

Leg splint technique

• ☐ Anatomical splint: tie the injured leg to the uninjured leg using padding between them
• ☐ For lower leg: rigid supports (branches, poles) on both sides of the leg, padded
• ☐ For ankle/knee injuries: immobilize foot to hip for full stability
• ☐ Secure with ties above and below the injury, plus additional ties
• ☐ Check pulse in the top of the foot after securing
• ☐ Patient cannot weight-bear — needs to be carried or use crutches
• ☐ DIY crutches: sturdy branches forked at the top, padded with cloth
• ☐ Elevate the injured leg during rest to reduce swelling

A splint kit is lightweight and fits in any first-aid kit. The SAM splint alone handles 80% of improvised splinting needs; the rest is common first-aid supplies you already have.

Splint kit essentials

• ☐ SAM splint universal — the workhorse  → Buy
• ☐ Triangular bandage (3-pack for slings/swathes)  → Buy
• ☐ Self-adherent elastic wrap (Coban)  → Buy
• ☐ 4x4 gauze pads for padding
• ☐ Medical tape for securing edges
• ☐ Trauma shears for cutting clothing away from the injury
• ☐ Nitrile gloves for treating others
• ☐ Small laminated reference card with splinting basics