Fractures

What to remember

• Fractures are the S in MARCH PAWS, which stands for splinting.CLS M17 Notes, PDF p.2
• Warning signs of a fracture: heavy pain and swelling, a snap, a limb with the wrong length or shape, loss of pulse or feeling, and crackling under the skin (crepitus).CLS M17 Slides, PDF p.7
• An open fracture has a break in the skin and is a major infection risk, so it also needs an antibiotic from the Combat Wound Medication Pack.CLS M17 Notes, PDF p.2-3
• Before you splint, check the pulse below the fracture and how fast color returns to the nail bed; after you splint, recheck the pulse, and if it is gone, loosen, reposition and reapply.CLS M17 Slides, PDF p.8
• Shape the splint on the uninjured limb, pad the gaps, and hold the joint above and the joint below the fracture still.CLS M17 Slides, PDF p.8
• Splint before moving the casualty, handle the limb as little as possible, and never splint over a wound that has not been treated.CLS M17 Slides, PDF p.9-10
• Before and after splinting, check circulation (pulse), motor (can he move fingers or toes) and sensory (can he feel a light touch), then record it on the DD Form 1380.CLS M17 Slides, PDF p.18

Where people go wrong

• Securing the splint so tight that it cuts off blood flow.CLS M17 Slides, PDF p.10
• Not immobilizing the joint above and below the fracture when you could.CLS M17 Slides, PDF p.10
• Splinting near or over a wound that has not been properly treated.CLS M17 Slides, PDF p.10
• Tying a cravat on the fracture site, where the pressure can add injury.CLS M17 Notes, PDF p.4

Check yourself

Questions on this module, each with the reason and the slide it came from.