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03.2014 BACKPACKER 43 Splinting 101 According to NOLS Wilderness Medical Institute Curriculum Director Tod Schimelpfenig, all splints should feature padding, be rigid but adjustable, immobilize joints above and below the injury, and be comfy. Extremities should be accessible to monitor CSM—circulation, sensation, motion—at regular intervals. L O W E R L E G 1) Cut a foam pad or fold an inflatable pad so it’s wide enough to wrap the leg and long enough to extend from the top of the femur to about 8 inches past the patient’s foot. Slide under the leg. 2)Add padding under the knee and around ankle. Keep it smooth to avoid hotspots. 3) Secure the pad with two or three ties (paracord, strips of cloth) above and below the knee. Close with a surgeon’s knot (see right). 4) Fold the excess padding under and tie to create an open-toed boot. Inflate pad slowly. N E C K Improvise a cervical collar by rolling an insulating layer from the bottom up with sleeves out. Place under the chin, wrap sleeves around the back of the neck, and tie them with an over- hand knot in the front (make sure not to obstruct airways). Basecamp Survival: Survival Lab DROP DEAD TED can fi x you up better than a million-dollar matchmaker. Watch him demonstrate six more backcountry splints at backpacker.com/dropdeadted. Be a hero Learn three ways to evac injured partners at backpacker.com/carries. Breaking Bad Sticks and stones can break your bones, and in the backcountry, they often do. Knowing how to stabilize and protect a break or sprain can help reduce pain and further injury until help arrives—or give you the best shot at hiking out when no one’s coming for you. –Ted Alvarez U P P E R A R M 1) Pad the outer arm (clothes are good). 2) Fasten a humerus- length (~10-inch) trek- king pole, stick, or tube of foam pad to it using socks, duct tape, web- bing, etc. 3) Improvise a sling: Place the hand of the injured arm over the chest. Slide a baselayer underneath so the wide part cups the elbow and tie the sleeves behind the shoulder. Secure the sling to the body with another layer. F O R E A R M 1) Apply padding to the forearm. Add rigidity with a stick or alumi- num pack stay that extends from elbow to at least the palm. 2) Secure with wide strips of fabric (bandanas, long socks, and duct tape work well). Make sure to fasten the splint below the wrist (to hand or fingers) to immobilize the joint. 3) Finish with a sling (see upper arm, above). For a broken hand, extend the splint to the fingers and place balled-up socks in the hand. Buddy-tape the fingers together to prevent accidental or reflexive movement. A N K L E Tape an anchor. Wrap a piece of duct tape around the leg 2 inches above the anklebone. Attach stirrups. Position the foot at a 90-degree angle to the leg, and tape it in place with three overlapping SURGEON’S KNOT Secure splints using this technique, which creates a fric- tion knot that’s easy to adjust for support and comfort. anchor, go under the arch, and behind the Achilles. Wrap twice. Dress the brace. Cover holes to elimi- nate spots where skin could abrade. (Watch a step-by-step slide- show at backpacker .com/anklebrace.) stirrups—they go under the arch and up to the anchor. Secure in place by adding another piece of tape over the anchor. Stabilize sway. From the inside of the anchor, wrap underneath the arch and over the top of the foot to end where you began. Do this three times, overlapping. Make figure eights. Start on the inside P H O T O B Y B E N F U L L E R T O N