Thank you to Maree for submitting the following question:

Splint or not to splint. I have received conflicting information from trainers and organisation in regards to whether splinting a fracture is the right thing to do. In the following situation what would be the best treatment until arrival of paramedics.

Worker falls and breaks his lower arm. Workplace is in a metropolitan area and an ambulance has been called. There is no need to move the worker. Should a first aider attempt to splint the limb of simply support it using a sling, pillow or blanket etc?

What would the ambulance dispatcher tell the caller in this situation?

Reply by Matthew Meister – Intensive Care Paramedic

Hi Maree, thank you for your question.

Emergency call takers will often give instructions that aim at protecting the patient from further immediate harm or danger – like only move the patient if there is danger, place the patient in the recovery position if unconscious or control bleeding etc.

In this case it is difficult for comprehensive instructions to be given without being able to see the patient and know how they present by the emergency call taker. In this scenario it would be advisable to make them as comfortable as possible in supportive position (most patients with lower arm fractures guard there arm in a position of comfort) – this may include splinting as taught through accredited training or may be as simple as keeping the limb in a comfortable/rested position (and yes sometimes this can be in a sling but each patient presents differently).

Most fractures will result in pain and discomfort and futher movement to splint the injury may cause further pain, hence why analgesia is needed to be given to move them on the majority of occassions. If the ambulance is on its way and the patient is not required to be moved it would be advisable to leave them as they are and ensure they are supported/made comfortable and ensure no further harm can come to the patient. If the patient is required to be moved (due to danger, remoteness etc) attempt to splint the limb as best you can to allow you to move the patient and keep the limb in anatomical alignment if possible.

Hope this helps. All the best.