Musculoskeletal Injuries, Splinting, and Immobilization
What the exam tests
This domain tests recognition of fractures, dislocations, sprains, and strains; neurovascular assessment; splinting; sling application; and spinal motion restriction.
Core rules
- Assess pulse, motor function, and sensation (PMS) distal to the injury before and after splinting.
- Splint in the position found. Do not attempt to realign a deformed limb unless a pulse is absent and you are trained and authorized.
- Immobilize the joint above and below the injury. Pad bony prominences and check that the splint is not too tight.
- Use a sling and swathe for shoulder, arm, or clavicle injuries.
- Suspect spinal injury after falls, vehicle incidents, or head injury. Keep the head and neck in line, limit movement, and wait for trained responders.
Worked example
A worker falls from a low ladder and complains of wrist pain. The first aider checks PMS, notes swelling and deformity, and splints the wrist in the found position using a padded rigid splint, immobilizing the hand and forearm. PMS is rechecked and capillary refill is documented. The patient is transported for X-ray.
Traps that cost marks
- Straightening a deformed limb to make it look normal.
- Splinting only the injured bone and not the joints above and below.
- Forgetting to reassess PMS after splinting.
- Letting a suspected spinal-injury patient sit up or walk.
Key points
- Check PMS before and after splinting.
- Splint in the position found; do not reduce deformities.
- Immobilize the joints above and below the injury.
- Use sling and swathe for upper-extremity injuries.
- Maintain spinal motion restriction when trauma suggests it.