At 09:08 AM 4/15/98 -0500, you wrote: > >Actually, a *deflated* paddle float wrapped around a limb and tied or >taped might make a good short splint. Comments, anyone? > >Chuck Holst The whole function of splints is to immobilize the injury --to prevent the bones from moving and bruising surrounding tissue. In acute fractures, the possibility of severing veins and areteries is a concern, but this is more characteristic of battlefield fractures than boating accidents. The typical fracture bruises a vast amount of surrounding tissue and results in significant swelling. I suppose I should add here that bruising is in essence internal bleeding of muscle tissue and fascia. The criteria for a splint it that it immobilize the affected part, that it be padded, and that it allow circulation to the injured area. One standard approach to splinting a broken leg is to secure it to the adjoining leg with an "Ace" bandage. An "Ace" bandage can be used to immobilize a forearm or upper arm against the body. The wetsuit and existing clothing provide excellent padding for these types of immobilizations. A wetsuit may be the perfect "splint" for fractured ribs. Fractures to hands and feet are often best managed by leaving shoes or gloves in place and supporting the area with an additional "Ace" bandage. (I should add here that the basic item in a battle-field medical bag is the "Ace" bandage, followed by gauze pads.) Immobilization is the objective, and often when the victim/patient is conscious, immobilization takes place naturally --it hurts to move the fracture and the patient restricts movement to manage pain. The unconscious patient immobilizes the part too, but here your concern is shock, not fractures. Of course evacuating the patient may result in some movement of the fracture which may cause pain and induce some shock. But this is more of a concern for large fractures of the leg or arm. If medical evacuation calls for waiting for an ambulance or medivac chopper, the best treatment of a fracture may be simply to avoid moving the injured person. I once was the fist-aid person for a swimmer who had fallen from a tree over the water and bounced off the rocky clifs, fracturing his lower leg. First-aid consisted of bringing the conscious victim to the steep rocks of the shore and allowing the fracture to sit suspended in the fairly cold water while the rest of him was kept warm with a borrowed jacket. The water supported the fractured limb, and also functioned as a cold compress to reduce swelling and further bruising. Evacuation required the Fire Department, a body board, and ropes to bring him up the side of the cliff --not resources typically available to swimmers on the beach. The upshot of this digression is that fractures are best managed by immobilization while awaiting evacuation by qualified, professional medical personnel. There's really nothing fancy about getting the injured person to hold still. Splints are readily available: paddles, cardboard, and inflated dry bag, sticks/firewood, paddle float, wet-suit, shoes, knife, an emergency flare. . . Take care not to restrict blood flow to the injued area. The stadard check for circulation is to gently squeeze a finger or toe and release. . . when it turns pink with blood, you have circulation. Fractures and dislocations are painful, but generally not life threatening. The real exigency for a first-aid kit is bleeding. For bleeding, the "Ace" bandage, a 2" roll of adhesive tape, and your T-shirt, long-john top, or sweatshirt/pants provide ample emergency bandages. The key to stemming bleeding is pressure. And stopping bleeding is the first issue in first-aid. (Number two is clearing the airway--which you can generally check while you're stopping the bleeding.) The Red Cross provides classes in basic first-aid and there are numerous books on the subject. In the 30 years since I was an Army Medic, I've been first on the scene of several accidents, car wrecks, and heart attacks in the local shopping center. The "contribution" to the Red Cross for "tuition" is well worth the cost of the class, and you get a certification card. All paddlers should know basic first-aid. ------------------------------------------------------- George Bergeron, Secretary OSWEGO HERITAGE COUNCIL P.O. Box 1041, Lake Oswego, Oregon 97034 Web Site: http://www.europa.com/~heritage/welcome.html Email: heritage_at_europa.com *************************************************************************** PaddleWise Paddling Mailing List Submissions: paddlewise_at_lists.intelenet.net Subscriptions: paddlewise-request_at_lists.intelenet.net Website: http://www.gasp-seakayak.net/paddlewise/ ***************************************************************************Received on Wed Apr 15 1998 - 08:33:04 PDT
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