Explore how to sling and swathe an injured arm with lead lab instructor: Miles Hackney. Check bit.ly/EMT2k19 for upcoming EMT classes, and prove that you have what it takes to step up a save a life (we dare you!).
Miles and Matt are back, detailing the process of how to make a sling and swathe to stabilize and protect an extremity injury in the upper or lower arm. From proper placement and sizing all the way through to checking for efficacy this is a comprehensive guide of the Extremity Splinting Skills Sheet as put forth by the NREMT. Whether you are new to EMS or a career medical professional this video can help exemplify the art of using triangular bandage to splint an arm.
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Thank you to Miles Hackney and Matt Macoy
Song Sound-Bite: Jump Around by House of Pain
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Transcript:
Hi, my name is Miles. Welcome to Best Practice Medicine TV. Today, we're going to be talking about extremity splinting, specifically shoulder immobilization using The Sling and Swathe Method. Extremity splinting is an important skill for all EMS providers, especially those working in a back country setting, such as wilderness first responders or ski patrollers. Effective immobilization will reduce patient pain and decrease the chance of additional injury during transport. The sling and swathe is used to immobilize injuries of the shoulder and upper and lower arm in order to take weight off the affected tissues and neighboring anatomy.
The standard sling and swathe is built using two triangular bandages or cravats and consists of two parts: a sling, which serves to take the weight of the injured extremity off of the shoulder joint; and a swathe, which binds the injured extremity to the patient's body, further stabilizing it. As of any extremity splinting, the first step is to manually stabilize the injured extremity. Can you hold your arm there for me? And to obtain an initial set of CSMs. Checking for a pulse, sensation. What finger am I touching?
My thumb.
Can you wiggle them for me? Awesome.
To construct your sling, first, you need to make a pocket by tying a knot in the right-angled corner of your triangular bandage. The size of knot you tie is determined by the length of the patient's forearm. A longer forearm will require a smaller knot, and a shorter forearm will require a longer knot. The corner of the triangular bandage is resting against the patient's body. It should go straight up to the shoulder that sets above the hand of the injured extremity. This will form a suspension line and help adequately support the extremity.
The side further away from the patient's body is then wrapped up over the opposite shoulder, minding the pocket, an effective even tensioning of the splinting material all the way across. Once the splinting material is properly positioned, prepare to tie a knot around the patient's back. Before you finish your knot, pull up on the splinting material in order to effectively take the weight off the extremity. You don't want to displace the shoulder so much that it causes the patient unnecessary pain, but by pulling a little extra tension will account for slippage in the knot and stretching and sagging of the material. It's best to warn your patient that this step might hurt a little bit, but it'll make them feel better, increase their comfort right away.
Once the sling has been applied, the next step is to immobilize the extremity of the patient's body using a swathe. Surface area is your friend here, so a wider swathe is better. Position the swathe material over the patient's arm and prepare to make a knot at the patient's back. Before you tie your knot, ask the patient to take a deep breathe for you to make sure you don't restrict their breathing. Take a deep breath, hold it, awesome. Okay. You can let it out
After the swathe is tied, dress it to make sure it's effectively immobilizing the extremity of the patient's body. Wide coverage over the elbow and the hand, leaving the narrow parts on a patient's back where it's less sensitive and less likely to bite in. When practicing, test the effectiveness of your swathe by asking your helper to bend over forward and see if his arm swings away from his body. Feel like you're swinging away?
Nope. I'm pretty secure.
Tight in there?
Yeah.
Cool.
In order to be effective, a sling and swathe should keep the patient's extremity immobilized without dislodging, shifting, or sagging despite bumping, jostling, or bouncing.
After splinting the extremity, recheck the patient circulation, sensation, and motion in the injured extremity. Read your pulse. What finger am I touching?
My thumb.
Wiggle them for me. Great.
Thank you for joining us on this beautiful Montana day. I hope you learned something that was informational and useful to your clinical practice.
16 май 2019
