If an injury needs a splint, apply the splint first and then apply the sling.
Always check the person's skin color and pulse (circulation) after the injured body part has been splinted. If the area becomes cool, turns pale or blue, or if the patient develops numbness or tingling, loosen the splint and bandage.
Injuries to nerves or blood vessels often occur with an arm injury. Your health care provider should check your circulation, movement, and feeling often.
The purpose of a splint is to prevent you from moving the broken or dislocated bone. Splints reduce pain, and help prevent further damage to muscles, nerves, and blood vessels. Splinting also reduces the risk of opening a closed injury.
Care for all wounds first before applying a splint or sling. If you can see bone in the injured site, call your local emergency number (such as 911) or local hospital for further advice.
HOW TO MAKE A SLING
You'll need a piece of cloth that is about 5 feet wide at the base and at least 3 feet long on the sides. (If the sling is for a child, you can use a smaller size.)
Cut a triangle out of a piece of this cloth.
If you don't have scissors handy, fold a large square piece of cloth diagonally into a triangle.
Place the person's elbow at the top point of the triangle, and the wrist midway along the triangle's bottom edge. Bring the two free points up around the front and back of the same (or opposite) shoulder.
Adjust the sling so the arm rests comfortably, with the hand higher than the elbow. The elbow should be bent at a right angle.
Tie the sling together at the side of the neck and pad the knot for comfort.
If the sling was placed correctly, the person's arm should rest comfortably against his or her chest with the fingertips exposed.
If you do not have material or scissors to make a triangle sling, you can make one using a coat or a shirt. Apply the sling in much the same way as shown in the pictures "Creating a Sling" with this article.
You can also make a sling using a belt, rope, vine, or sheet.
If the injured arm should be kept still, tie the sling to the body with another piece of cloth wrapped around the chest and tied on the uninjured side.
Occasionally check for tightness, and adjust the sling as needed.
Do NOT try to realign an injured body part unless the skin looks pale or blue or there is no pulse.
When to Contact a Medical Professional
Seek medical help if the person has a dislocation, broken bone, or severe bleeding. Also seek professional medical help if you cannot completely immobilize the injury at the scene by yourself.
Safety is the best way to avoid broken bones caused by falling. Some diseases make bones break more easily, so use caution when helping a person with fragile bones.
Avoid activities that strain the muscles or bones for long periods of time, because these can cause weakness and falls. Also, use caution when walking on slippery or uneven surfaces.
Brabson TA, Greenfield BS. Prehospital immobilization. In: Roberts JR, Hedges JR, eds. Clinical Procedures in Emergency Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 46.
Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.