How to splint a broken (plastic) wrist

Paramedic Julie Grainger, right, teaches Emily Mathieu some splinting techniques.

When I arrive at the Riviera Paramedic Response Station in Markham, paramedic Julie Grainger has already started unpacking the arms on to a table laden with medical supplies

The arms, made of a soft pinkish plastic on top of a hard frame, are used to train people to splint wrists and arms and insert needles. 

I’m here to learn how to splint a broken wrist.

During training, the arms are often connected to bags of viscous red liquid meant to mimic blood. The arm on the table still has some smeared on the side.

Grainger notices, “Let’s get the fake blood off this arm. He is a little dirty,” she says pulling out an alcohol swab.

Grainger, 33, is a Tactical Advanced Care Paramedic on the Special Response Unit in York Region. She has been a paramedic for about 13 years and attends calls with the region’s bomb squad and emergency tactical units. She is also with GlobalMedic, a group that flies to disaster zones around the world.

Medical training is high on my list of things to do as I work to become more self-reliant. Having Grainger as a teacher is humbling. She puts up with my questions about her job and offers instructions with the calm of someone who could (and likely has) put a person trapped beneath a car at ease.

Grainger picks splinting a broken wrist, because it is a common injury. She broke her wrist once snowboarding, so she knows that when moved the pain can be “unbearable.”

Wrists are a common break because when people fall they tend to land on their hands and wrists.

The main reason you put on a splint is to prevent a broken bone from shifting or moving and poking or cutting into areas that could cause damage, Grainger explains.

 There are lots of vessels and nerves next to bones in the human body and if those bones have a broken jagged edge, even slight movement can sever vessels or nerves, causing permanent injury and potentially arterial bleeds, she says.

When presented with an injury, the first step is to take a good look at the injury, to assess the severity of the break, says Grainger. You also want to understand the impact your splint is having on the person, to make sure you are not making the injury worse.

 “Assessing that before and after is really paramount,” says Grainger.

We use a premade splint of soft grey foam on top of a flexible piece of metal. I secure the arm to the frame with gauze, wrapping above and below the injury. The point is to have an area free of gauze — or window — so you can watch for swelling and bleeding and keep an eye on circulation. Limited blood flow can lead to more damage, she explains.

A tight bandage right on top could also cause bones to shift, says Grainger.

In a pinch you can use almost anything flat as a splint, including sticks, boards and pizza boxes.

“In an uncontrolled environment you have to think on your feet and come up with ideas,” says Grainger.

When applying the splint, the wrist should be straight and the hand should be in a position similar to clutching a softball, as that is a more natural position for a resting hand and will be more comfortable, she says. A wadded up sock can be placed in the hand to achieve that shape.

We use a piece of cloth as a sling, to elevate the limb and keep it stable and close to the body, but a belt could also work she says.

It takes only a few minutes, from start to finish, to set the plastic arm.

With a real person you would be moving at a much slower and more careful pace to prevent as much pain as possible.

 

 Grainger's neatly wrapped wrist (she showed me how to do it first).

 

 

Emily can be seen wringing her hands slightly, after her less-than-perfect gauze technique.

 

 

 

Grainger suggested if I want to learn more about medical training I should sign up for courses offered by St. John Ambulance. I'm planning on taking a two-day course in about two weeks. Included in the training is emergency scene management, choking, severe bleeding, wound care, burns and poison.

It sounds mildy intimidating, but really exciting.