You make all this look so simple - air mattress and bandannas readly available. This may work for backpacking but what about a more challenging scenario where these items are probably not available such as in mountain climbing. In this case you use what is available to you at the momment. Splinting material may consist of a Sam Splint, trecking poles, ice axe, tree limb, the uninjured limb, etc., held in place with an Ace Bandage, medical tape, duct tape, belt, extra clothing, etc., not quite as simple as in backpacking.
These traing videos are great. One suggestion for this one though: you tell folks to check the injured leg for a pulse, but say nothing about what to do if there is NO pulse. You might reshoot this to address this extremely serious situation.
One important things to add: You must always ensure circulation to the area beyond the splint. In this case the foot. If not, on the mild side, you could have your foot get cold, numb, and lose the ability to feel making it unsafe to apply weight to it. On the bad side, the cold foot is more susceptible to frost bite, and you could potentially lose the foot because of cell death from a lack of oxygen known as necrosis.
There are 2 ways to do this.
1. Check for pulses in the foot: There are 2 the doralis pedis, and tibialis posterior (aka posterior tibial). It takes a little time to find a picture, but you can google these.
2. The EASIEST way is to check for capillary refill. You can do this by squeezing a toe on the foot and watching the color return to the nail bed. It is harder on a cold foot, so try it now on you finger to see what you are looking for. Just squeeze for about 3 seconds and notice it gets white, then the color returns. On Caucasian people you can normally just press the skin anywhere and see the same thing.
Check your distal circulation before you apply the splint to ensure the injury has not cut off the blood supply. (Seek advanced training on how to treat this. It can be dangerous and painful, but if untreated you stand a good chance of losing a portion of your leg, as well as other problems, if the evacuation takes very long.) The other reason is that you will have a reference to go by to assess the circulation after the splint is applied. While it has been proven to not be a reliable indicator of "shock" in adults, capillary refill is great for this situation and will allow you to periodically assess the foot as you evacuate. (The leg could swell and cause a lose of blood flow later on the way back.) The "text book" answer is that it should take no more than 2 seconds for the color to return. This is in ideal conditions, rarely what we face when this happens. The most important thing is that you do not reduce the refill by more than a second or two slower than it was before the splint was applied. (If it is already over about 5 seconds, you really don't want to slow it at all if possible. These are not official numbers, just my personal rule of thumb.)
Hope this helps!!! Have a safe trip and LNT!!! :o)
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