Splints For Broken Bones

Snow, deep and soft, hid the rock. When the young woman slipped while descending the steep slope, she extended her left arm to break the fall. Her arm found the rock, broke near the wrist, and bent in a way that those bones aren’t supposed to bend. It wasn’t pretty. Made me hurt just to look at it.

We could have hiked her out that way, with pain tearing at the arm like a hungry coyote, but I had a little helper–SAM, by name–in my relatively small first-aid kit. Rolled up into less space than a can of beer takes up and weighing much less, the SAM Splint provided the urgent support she needed. Unrolled, folded in half, bent to create rigidity, and held snugly in place with an elastic wrap, SAM prevented further injury and eased her pain while we finished the walk to the road and drove to the hospital. That young woman got a lot of relief from just a little bit of foam and metal.

The splint known as SAM–a name that wasn’t intended as an acronym, though it has come to be known as standing for “structural aluminum malleable”–is the brainchild of Dr. Sam Scheinberg, a man who learned a big lesson in discomfort when he served as a field medic in Vietnam. Dr. Scheinberg saw injured legs and arms strapped to gun butts, tree limbs, or nothing at all. It wasn’t until about 5 years after Dr. Scheinburg returned home, late one night after surgery, his wife, Cherrie, remembers, that “he was folding a gum wrapper and realized it was not the weight but the curve that could give strength to a splint.” Thus was born the most innovative emergency splint ever to cradle a broken bone.

Dr. Scheinberg’s SAM is a thin, durable, very flexible piece of aluminum surrounded by closed-cell, hypoallergenic foam. Vibrant blue on one side and bright orange on the other, the foam is also available entirely in dull gray for those who desire less colorful emergency care. X-rays pass through, and it’s waterproof, completely washable, and can be used many times. This “pocket cast” also cuts easily with scissors to build splints for smaller bones. If you’d rather not cut, SAM comes in four lengths: 36 inches, 18 inches, 9 inches, and 41/4 inches. SAM can be curved and bent by the strength of a 5-year-old, and it’s malleable even when it’s cold. With creative shaping–sort of like first-aid origami–SAM can be used on just about every bone in the body except the femur (big thigh bone).

Putting SAM To Work

• When it’s time to use SAM, do the folding before applying the splint to the injured person. Although minor adjustments can be made to the splint after placement along an extremity, you don’t want to increase pain by moving the injured limb excessively.
• A longitudinal bend gives the splint an amazing amount of rigidity; adding a reverse bend along the outer edges (basically creating a lip along each side) increases the overall strength fourfold.
• After using SAM dozens of times, I’ve found that adding padding–extra socks, T-shirts, etc.–against the limb before putting the splint in place increases comfort for the long haul, which is important since most wilderness evacuations take awhile.
• SAM can be held in place with first-aid tape, roller gauze, elastic wrap, vet wrap, or anything that enables you to tie it down.

Splinting:

1.Finger: Curve the splint into a basic lengthwise bend and secure it in place. You can fold the end of the splint back to protect the fingertip.
• 3.Wrist: Fold the splint in half to increase its overall strength before bending it lengthwise. Round the end at the hand to hold the hand cupped in a natural position, which is more comfortable than forcing it to lie flat. Suspend the arm in a sling held in place with a swathe to keep it out of harm’s way. 4.Lower arm: Apply like a wrist splint.5.Elbow: If for some reason, such as a dislocation, you can’t flex the elbow into a sling, you can fold SAM lengthwise and secure it in place with the arm extended.
• 6.Upper arm: Bend the splint lengthwise, then fold it around the elbow and up over the shoulder before applying a sling and swathe. The broken bone is now comfortably held against the injured person’s chest wall and is also protected by SAM. 7.Ankle: Bend SAM lengthwise, then fold the entire splint into a “U” shape and secure it around the ankle with the foot in the “stirrup.” From my experience, you really need more padding around the ankle to fully immobilize it when using SAM this way.8.Lower leg: You need two SAMs to splint the lower leg. After making the lengthwise bend, fold both SAMs over at the foot end to form a “cup” to hold the foot in place. Then secure the splints along both sides of the injured leg, one SAM on each side. Here the additional strength of the reverse bend along the outer edge of both splints is very helpful. The SAMs should extend above the knee. You have to immobilize both the ankle and the knee to secure a broken lower leg.9.Knee: Two SAMs are needed, one secured to each side of the knee. To maximize the strength of the splints, fold each SAM into the shape of a T.10.Neck: Any person with a suspected injury to neck or back needs to be completely immobilized. Additionally, the neck should be secured within a supportive “collar.” Fold SAM into a collar by first folding about 8 inches of splint over onto itself, then form a chin cup in the double fold. With the cup held in place manually under the person’s chin, gently fold the rest of the SAM completely around the neck and down onto the chest. The excess splint length should then be folded back up to add more support for the neck. Gentle squeezes at the sides of the neck will form “wings” in the splint for more strength. Finally, secure the SAM in place with tape or elastic wrap.

2.Thumb: Round the end of the splint to form a protective “cup” for the thumb. Extend the splint up the arm to completely immobilize the hand.

You’ll undoubtedly find more uses for your supportive little rescue buddy. Hey, who knows when you might get caught in a surprise snowstorm and need to ski out on a pair of SAMs? Contact: The Seaberg Company, Inc., (800) 818-4726; www.samsplint.com

SIZE OPTIONS:

36″ The most versatile length; the minimum every backpacker should carry; $15

18″ SAM Junior; okay for splinting arms of children and small adults; $8

9″ Ideal for thumb and wrist injuries, but little else; $4.50

4?” x 2 Useful only for fingers; $1.30