Imagine you are bugging out following a catastrophic event. You are following your perfectly laid plans and you and your group are heading to your ready stocked and secure bug out location. You are still a few hours traveling time away when one of your group suffers a major lower body injury.
They are in considerable pain, unable to walk and it is likely they have a broken ankle. This situation needs immediate attention to prevent this from becoming a fight for survival.
Here’s what you need to know and do. These practices can be applied to most broken bones in your extremities:
- Think about the kit you have on hand – if you are bugging out you should have your bug out bag with you. This means you will have a knife, a basic first kit and some other useful tools with you, so with a little improvisation, you and your casualty can be back on the move ASAP.
- Think about the environment around you – look around you, think creatively and decide if there is anything you can use to help the situation. Depending on your location, there are likely to be materials available for an impromptu splint – things such as sticks, discarded umbrellas, etc., can all be used.
- Think about YOUR SAFETY first – your casualty is already injured, you need to help them the best you can. The only thing that can make this situation immediately worse is if you were now to become injured. Stop and assess the potential danger of helping your casualty DO NOT rush straight in – if they have fallen, what made them fall? Could this also make you fall?
- Think about hygiene and infection – if you have established that it is safe to approach and help your casualty then hygiene should be your next thought. Put gloves on to prevent cross infection to open wounds. All the effort you are about to put in to saving your friends broken ankle will be wasted if they become severely ill a few days later because of an infection.
At this point, it is time take a breath to ensure you stay calm and get ready to help your casualty!
- Expose the injury so a basic assessment can be made. You will need to treat any major bleeding very quickly to prevent shock and loss of life. Direct pressure needs to be applied to any bleeding wound until the bleeding stops. If your casualty has a compound fracture (the bone is sticking out through the skin) DO NOT apply direct pressure to the open wound. If you need to stop bleeding – indirect pressure can be applied above the wound or – as a last resort- a tourniquet may be required (see below for details).
- Manually stabilize the injury – you need to keep the injury still. Any movement will not only cause severe pain to your casualty but it can also cause internal bleeding as the broken bone can tear arteries. Get someone else in your group to support the injury. The joint should not be realigned or straightened, it needs to be supported in the position it is now in. Another helpful way of keeping the injury immobilized is by reassuring your casualty. Talk to them, try to take their mind away from the pain and urge to move.
- Find materials for your splint – your creativity for this is only limited by the tools you have around you. To make a splint you will need 2 ridged objects, which are the same length, to splint either side of the fracture. As previously mentioned, anything can be used – umbrellas, axe handles, walking sticks, branches etc. You will also need material to tie the splints to the injury. For this you could use a handkerchief, belts, paracord, duct tape – anything that is strong but will not hurt when applied to the casualty.
- Apply the splint – first, get your ties and carefully lay them in position ready to tie the splint to the ankle. Lay your ties under the limb — you can carefully slide the tying devices underneath the back of the lower leg and ease them back and forth until you’ve slid them into place. I would use at least 2 – 3 ties to ensure the splint will be completely secure. DO NOT position ties directly on top of any joint or wound.
Once your ties are in the correct position, you then need to place the splints either side of the injury on top of the ties. You can now start tying the splints to the injury. Start from the tie closest to the ankle and work upwards. Be careful not to tie too tightly. The splint is for support so it should be as comfortable as possible for your casualty.
At this point you need to decide how you are going to move your casualty for the remainder of the journey!
If they are able to hop on one leg with support and you have access to a vehicle – help them into a comfortable position and drive the remainder of the way.
If you do not have access to a vehicle you are likely to need some kind of stretcher. This can be made from branches, sticks, etc., but this will be very time consuming as well as using lots of effort. In my opinion, providing it is safe to do so – I would take the time to make a carrying device of some description. It will be much more comfortable for the casualty and although your journey will be slower than it was previously, it would be much quicker than an injured person hobbling along.
Your last resort is to carry them yourself. I would not choose this option unless we were in immediate danger and had to leave right now. This method is likely to cause pain to the casualty and the chances of injury are severely elevated.
In any medical emergency like this – the key is to get the injured party to professional medical care as soon as possible. The best you are going to be able to do is to make them a bit more comfortable and stop the situation from becoming worse. In order for them to make a full recovery and providing it is still available, medical treatment needs to be your top priority.
More Information: How To: Emergency Tourniquet