How to: Build a "SWELL" Splint
Picture this: you’re biking down a sendy ridge line with a friend when they fly over their handlebars and land directly on their wrist. They scream out in pain and are holding their wrist tightly to their body when you screech to a halt.
What the heck do you do?!
Take a deep breath, and remember “SWELL”! You build them a splint to support their wrist, walk out to the trailhead with their bike in tow, and take them to urgent care, where the staff takes an x-ray and commends you for your SWELL splint.
When should you splint something?
Extremity (arms and legs) injuries should be splinted if a fracture is suspected or if a bad sprain requires additional support.
Signs and symptoms of this may be: pain, tenderness, swelling, discoloration, inability to bear weight, deformity, etc.
What makes a splint “swell”?
A “swell” splint will support the injured area while you determine your evacuation plan. If the injured area is a joint (wrist, elbow, knee, ankle), you’ll want to support the long bones above and below the joint (i.e. support the hand and forearm for a wrist injury). If the injured area is a long bone, you’ll want to support the joints above and below the bone (i.e. if the forearm is injured, you’ll want to support both the wrist and elbow).
SWELL: SIMPLE
The first step in creating a SWELL splint is to make it simple. You don’t need anything fancy: just support, padding, and something to secure it all.
If you have a manufactured splint (like a SAM splint) on hand, great! If not, find something else (like a trekking pole, stick, etc.) to support the injured area.
SWELL: WELL-PADDED
The second step in making a SWELL splint is to make sure that it is well-padded. This will ensure comfort for the injured party, as well as minimize further damage.
Pad the injured area, along with the rest of the splinted area, with soft material like extra layers or a hydration bladder.
SWELL: EASY TO ACCESS
The third step in creating a SWELL splint is to make sure that you easily access the CSMs. What are CSMs? That stands for circulation, sensation, and motor function.
You want to make sure that the injured person has pulses, sensation, and movement below the injured site (i.e. in their hand if their wrist is injured). If they don’t, this can indicate something like nerve damage or dislocation, and you’ll want to expedite getting them to an emergency department.
SWELL: LIGHT WEIGHT
The fourth step in making a SWELL splint is to make sure that it is light weight.
If you’re in the backcountry and someone breaks their arm, you wouldn’t want them to have to hike out with a splint that weighs 30 pounds. Use simple, light weight materials — just enough to support the area without weighing it down.
SWELL: LONG LASTING
The final step in making a SWELL splint is to make sure that it is long lasting.
Similar to not wanting a splint to weigh someone down on a hike out, you don’t want it falling apart, either. While you might have to get creative with the materials you use, make sure they’re secured in a way that will last the trip out.
Here is an example of a SWELL lower extremity splint. This would be great for someone with a suspected knee, lower leg, and/or ankle injury, as it immobilizes almost the entire leg. The wood and sleeping pad provide support and the straps secure it simply. If using something like this, you would just want to make sure that the straps did not add undue pressure over the injured area by strapping it above and below the injured site. The inside of the sleeping pad is padded with clothing layers for comfort.
Now what?! Reassess and make a plan!
You’ve built your SWELL splint, and your friend who hurt their wrist full-sending off a bike feels better. YAY!
Now what? Decide your evac plan. Can this person walk out? Does search-and-rescue need to be called for support? Manage pain in the meantime with meds like Tylenol and Ibuprofen, and make sure you’re staying well-fed and hydrated.
Homework:
Think about what you carry in your pack for the outdoorsy things that you do. What could you use to make a splint? If you’re a backcountry skier, poles, probes, and shovel handles can provide rigid support. If you’re a hiker, your hydration bladder can provide support to an injured wrist. If you’re backpacking, you probably have plenty in your pack (tent poles, sleeping pad) that can be used to create a splint. If you’re a mountain biker and don’t carry much in your pack, maybe you need to consider carrying a SAM splint with you.
Leave a comment below and let us know what your main sport is, and what you would use from your pack to create a splint for an injured wrist or ankle!