MEDICAL the .suliLiing of the patient and prolongs the time required for healing. 2. Before applying the splints, make the injured limb look as much like its fellow as possible, and follow the directions for the treat- ment of particular fractures. 3. Handle the injured part gently, and, when it has to be moved in order to be placed in proper position, grasp the limb firmly both above and below the fracture. 4. See that the splints are firmly but comfortably applied, and that all knots lie on the splints. Extemporised Splints, Bandages, and Slings A doctor keeps on hand a complete assortment of splints and bandages, but the good Samaritan who renders first aid must use whatever is most handy. It is hardly ix)ssible for an accident to occur where a splint of some kind may not be extemporised, are umbrellas and walking-sticks — which may be lashed together to increase their length, if necessary ; in a country lane there are hedge- stakes ; in the workshop pieces of wood and tools ; and in the home there are broom-handles, pokers, blind-laths, and other pieces of wood ■which form excellent splints. Bandages may be extemporised from handkerchiefs, braces, straps, curtain bands, pieces of sheet, or any other fabric. What can be used as a bandage can likewise be used as a sling, but it must not be forgotten that a sling can be extemporised by turning up the tail of a coat and pinning it to the breast, and also by pinning the sleeve itself to the coat or dress. How to Treat Particular Fractures 1. Fracture of Lower Jaw. This is always a compound fracture. The mouth cannot be closed, the teeth are uneven, there is bleeding inside the mouth, and a gap may be felt outside. Place the palm of the hand under the chin, and press the lower jaw gently against the upper one. Apply the middle of a bandage to the chin, and tie the ends at the back of the head. Fold another bandage, pass it under the lower jaw, and tie it at the top of the head. In this case Nature provides the splint, which is the upper jaw (Fig. I.). ^^ 2. Fractured Collar-Bone. The arm on the injured side is almost useless, the patient supports the elbow of it with the other hand, and leans the head over to the injured side. Take off the coat, observing the rule of removmg clothing from the sound side first. Make a pad, about two inches thick and four mches m the other dimensions, from a hard substance, such as a purse, small book, or folded niagazme. and press it upwards in the armpit of the mjured side. Gently bend up the forearm keepmg the elbow well back and implanted agamst the side. Tie a narrow bandage round the body and arm to keep both in this position. I ut the arm m a broad sling, with the hand above the level of the elbow and with the Fig. 2. For a fractured collar-bone tie a narrow bandage round the body and arm, and put the arm in a broad sling In the street there i thumb pointing uf)wards (Fig. 2.). 3. Broken Shoulder- Blade. Apply the same treatment as for a broken collar-bone, but omit the pad in the armpit. 4. Fractured Humerus, or Arm-Bone. (fl) Neck of Humerus — i.e., the part of the bone which fits into the shoulder- blade. Treat as for a broken shoulder-blade. (b) Middle of Humerus. Bend the forearm at a right angle to the arm, with the palm of the hand inwards and the thumb pointing upwards. Apply splints reaching from shoulder to elbow on the outer and inner sides of the arm, and, if procurable, short ones to the front and back also. Keep the splints in posi- tion by a bandage above and one below the seat of injury, and place the arm in a nayrow sling. (See ustration in last issue.) (c) End of Humerus. Lash two splints together to form an acute angle, taking care that one stretches easily from elbow to arm-pit. Place one end of the splint into the arm-pit, and bend up the forearm to rest against its lower portion. Bandage the arm to the two ends of the splint, adding outside the arm, for extra support, a piece of stiff substance, such as a rolled newspaper, a piece of cardboard, or the straw cover of a wine-bottle. Apply a broad sling (Fig. 3). 5. Fractured Elbow. Treat exactly as the end of humerus ; but, if the accident occurs indoors, it is best not to bind up the arm, but to place a pillow to support the arm com- fortably, and apply cold water dressings till the doctor arrives. Fig. 3. Splints and broad sling for a broken forearm
