Using a sling, a cravat or a collar’n’cuff, the arm and/or shoulder girdle is supported.
The sling is a triangular cloth. This cloth has two short sides and one long side. The two short sides form a 90° angle. The other two corners of the triangle form 45° angles; these are known as the tails. The sling can be folded into a cravat [Figure 104]. The tails of the triangular cloth should ideally be tied together using a reef knot. This knot can be easily loosened without moving the affected body part.
Figure 104
How to Apply a Sling
Indications and Contraindications
- Injuries involving the soft tissue of the upper arm, forearm and hand, providing the sling does not exert undesired pressure on the injury.
- (Suspected) fractures to the forearm and hand.
- Contra-indications include: Injury to the shoulder girdle and (suspected) fractures to the upper arm. In these cases, use a cravat to support the forearm.
Material
- Triangular cloth.
- Safety pins or tape.
Procedure
- Stand in front or behind the patient.
- Bend the elbow and place the forearm against the chest.
- Make sure that the hand is about 10 cm higher than the elbow.
- By placing the hand higher than the elbow, venous return in the forearm will not be impaired.
- If this preferred position is not possible, select one which is least painful for the patient.
- Place the triangular cloth between the wounded arm and the chest, so that the 90° corner is next to the elbow and the tail lies across the shoulder of the healthy arm [Figure 105].
- Slide the cloth via the elbow crease between the arm and the chest if moving the arm is painful or undesirable.
Figure 105
- Fold the triangular cloth around the forearm and place the remaining tail on the shoulder of the wounded arm.
- Tie the two tails together on the healthy shoulder using a reef knot [Figure 106].
- Before doing so, check that the arm is still hanging in the correct position and that both shoulders slope downwards.
- Never tie the knot in the middle of the neck as the pressure on the cervical vertebrae can cause pressure sores.
Figure 106
- Make sure that the middle of the hand is resting fully in the triangular cloth.
- Fold the triangular cloth in at the elbow and fix it with a safety pin or tape.
- Place the safety pin in the lengthwise direction of the upper arm [Figure 107].
- The triangular cloth has been correctly applied if:
- The forearm up to the middle of the hand is supported in the cloth.
- The hand is about 10 cm higher than the elbow.
- The shoulder is not pushed upwards by the sling.
Figure 107
How to Apply an Elevated Sling
Indication
To be used as a secondary aid for internal and external bleeding to the forearm and hand. The hydrostatic pressure difference in the forearm promotes venous return and slows down arterial blood supply.
Material
- Triangular cloth.
- Safety pins.
Procedure
- Apply the sling.
- Bend the elbow and place the fingertips of the wounded arm against the collar bone.
- Fold the triangular cloth over at the forearm and fix it to the underlying tail using a safety pin [Figure 108].
Figure 108
How to apply a cravat
Indication
- (Suspected) fractures of the upper arm and shoulder girdle.
- Dislocation in the shoulder girdle.
- Injuries involving the elbow joint.
Material
- Triangular cloth.
Procedure
- Fold a triangular cloth into a cravat.
- Lay the cravat across the uninjured shoulder.
- Bend the elbow to form a 90° angle and place the forearm against the cravat [Figure 109].
Figure 109
- Fold the cloth around the wrist joint and place this tail over the injured shoulder.
- Tie both tails on the uninjured shoulder using a reef knot.
- Never let this knot rest on the cervical vertebrae as the pressure on the tissue can cause pressure sores.
- The cravat has been properly applied if the forearm is only supported at the wrist [Figure 110].
Figure 110
The Collar’n’Cuff
The collar’n’cuff offers excellent support, is comfortable to wear and easy to apply. The range of uses are clearly indicated and described on the outer packaging, making further elucidation unnecessary. One of the potential uses is demonstrated here for illustrative purposes [Figure 111].
Figure 111