Letter Re: An Overlooked Aspect of Preparedness–Crutches and Canes

Mr. Rawles,
Hi again and thanks again for the wonderful blog! I wanted to address the request for more information about splinting injuries and stretchers. Before I begin discussing methods of splinting we need to first address the degree of injury. I once “sprained” my wrist playing sports. It swelled, hurt, was sensitive, caused immense pain, and was hot to the touch. Our sports trainer pulled me out of the game, three hours after a “minor injury.” [X-rays showed that] I had two hairline fractures and went home with a cast. The doctor was shocked that I waited till halftime and said I was lucky not to further break my arm while I was playing. In the original poster’s story, he couldn’t even move his knee and it was a sprain versus my case, where I could move my arm and yet it was broken. I could have easily fallen on my arm again and seriously broken it! A real problem with trauma and any kind of illness is that you have an increased chance of falling and re-breaking or breaking additional bones. You have to always consult qualified medical advice on an injury that requires splinting, crutches, or any kind of assistance. In a post-TEOTWAWKI situation that may be your medical person in the group, or “Where There Is No Doctor” but unless you have a serious fracture that is apparent (i.e. bone sticking out of flesh, deformity or immediate inability to move the extremity) you really can’t tell and should make every effort to go to a medical professional to get their help. Splinting [in order] to get there is good and fine, but you really should have it looked at by a medical professional before splinting for a long time.

Generally speaking we splint to immobilize an extremity. This is achieved by keeping the joint about and below the injury from moving. If its a knee, splint the injury so the ankle can’t move and the hip can move in a forward backward motion while moving the entire leg but unable to bend the knee. For wrist or elbow sprains simply bend the elbow 90 degrees and hold it to your chest. Splint in place. A critical assessment to make prior to and after splinting is to see if you can feel a pulse, if they can feel sensation and their degree of mobility. This allows you to loosen, tighten, or change the split as needed if they lose one of those three things during or after splinting. By far, splinting is more about technique than the materials on hand. Before x-rays and plaster were used, doctors used splints to treat fractures. Anything hard, and straight can be used. From tree branches to long wooden spoons, to a piece of stiff plastic. I once watched a friend splint an arm for a wilderness class using a soft paper back book and magazines with a lot of tape. You can also buy commercial splinting supplies. There are wire mesh types and card board cut outs and of course the simple ACE [elastic cloth] bandage. Galls.com is a great place to find splinting supplies! Look under medical supplies then splinting. I do not recommend the air splints, they generally are fragile and can pop relatively easily. Once you buy your items open them up and experiment with them, to try different things out and different ways. I also highly recommend taking a basic first aid course that will help you with splinting and immobilizing. For treatment of sprains and twists use the RICE acronym: Rest, Ice, Compress, and Elevate.

As far as stretchers go and hospital beds there are a few prominent brands out there. Mostly in hospitals and in Emergency Medical Service we use Stryker products or Ferno products. These offer a large variety of positions and features. The Stryker ambulance stretchers I can say from first hand experience are extremely rugged and durable! American Medical Response is the largest ambulance company in the US uses Stryker gurneys across the nation! While these stretchers are durable, and rugged they have some serious faults:
1. They are very heavy, around 100-120 pounds.
2. Due to their design, narrow wheel base and where the patient sits, they are also very top heavy and tip over easily.
3. More EMTs and Paramedics careers are ended due to back injury than any other reason. All it takes is one improper lift, one time and one back injury to do permanent damage! Proper body mechanics must be used at all times!
4. They are very expensive–usually around $3,000 when purchased new. Typically they are just repaired until they can’t function at all, so its difficult to get a quality used one.

Back Boards and Garden Carts:

A better option [for prepared families] in my opinion is to simply buy a back board and put the person on a cart or simply carry them. They run about $100 dollars and the straps (spider straps) are about $50 dollars and are easy to use. As I recall, Mr. Rawles recommends having a garden cart for hauling wood and other work related materials around your retreat. Likely this cart would have big heavy duty wheels and could go just about anywhere on your retreat. Back boards have slots at the top and sides for handling and you can easily secure the board via hooks, ropes, or seat belts to the top and rear of the cart. Boards can be made out of wood, but are largely made out of plastic. It would not be difficult to attach one to the side of the cart at all times just in case you need it. In all of these cases back boards should only be used to move the person and not to prevent any head or neck injury which is their primary design in modern medicine unless you are trained to that level of care. Another benefit to a back board is that by strapping them down you are in effect splinting their arms and legs and don’t need to do that until after they have been moved or time allows. Another great option is to secure all of your first response medical gear to the board! Get someone to help you, and have all your emergency field gear on top of the board and simply carry it to your patient and have another set of hands to help! So for about $150 to $200 and a cart used for other purposes, you have a heavy duty stretcher to get the injured person back to your retreat!

In my experience as an EMT, I have found that some great places to find emergency gear are:
The foregoing comments are purely suggestions and advice. I accept no responsibility for your actions and consequences thereof.
Thanks again for the blog , James! – Michelle, “The 20-something EMT”