inches above the level of the elbow. Support the
forearm in this position by means of a wide sling
(fig. 4-57). A wide roller bandage (or any wide
strip of cloth) may be used to secure the victims
arm to the body (see figure 4-53). A figure-of-eight
bandage may also be used for a fractured clavi-
cle. Treat the victim for shock and evacuate to
a definitive care facility as soon as possible.
Fracture of the Rib
If the ribs are broken, make the victim com-
fortable and quiet so that the greatest danger
the possibility of further damage to the lungs,
heart, or chest wall by the broken endsis
The common finding in all victims with frac-
tured ribs is pain localized at the site of the frac-
ture. By asking the patient to point out the exact
area of the pain, you can often determine the loca-
tion of the injury. There may or may not be a rib
deformity, chest wall contusion, or laceration of
the area. Deep breathing, coughing, or movement
is usually painful. The patient generally wishes to
remain still and may often lean toward the injured
side, with a hand over the fractured area to im-
mobilize the chest and to ease the pain.
Figure 4-57.Sling for immobilizing fractured clavicle.
Figure 4-58.Swathe bandage of fractured rib victim.
Ordinarily, rib fractures are not bound,
strapped, or taped if the victim is reasonably com-
fortable. However, they may be splinted by the
use of external support. If the patient is con-
siderably more comfortable with the chest im-
mobilized, the best method is to use a swathe (fig.
4-58) in which the arm on the injured side is
strapped to the chest to limit motion. Place the
arm on the injured side against the chest, with the
palm flat, thumb up, and the forearm raised to
a 45° angle. Immobilize the chest, using wide
strips of bandage to secure the arm to the chest.
Wide strips of adhesive plaster applied directly
to the skin of the chest for immobilization should
not be used since the adhesive tends to limit the
ability of the chest to expand and this interferes
with proper breathing. Treat the victim for shock
and evacuate as soon as possible.
Fracture of the Nose
A fracture of the nose usually causes localized
pain and swelling, a noticeable deformity of the
nose, and extensive nosebleed.
Stop the nosebleed. Have the victim sit quietly,
with the head tipped slightly backward. Tell the
victim to breathe through the mouth and not to
blow the nose. If the bleeding does not stop within
a few minutes, apply a cold compress or an ice
bag over the nose.