directly  to  the  injured  part.  If  you  decide  to remove clothing over the injured part, cut the clothing or rip it along the seams. In any case, be careful! Rough handling of the victim may turn a closed fracture into an open fracture. That could increase  the  severity  of  shock  and  cause extensive damage to the blood vessels, nerves, muscles, and other tissues around the broken bone. If the fracture is open, you must treat the wound before you can deal with the fracture. Bleeding from the wound may be serious. Most bleeding can be stopped by direct pressure on the wound or by finger pressure at the appropriate  point.  If,  after  your  best  efforts,  these methods are not successful, use a constricting band; then treat the fracture. Use of Splints An  essential  part  of  the  first-aid  treatment  is immobilizing the injured part with splints so that the sharp ends of broken bones won’t move around and cause further damage to nerves, blood vessels, or vital organs. Splints are also used to immobilize severely injured joints or muscles and to prevent the enlargement of extensive wounds. Before you can use a splint, you need to have a general understanding of the use of splints. In an emergency, almost any firm object or material can be used as a splint. Such things as umbrellas, canes, swords, rifles, tent pegs, laths, sticks, oars, paddles, spars, wire, leather, boards, pillows, heavy clothing, corrugated cardboard, and folded newspapers can be used  as  splints.  A  fractured  leg  may  sometimes  be splinted by fastening it securely to the uninjured leg. Splints, whether ready-made or improvised, must meet the following requirements: Be light in weight, but still be strong and fairly rigid. Be long enough to reach the joints above and below the fracture. Be wide enough so the bandages used to hold them in place won’t pinch the injured part. Be well padded on the sides that touch the body. If they’re not properly padded, they won’t fit well and  won’t  adequately  immobilize  the  injured part. To improvise the padding for a splint, use articles of clothing, bandages, cotton, blankets, or any other soft material. If the victim is wearing heavy clothes, apply the splint on the outside, allowing the clothing to serve as at least part of the required padding. Although splints should be applied snugly,  never apply them tight enough to interfere with the circulation of the blood. When applying splints to an arm or a leg, try to leave the fingers or toes exposed. If the tips of the fingers or toes become blue or cold, you will know that the  splints  or  bandages  are  too  tight.  You  should examine a splinted part approximately every half-hour, and loosen the fastenings if circulation appears to be cut off. Remember that any injured part is likely to swell, and splints or bandages that are all right when applied may be too tight later. Figure 14-18 shows a method of immobilizing the leg of a person with a broken kneecap. To secure the limb  to  the  splint,  belts,  neckerchiefs,  rope,  or  any suitable material may be used. If possible, tie the limb at two places above and two places below the break. Leave the treatment of other types of fractures, such as jaw, ribs, and spine, to medical personnel. Never try to move a person who might have a fractured spine or neck.  Moving such a person could cause permanent paralysis. Don’t attempt to reset bones. SPRAINS AND STRAINS A person with a sprain or a strain might have some of the same symptoms as a person who has a fracture. The information contained in this section will help you 14-22 Student Notes: Figure 14-18.—Splinting.