Introduction: The Sling and Swathe Method
The Sling and Swathe Method is a technique designed to stabilize the arm in cases of a shoulder dislocation, subluxation, or fracture. A dislocation is an injury to a joint in which the ends of the articulating bones are forced from their normal positions and remain out of place. On the other hand, a subluxation occurs when the ends of the articulating bones are forced from their normal position, but return to their starting position as opposed to remaining displaced. A fracture is a crack or break in bone or cartilage.
This instruction set is intended for coaches, lay responders, athletic training students, and those who are basic CPR and First Aid trained. A shoulder dislocation, subluxation, or fracture can occur at any time, therefore, the Sling and Swathe Method is not limited to use on athletes. Children playing on a playground or an elderly person that slips and falls could just as easily sustain a shoulder injury where the Sling and Swathe Method would be warranted.
Note: When a shoulder dislocation, subluxation, or fracture occurs, the Sling and Swathe Method should be immediately applied and the individual should be taken to the hospital or Emergency Medical Services (EMS) should be contacted. Do not attempt to re-position the displaced ends of a bone, instead, Sling and Swathe the injured arm as it is presented to you.
Step 1: Gather Your Materials
In order to perform the Sling and Swathe Method, you will need a 6 inch x 10 yard elastic bandage. These dimensions will ensure that you have a bandage long enough to properly perform the technique. Additionally, you will need one roll of 1.5 inch athletic tape. Most elastic bandages are packaged with metal fastening clips, however, these items are small and may be easily lost or misplaced. Athletic tape is an easy and efficient way to secure your bandage.
Most grocery stores carry athletic tape and elastic bandages in the Pharmacy section. However, these items can just as easily be ordered online from a Sports Medicine website. When ordering online, simply open a web browser and search for the items.
Step 2: Determining When to Use the Sling and Swathe Method
There are several things to consider when determining if an individual sustained a shoulder injury that would necessitate the use of the Sling and Swathe Method. First note the posture of the individual. If he or she is demonstrating a guarded posture like in the picture, the responder should Sling and Swathe the injured arm. The individual may also be apprehensive towards other people attempting to touch or move the shoulder, which should indicate to the responder that a serious injury occurred. Additionally, if an obvious deformity is noticed when comparing the injured shoulder to the non-injured shoulder, the individual's arm should be secured.
Second, listen to what the individual reports in regards to how the injury occurred. If he or she describes feeling the shoulder move out of place or hearing/feeling a crack, use the Sling and Swathe Method. A shoulder dislocation, subluxation, and fracture are all serious injuries and the reaction of the individual, whether it be crying or screaming, can indicate the nature of the injury.
Step 3: Begin at the Wrist
After determining the Sling and Swathe Method should be used, begin by placing the end of the bandage on the individual's wrist. Position the roll like what is shown in the picture. Apply a moderate amount of tension to the roll.
Step 4: Wrap Up the Forearm
Wrap around the forearm and continue until you reach the individual's elbow.
Step 5: Up and Over the Shoulder
Begin the first pass up and over the individual's shoulder, securing the arm to the body. Again, keep a moderate amount of tension on the roll. Keep in mind that the individual will be in pain and the bandage should be secure but not constricting.
Step 6: Continue Behind the Back
Once the bandage passes up and over the individual's injured shoulder, pull the bandage in a diagonal pattern across the back and under the individual's non-injured arm.
Step 7: Bring Around to the Front
After wrapping the bandage under the individual's non-injured arm, bring the bandage to the front of the individual and place horizontally along the bottom of the forearm.
Step 8: Continue Horizontally
Continue placing the bandage horizontally around the individual, bringing the bandage to the back and then to the front of the individual again.
Step 9: Second Pass Over the Shoulder
Once the bandage is brought around to the front of the individual, angle the bandage upwards and complete a second pass up and over the shoulder.
Step 10: Second Pass Behind the Back
Again, wrap the bandage in a diagonal pattern across the individual's back and underneath the non-injured shoulder. Bring the bandage around to the front and complete a pass along the forearm, behind the back, and around to the front again.
Step 11: Continue Pattern
Continue wrapping the bandage in an alternating pattern of up and over the shoulder and behind the back, followed by around the forearm and behind the back. Fan out the pattern so that the bandage covers the individual's entire arm and shoulder.
Step 12: Secure the Bandage
Apply the white athletic tape to secure the bandage.
Step 13: A Stabilized Shoulder
When finished, the individual should not be able to move his or her shoulder.
Step 14: Check the Hand
The hand should be left out so that the responder can periodically check the color of the individual's hand and ensure that blood is still circulating throughout the entire arm. The individual should immediately be taken to the hospital or EMS should be on their way to transport the individual.
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