How to Prioritize CMS When Splinting an Arm Fracture? While splinting an arm that has sustained a broken humerus, the highest priority is to?

Splinting an Arm Fracture: Why CMS Function Matters Most

As an EMT responding to an arm injury, your top priority is always circulation, motor function, and sensation — or CMS. Properly splinting a broken arm relies on understanding why CMS must be preserved above immobilization or speed. This guide will walk through an arm fracture scenario and explain proper arm splinting techniques with a focus on maintaining CMS.

You arrive on scene at a football field where a 19-year-old male has suffered an arm injury. After securing the scene and donning appropriate PPE, you make patient contact and begin your assessment. Vitals are stable. Upon examination, you suspect a mid-shaft humerus fracture. It is now time to splint the arm.

Your first instinct may be to immediately immobilize the arm or quickly transport. However, while immobilization and fast transport are important, the highest priority is CMS — circulation, motor function, and sensation. A properly applied splint will immobilize while optimizing CMS.

Why CMS Matters

Circulation refers to proper blood flow to the injured limb. Unmanaged arm fractures can put pressure on or sever blood vessels, restricting circulation. Loss of circulation threatens limb viability and must be avoided.

Motor function refers to the ability to move muscles in the injured arm. Splinting that over-immobilizes can cause avoidable loss of motor function.

Sensation refers to neurological function and ability to feel the limb. Splinting errors like excessive tightness can cut off sensation and cause nerve damage.

CMS viability is vital not only for initial injury management, but for long-term outcomes. Your splinting technique directly impacts CMS.

Splinting Steps with a CMS Focus

With CMS as the priority, follow these steps to properly splint an arm fracture:

1. Assess CMS — Before applying a splint, check CMS distal to the injury. Note color, temperature, pulses, motor function, and sensation.
2. Select an appropriate splint — Choose a splint that will immobilize the arm without limiting CMS. Padded boards or vacuum splints mold safely to the arm.
3. Position the arm — Gently place the arm in a neutral, anatomical position. Do not pull, twist, or bend.
4. Secure the splint — Use ties to secure the splint snugly but not too tight. Ties should never restrict circulation.
5. Reassess CMS — After splinting, re-check CMS. Make sure circulation, motor function, and sensation are intact.
6. Document CMS — Note CMS assessments and any changes before and after splinting. Continue monitoring CMS en route.

Common Splinting Errors

Knowing what not to do when splinting an arm fracture is also key:

• Do not cover antecubital areas needed for IV access
• Do not overtighten ties or over-immobilize joints, restricting CMS.
• Do not bend or twist the arm when positioning or moving.
• Do not apply splints over impaled objects or penetrating wounds.

Prioritizing CMS over immobilization and speed results in optimal outcomes when splinting arm fractures. Use your assessments and clinical judgment to guide appropriate splint placement and adjustments. A properly splinted arm reduces pain while maintaining circulation, motor function, and sensation.

This careful approach protects CMS and supports the arm until definitive care. Whether an arm fracture splint is short-term or will remain for hours until surgery, CMS must be routinely assessed and documented. Keeping CMS intact provides the best chance for your patient’s arm to heal well.

When in doubt, remember — CMS before immobilization and transport speed. Monitor circulation, motor function, and sensation at every stage when splinting an arm injury.

Proper arm fracture splinting relies first and foremost on maintaining optimal CMS.