1. SCENE SAFETY AND BSI: Confirm the scene is safe before approaching the patient. Don appropriate PPE, including gloves, before making patient contact.

2. PATIENT ASSESSMENT AND PMS BASELINE: Perform a primary survey and direct the patient to remain still. Expose the injury site by cutting clothing as necessary, then assess and document Pulse (radial), Motor function (finger movement), and Sensory function (finger identification). An absent pulse indicates high-priority evacuation.

3. MEASURE THE SPLINT: Use the patient's uninjured arm as a sizing template. The splint must extend from mid-humerus to past the wrist to immobilize the joints both above and below the fracture site.

4. CUT TO LENGTH IF REQUIRED: Use trauma shears to trim the splint to the measured length. Immediately fold tape or gauze over any cut aluminum edge to eliminate laceration risk to both patient and rescuer.

5. FORM THE C-CURVE: Grasp both ends of the splint and bend it into a shallow trough configuration. This geometric shaping converts the pliable aluminum core into a rigid, load-bearing structure capable of supporting the limb.

6. CUSTOM MOLD FOR JOINT INJURIES: For injuries involving a joint, pre-bend the splint to match the resting angle of the uninjured joint. Pad any gaps or voids between the splint and the limb with rolled gauze to eliminate pressure points.

7. MAINTAIN MANUAL STABILIZATION: Assign a partner to maintain continuous manual stabilization of the injured limb throughout the entire application process. Do not release stabilization until the splint is fully secured.

8. POSITION AND APPLY THE SPLINT: Slide the pre-formed splint beneath or alongside the injured forearm. Place the patient's hand in the position of function, fingers loosely curled as if holding a can.

9. SECURE THE SPLINT: Apply elastic or self-adherent wrap beginning distally at the hand and working proximally toward the elbow. The wrap must be snug but not constrictive. Two fingers must be able to slide under the wrap. Leave fingertips exposed for capillary refill monitoring.

10. APPLY SLING AND SWATHE: Secure a sling to support the full weight of the arm and apply a swathe to restrict arm movement during patient transport.

11. REASSESS PMS POST-APPLICATION: Immediately repeat Pulse, Motor, and Sensory checks and compare findings against the pre-application baseline. Any loss of pulse, numbness, tingling, or inability to move fingers indicates the wrap is too tight. Loosen and re-secure at once.

12. MONITOR CONTINUOUSLY DURING TRANSPORT: Continue PMS reassessment at regular intervals throughout evacuation. Brief receiving medical staff on all materials used, noting that securing wraps may not be radiolucent even though the splint itself is X-ray transparent.

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