Fractures and Splinters

(Medical Self-Help Film Series)

Department of Health, Education and Welfare

Office of Civil Defense


Recognizing that an enemy nuclear attack could easily overwhelm the medical infrastructure of the United States, officials within the Office of Civil Defense and the Department of Health, Education and Welfare developed the concept of Medical Self-Help.  In targeted areas, projected casualties would far exceed the limited number of available doctors and nurses, and the presence of fallout radiation would further isolate patients from necessary aid.  Medical Self-Help, then, sought to teach Americans to treat common medical emergencies with the understanding that trained medical personnel may never arrive. (1) In 1965, the two agencies published an 11 chapter booklet with each chapter detailing a different medical issue likely to arise in a post-attack environment.  That same year, a series of motion pictures was released, with each entry corresponding to a chapter from the booklet. (2)  While the first two films (Radioactive Fallout and Shelter, Healthful Living in Emergencies) deal directly with nuclear attack, the rest of the films deal directly with conventional injuries like burns, bleeding and shock which would no-doubt be widespread in the aftermath of such an attack.  This is the premise of Fractures and Splinters, the fourth entry of the Medical Self-Help series.  Curiously, no mention is made of a nuclear attack.  Instead, the narrator (who provides, voice-over work for all of the films) describes a "serious catastrophe" which requires casualties to be immediately transported to a sheltered area.

"In a major disaster situation, the majority of all injuries would be fractures."  As the narrator makes this observation in the opening moments of the film, the camera pans across the scene of an apparent "major disaster".  Scores of well-dressed men, women and children lie among the ruins of collapsed buildings while rescue teams work to extricate them.  The key role of these rescue teams, the narrator explains, is to stabilize and remove the injured from immediate danger.  When a casualty is unconscious in rubble, a fracture should always be assumed.  A simple fracture, where the shattered bone has not penetrated the skin, may still be noted by lumps and swelling.  A victim?s clothes should be cut, not pulled off, as unnecessary movement may cause a simple fracture to break the skin or sever nerves or arteries internally.  Once a simple fracture is identified, the broken limb should be set between splints which may be made from scraps of torn cloth and scrap lumber.  When the casualty has a compound fracture, where the bone has broken through the skin, the rescue team should first stop external bleeding before splinting the limb.  The ultimate goal, according to the film, is to move injured victims into a sheltered area.  At this point, Fractures and Splinting cuts to an industrial basement which is the setting for the majority of the films of the series.  Although not specifically identified as a public fallout shelter, standard government shelter supplies including food, water barrels, and medical kits (all adorned with a CD label) line the walls. 

Within the basement setting, a woman tends to the injured.  The same actress had earlier played the psychotic fallout shelter occupant Ms. Dennis in the 1963 Office of Civil Defense film Three Reactions to Shelter Life.  Here, she demonstrates the importance of importance of disinfecting compound fractures with clean water.  She also shows how to realign broken legs with improvised traction rigged from a cot and strips of torn cloth.  Beyond arm and leg fractures, all bones are susceptible to breaking.  Cutting back to the outside rubble, a woman lies unconscious on a pile of bricks.  Bleeding from the mouth and ears, the narrator indicates this is evidence of a skull fracture.  As she rouses to consciousness, rescuers check for signs of confusion as evidence of a concussion.  Similarly, a young girl lies nearby unconscious under rubble.  An aid worker binds her head to set a fractured jaw after checking to make certain the girl?s teeth are not cutting into her mouth.  When the victim is elderly, hip and rib fractures must be considered before transport can take place.  At all ages, a spinal fracture is most severe and the victim should be completely immobilized with sandbags and a rigid stretcher prior to moving.  Final scenes depict the injured being well cared for inside of the fallout shelter.  Likely due to the fact the film focused on general conventional first-aid measures, Fractures and Splinting was not deemed obsolete like many of its contemporary civil defense films.  Conversely, it was available for rent or purchase throughout the 1970?s and was even converted to VHS cassette tape and was possible to obtain from government catalogs into the early 1980?s. (3)

1. Office of Civil Defense.  1962 Annual Report.  United States Government Printing Office.  1963.  62.
2. Office of Civil Defense.  Department of Health, Education and Welfare.  Family Guide to Emergency Healthcare.  U.S. Government Printing Office.  1963.
3. General Services Administration.  A List of Audiovisual Produced by the U.S. Government For Emergency Medical Services.  National Archives and Record Services.  1982.