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Splinting in the Emergency Room Tammy Whitehead RN, BSN
Why Do We Splint? • To stabilize the extremity • To decrease pain • Actually treat the injury
Complications of Splinting • Abrasions • Sores • Neurovascular compromise (tight fitting splints) • Contact dermatitis • Pressure ulcers • Thermal burns
How to prevent complications • Apply splint by trained professional • Apply splint correctly • Monitor neurovascular status. U What we do! s ! Collaboratio n with the Docs!
The 6 P’s of extremity assessment Pain: Palpate the entire extremity for increase pain Pallor: Pulses: Note color and Palpate proximal temperature and distal pulses capillary refill Paresthesia: Assess for burning, tingling, numbness Paralysis: Assess motor function (both active and passive Pressure: Palpate for firmness of compartment
Equipment need for application • Cotton bandage( soft roll, cotton roll) Pad entire area to be splinted • Plaster slabs or pre padded fiberglass (Orthoglass), immobilize above and below injury • Room temperature water (apply generously) • Elastic bandage • Adhesive tape or fastners
Types of Splints • Yes, its broken and needs a splint! • Why sure Doctor, not a • problem!
Volar Splint • The Volar short arm splint is used for: • Fractures of the wrist • Fractures of the second to fifth metacarpals, • Carpal tunnel syndrome • Soft tissue injuries
Finger Splint • Finger Splints are used for phalangeal fractures • (A&B) commercial splints • © is custom splint
Gutter Splint • Two types: radial and ulnar • Gutter splints are used for: • Phalangeal fractures • Metacarpal fractures • Two types: radial and ulnar
Figure Eight Splint • Used to stabilize a clavicle fracture • To be applied properly the patient must be erect with hands on his iliac crest with shoulders in abduction (as seen in picture)
Buddy taping of toes • Secure the fractured toe to the adjacent toe with adhesive strips • Sheet wadding between toes prevents maceration
Posterior Leg Splint • • • This splint is used for: Distal leg fractures Ankle fractures Tarsal fractures Metatarsal fractures
Stirrup Splint • To prevent inversion or eversion of the ankle • Immobilizes the ankle for fractures near the ankle • Apply from below the knee and wrap around the ankle
Thumb Spica Splint • This splint is used for : • Scaphoid fractures • Extraarticular fractures of the thumb • Ulnar collateral ligament injuries
What do you do after you have applied your splint? ? ? 1. Have MD/PA evaluate splint 2. Document what you have done!!!
Documentation • Which Splint you applied • Which extremity you applied the splint to • 6 P’s • Time you applied the splint • Condition of any wound • How the patient tolerated the procedure • Which MD/PA evaluated splint and time
Application of Splints • Follow up on the floor and perform the following splints under the observation of your preceptor • • • Gutter splint Volar splint Thumb Spica Posterior leg splint Stirrup leg splint Clavicle Brace
To Receive Credit for having completed this Review of Splinting : • Certificate of Completion of On-line Module – Splinting in the ED – Complete the Certificate with your name and date of completion – Print and sent to Tammy Whitehead for records.