Fractures External Immobilization pt.2 (Exam 3) Flashcards
Casts
Circumferential immobilization
Common treatment after closed reduction
Cast Material
Most = Fiberglass
Plaster of Paris = not really anymore
Cast Care: Plaster of Paris
- Heat is felt
- Handle with palms while wet (avoiding finder indication
- Petal edges (turn outward so it does not dig in)
-no/covering
-reposition q 1-2 hours until set
-neurovascular checks q1hr x 24 hrs
-Insert finger (confirm room)
-ice first 24-36 hours
After placement of cast how often and neurovascular checks completed?
Q 1 hr x 24 hours
Cast: Peripheral Neurovascular Assessment
5 P-s
Pain (first sign)
Pallor (late)
Pulselessness (late)
Paresthesia
Paralysis (late)
Cast Complications
Infection
Circulation impairment
Peripheral nerve damage
Complication of immobility
Splints and Immobilizers
Removable (unlike cast)
Braces
Dial in amount of flexion and etc
Traction
Applies pulling force on fractures extremity
Two different types of traction
Skin Traction
Skeletal Traction
Skin Traction
Short term (skin can not toleration very long)
5-10 lbs
Skeletal Traction
5-45 lbs
Pins used to immobilize part
Tolerated better than skin traction and can use more weight
Traction Pulling Force
Must be continuous (unless ordered intermittent)
Running vs Countertraction
Running = Traction is unidirectional
Countertraction = Traction going in both direction
Bucks Traction
Simplest form of skin traction
Provides straight pull on affected extremity (Running)
Relieve muscle spasm or temporary immobilization before ORIF
When is Buck’s Traction Most commonly used?
Relief of muscle spasms
Temporary immobilization before ORIF
Russell Traction
Permits pt to move somewhat in bed (countertraction)
Permits flexion of knee joint
Relieve muscle spasms / back pain
What are the two types of skin traction
Bucks
Russells
Balanced Suspension traction (For Skin or Skeletal)
Provides counter traction
Prevents patient from sliding to end of bed
Pulling force of traction is not altered when bed or patient is moved
Allows for increased patient movement and facilitates care
Nurse must maintain constant traction (no interruption in weights)
Traction Line of Pull
Direction of pulling force (nothing should be interrupting it)
External Fixators (Ex-Fix)
Screws are placed into the bone above and below the fracture and device is attached to the screws from outside the skin
Patient is not confined to bed
External Fixation / Skeletal Traction: The concern
Break in skin integrity is concerning because of the risk for infection
WE SHOULD AWLAYS ASSESS THE PIN SITE
Pin Site Assessment
Asses for pin loosening
Assess for infection
Meticulous pin care
Meticulous Pin Care
1/2 peroxide and 1/2 NS and cleaning with sterile q-tip
Avoid ointments (they attract bacteria)
Avoid Touching Site
