Lab - Splinting and Immob Flashcards
4 whys of splinting
decrease pain and minimize discomfort
decrease tissue damage
minimize effects of associated injuries (bleeding)
prevent closed fractures from opening
2 types of splints
rigid splints - non-yielding, max support
soft splints - conforming, less stable
When do you splint?
when in doubt - before moving the patient
Only splint
if you can do so without causing more pain and discomfort
How to splint
immobilize the joints above and below the injury site
What to do before and after splinting
check for circulation and sensation
Severely angulated fractures - 3
potential medical emergency - compromising circulation/nerve function
gentle traction to incorporate limb into a splint - or give pulse to distal limb
an obvious fracture with deformity may be straightened if:
it doesn’t significantly increase the pain
no resistance to the correction
Before applying the splint
cover all wounds with a sterile dressing
Neck and spine injuries
correct deformity only as much as is necessary to eliminate airway obstruction after first having attempted to clear the obstruction without moving the cervical spine
Open fractures
avoid reducing them, if done inadvertently notify the physician
Splint so that
there is easy access to distal pulse - toes, fingers…
Advantages and disadvantages of rigid splints
non-yielding, max support
may be difficult to position
Advantages and disadvantages of soft splints
able to conform
less stable than rigid, air splints may deflate/change pressure
3 types of splints
rigid, soft, air
air spint
air filled double walled tube
3 rules of air splints
inflate by mouth only
changes in air temp - check splint pressure and adjust accordingly
if splint is on for a long time, put in rest period
3 advantages of air splints
applies uniform contact
applies gentle, diffuse pressure
x-rays can penetrate
Proper application of splint - 3
requires 2 people
1 gently stabilizes and supports the limb and the fracture site
2 places splinting device and pads area to ensure even pressure/contact and protect bony prominence
2 applies the straps to secure the splint
if bandages or cravats are used when applying a splint -
applied above and below the fracture site
if splint size permits, bandage should be applied at the top and bottom of splint
tied away from fracture
do not apply the the bandage directly over fracture
padding should accompany
application of rigid splints
Emergency care of fracture
monitor a patient with a fracture/dislocation for loss of pulse, numbness/paralysis below the injured site
4 critical signs of fracture
no pulse/change in pulse
extremity may feel cold
change in skin colour
no sensation
ecchymosis
discoloration of the skin from bleeding underneath
6 steps of fracture examination
Palpate the bones
tap test and indirect compression test if one is negative
palpate surround bone, joint and soft tissue
assess sensory
assess circulation
assess function
Where to splint and procedure after
on the field
transport to sidelines, monitor vitals, assess for shock while awaiting EMS
may decide how and where to transport - hospital, team physician
suspected cervical fracture
check myotomes and dermatomes if time permits, type and severity of injury affects decision of immobilizing/transport
After fracture/dislocation of emergency situation is ruled out..
finish assessment ending with palpation of soft tissue
- active/passive ROM
- resisted
- special tests
- palpation
special test for GH dislocation
spprehension and relocation test, load and shift and sulcus test
special test for ankle injury
ant drawer
