Splinting in the Emergency Room

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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

What we do!

Collaboration with the Docs!

• Monitor neurovascular status.

The 6 P’s of extremity assessment
Pain: Palpate the entire extremity for increase pain Paresthesia: Assess for burning, tingling, numbness Pallor: Note color and temperature and capillary refill Paralysis: Assess motor function (both active and passive Pulses: Palpate proximal and distal pulses 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.

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