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 Us! What we do! Apply splint correctly Collaboration with the Docs! Monitor neurovascular status.

The 6 P’s of extremity assessment Pain: Palpate the entire extremity for increase pain Pallor: Note color and temperature and capillary refill Pulses: Palpate proximal and distal pulses 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

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.