1. THE BASICS OF ORTHOPEDIC SPLINTING
School Nurse Survival Training Conference
July 26 & 27th, 2018

2. Erica Asher, ATC John Runde, MS, ATC
Lead Orthopedic Technician, Center for Advanced Medicine South County
John Runde, MS, ATC
Orthopedic Technician II

3. WHEN AND WHY DO YOU APPLY A SPLINT
ANY SUSPECTED FRACTURE SHOULD ALWAYS BE SPLINTED BEFORE THE PATIENT IS MOVED.
THE PURPOSE OF AN INITIAL SPLINT IS TO STABILIZE THE FRACTURE AND GET THE PATIENT TO A SAFE AREA WHERE THEY NEED TO BE SEEN BY A MEDICAL PROFESSIONAL.

4. BASIC SPLINTING PRINCIPLES
DO WHAT YOU FEEL IS RIGHT AND LISTEN TO YOUR PATIENT
ALWAYS SPLINT IN THE POSITION THE FRACTURE PRESENTS ITSELF
IF THE PATIENT IS IN TOO MUCH PAIN, DO NOT MOVE THE PATIENT, CALL 911 AND WAIT FOR EMERGENCY PERSONAL
DOCUMENT YOUR INITIAL OBSERVATIONS
SUPPORT THE LIMB ABOVE AND BELOW THE JOINT
DO NOT WRAP THE INJURED LIMB TOO TIGHTLY
CONSISTANTLY MONITOR PULSES, MOTOR FUNCTION AND SENSORY FUNCTION
REMOVE ALL JEWLERY
SUSPECTED FEMUR FRACTURE-Call 911 immediately. Patient needs to be transported immediately because of the possibility of severe vascular injury and the loss of substantial amounts of blood.

5. ORTHOPEDIC SUPPLIES KNOW WHAT YOU HAVE ON HAND
BE CREATIVE AND BE PREPARED TO IMPROVISE
CREATE RELATIONSHIPS WITH YOUR LOCAL ORTHOPEDIC OFFICES WHO STOCK MEDICAL EQUIPMENT OR MEDICAL EQUIPMENT FACILITIIES IN THE AREA. MANY TIMES THEY HAVE EQUIPMENT THAT MAY BE AVAILABLE FOR DONATION.

6. IDEAL MATERIALS TO HAVE ON-HAND
Bandage Scissors
Tongue Depressors
Ace Bandages
Stockinette
Cotton/Webril
Foam and Felt
Orthoglass
Gloves
Plaster
SAM Splint
Bandage Tape
Arm Slings
Straight Knee Immobilizer
Walker Boot
Crutches or a walker- Available for transport

7. NON-TRADITIONAL MATERIALS FOR SPLINTING
Soccer shin-guard or shoulder Pad
Pieces of cardboard
Bandanas or strips of other cloth material
Pillows
Use non-injured body parts-“Buddy tape”

8. TYPES OF SPLINTS: PREPEARTION OF THE SPLINT
REMOVE ALL JEWLERY
REMOVE ALL RESTRICTIVE CLOTHING
GET THE PATIENT IN A COMFORTABLE POSITION-DO NOT MOVE THE INJURED LIMB
DRESS ANY OPEN WOUND
ACE BANDAGES HOLD A SPLINT-DO NOT USE FOR COMPRESSON

9. UPPER EXTREMITY
Volar-wrist sprain, lunate dislocation, 2nd-5th metacarpal head fracture
Ulnar Gutter-4th and 5th Metacarpal fractures
Thumb Spica-scaphoid, lunate fractures, ulnar collateral sprains

10. UPPER EXTREMITY
Posterior Elbow Splint-forearm and elbow fractures, distal humerus.
Sugar-tong splint-wrist and forearm fractures
Sling & Swathe – upper arm, shoulder and clavicle fractures

11. LOWER EXTERMITY
Posterior Leg Splint-ankle sprains, ankle dislocations, fractures of the distal leg, ankle, and foot, Achilles tendon rupture.
Posterior Leg Splint with Stirrup-provides greater stabilization for the injuries above and prevents inversion and eversion.
Long Leg Splint-Knee and upper leg injuries.

13. ROUTINE CARE AFTER SPLINT IS APPLIED AND PATIENT IS BEING TRANSPORTED
ELEVATE THE LIMB
CONTINUE TO EVALUATE DISTAL MOTOR FUNCTION, SENSORY FUNCTION, AND CAPILLARY REFILL
THE SPLINT SHOULD BE COMFORTABLE-LOOSEN ACE BANDAGE IF NEEDED
LISTEN TO WHAT THE PATIENT IS TELLING YOU

14. Washington University and Barnes-Jewish Orthopedic Injury Clinic
To better serve you, we offer two walk-in locations for urgent orthopedic care — in South County at I-55 and Butler Hill Road, and in Chesterfield at South Outer Forty Road and Timberlake Manor.
Monday-Thursday: noon-8pm Friday: noon-6pm Saturday: 8am-noon (Chesterfield only) Sunday: closed
For patients ages 5 and up, we specialize in treating: 
Sprains
Strains
Fractures
Minor dislocations
Sports injuries
Pain in the back, shoulder, elbow, hand, wrist, hip, knee, ankle or foot