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

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

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.

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.

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.

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

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”

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

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

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

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.

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

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