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Splinting

Clinical Indications: Last update 02/2009

    Immobilization of an extremity for transport, either due to suspected fracture, sprain, or injury.
    Immobilization of an extremity for transport to secure medically necessary devices such as intravenous catheters

Procedure:

    1. Assess and document pulses, sensation, and motor function prior to placement of the splint. If no pulses are present and a fracture is suspected, consider reduction of the fracture prior to placement of the splint.

    2. Remove all clothing and Jewlery from the extremity and place it in a secure area and return to patient and document.

    3. Select a site to secure the splint both proximal and distal to the area of suspected injury, or the area where the medical device will be placed.

    4. Do not secure the splint directly over the injury or device.

    5. Place the splint and secure with Velcro, straps, or bandage material (e.g., kling, kerlex, cloth bandage, etc.) depending on the splint manufacturer and design.

    6. Document pulses, sensation, and motor function after placement of the splint. If there has been a deterioration in any of these 3 parameters, remove the splint and reassess

    7. If a femur fracture is suspected and there is no evidence of pelvic fracture or instability, the following procedure may be followed for placement of a femoral traction splint:
    Assess neurovascular function as in #1 above.
    Place the ankle device over the ankle.
    Place the proximal end of the traction splint on the posterior side of the affected
    extremity, being careful to avoid placing too much pressure on genitalia or open
    wounds. Make certain the splint extends proximal to the suspected fracture. If the
    splint will not extend in such a manner, reassess possible involvement of the pelvis
    Extend the distal end of the splint at least 6 inches beyond the foot.
    Attach the ankle device to the traction crank.
    Twist until moderate resistance is met.
    Reassess alignment, pulses, sensation, and motor function. If there has been
    deterioration in any of these 3 parameters, release traction and reassess.

    8. Document the time, type of splint, and the pre and post assessment of pulse, sensation, and
    motor function in the patient care report (PCR).

Competency Based Skill Requirements:

    Maintain knowledge of the indications, contraindications, technique, and possible complications of the procedure. Assessment of this knowledge may be accomplished via quality assurance mechanisms, classroom demonstrations, skills stations, or other mechanisms as deemed appropriate by the local EMS System.

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