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(IMMOBILIZATION DEVICES)
BY:
SUSIE MAY D. JARDIO RN, RM, MSN
TRACTION
Is the act of pulling and drawing which is associated with counter traction.
TYPES OF TRACTION
1. FIXED the traction is applied against a counter force while the pull is continuous and intact. ex. HARE traction used by paramedics during rescues. 2. SLIDING - the patient's weight is balanced against an applied load making use of the gravitational pull to counter balance the applied traction. ex. Crutchfield tong while the bed is tilted by shock blocks.
1. 2. 3. 4. 5. 6.
PRINCIPLES OF TRACTION
1. Patient should be on a dorsal recumbent position. 2. Line of pull should be in line with the deformity. 3. Should always be continuous, emphasize the importance of manual traction. 4. Avoid friction. 5. Provide counter traction.
TRACTION EQUIPMENTS
1. 2. 3. 4. 5. Thomas Splint with Pearson Attachment Rest Splint 5 Slings of variable sizes 5 Paper clips or safety pins Cord Sash different length short for the thigh long for the traction longest for the suspension 6. Weights and Bags Suspension weight is lighter than the weight of the traction. 7. Foot Support to prevent foot drop.
4. Mount the Thomas Splint and Pearson Attachment on the Rest Splint. Splint. 5. Tie the short rope on the medial upright of the Thomas Splint with a slip knot. 6. Attach slings to the Thomas Splint and Pearson Attachment. 7. Apply manual traction on the affected leg. 8. Instruct the patient to flex the unaffected leg and hold on to the overhead trapeze. 9. Insertion of the apparatus under the affected knee with the help of assistants. 10. Apply the Traction Weight. 11. Apply Suspension Traction. 12. Remove the Rest Splint. 13. Apply Foot Support. 14. Check the Principles of Traction
3 MANPOWER NEEDED
1. To insert the whole apparatus under the affected extremity. 2. Manual traction to be released after the completion of the traction weight on the third (3rd) pulley. 3. To lift the affected extremity, simultaneous at the count of three (3).
REMOVAL OF TRACTION
1. Apply rest splint. 2. Hang suspension weight on the first (1st) pulley. 3. Complete removal of suspension weight. Remove the knot on the Pearson attachment and Thomas splint. 4. Manual traction on the Steinman pin holder, remove the traction weight on the third (3rd) pulley, secure the traction rope on the rest splint another on the Thomas splint and Pearson attachment.
3. Potential complications: complications: a. Upper respiratory - PNEUMONIA bronchial taping and deep breathing. b. Bedsore good perineal care, proper skin care, turning left buttocks once in a while. c. Urinary and kidney problem good perineal care, increase fluid intake. d. Bowel complication fear of apparatus, no privacy, lack of fluids, perineal care. e. Pin site infection observe for s/sx of infection, loosening pin tract, pus coming out, foul smelling, fever. - aseptic technique and proper referral to DIC. f. Deformity contracted knee, atrophy of muscles, foot drop, joint contractures.
4. Provision of Exercises
a. ROM exercises with the use of trapeze. b. Deep breathing exercises. c. Static quadriceps exercises, alternate contractions and relaxation of quadriceps muscles. d. Toes pedal exercises. 5. Nutritional Status depending on the status of patient. 6. Psychological Aspect fear of unknown, fear of death, fear of the apparatus, fear of losing job, financial fear. 7. Provision of supportive therapy offer book to read, something to listen radio or television, discover interest. 8. Spiritual Aspect know his religion, encourage relatives to give spiritual, communication, visiting chaplain. 9. Diversional activities divert attention.
INDICATIONS For Scoliosis For Severe Scoliosis Congenital hip dislocation, fracture of femur for children ages 0 to 6 years old. Post-poliomyelitis with residual paralysis
TRACTION 10. Ninety Degrees Traction 11. Stove-In Chest Traction 12. Hammock Suspension Traction
INDICATIONS Fracture of the femur Severe chest injury with multiple rib fracture Pelvic affection
4. Taylor Brace
BRACES 5. Jewett Brace 6.Chair-Back Brace 7. Banjo Splint 8. Bilateral Leg Brace 9. Dennis Browne Splint
INDICATIONS Lower Thoracic affection Lumbo-Sacral affection Peripheral Nerve Injury Post-poliomyelitis with residuals Clubfoot Deformity
BRACES
INDICATIONS Wrist Drop Polio (one leg affection) Fracture of Finger Cervical Affection Scoliosis
10. Cock-up Splint 11. Unilateral Leg Brace 12. Lively Finger Sprint 13. Philadelphia Brace 14. Yamamoto Brace
CASTS AND MOLDS 1. Rizzers Jacket Cast 2. Minerva Cast 3. 4. 5. 6. 7. Collar Cast Body Cast Pantalon Cast 1 Hip Spica Cast Double Hip Spica Cast
INDICATIONS Scoliosis Upper Dorsal Cervical Spine affection Cervical Spine affection Lumbar Spine affection Pelvic Bone fracture Hip and Femur affection
CASTS AND MOLDS 8. Single Hip Spica Cast 9. 1 Hip Spica Mold 10. Double Hip Spica Mold 11. Single Hip Spica Mold
INDICATIONS Hip and one femur fracture Hip and femur with compound affection Pelvic affection with callus formation Pelvic bone fracture with callus formation
CASTS AND MOLDS 12. Frog Cast 13. Cylinder Cast 14. Short Leg Circular Cast 15. Long Leg Circular Cast
INDICATIONS Congenital Hip Dislocation Fracture of Patella Fracture of ankle, tarsals and metatarsals For affections of tibiafibula
CASTS AND MOLDS 16. Patellar Tendon Bearing Cast 17. Quadrilateral Cast (Ischial Weight Bearing Cast) 18. Long Leg Posterior Mold
INDICATIONS Fracture of tibia-fibula with callus formation. For affection of femur with callus formation. For fracture of tibiafibula with open wound, swelling and infection.
CASTS AND MOLDS 19. Night Splint 20. Basket Cast 21. Short Leg Posterior Mold
INDICATIONS Post-polio For Massive Bone Injury Fracture of ankle, tarsal, and metatarsal with open wound, swelling or infection. Fracture of the distal third of tibia. Post Hip Surgery Affection of distal third of femur with callus formation.
22. Delvit Cast 23. Internal Rotator Board 24. Brace Cast
CASTS AND MOLDS 25. Short Arm Circular Cast 26. Short Arm Posterior Mold 27. Long Arm Circular Cast 28. Long Arm Posterior Mold
INDICATIONS Fracture of wrist, carpals, and metacarpals. Wrist, carpals, and metacarpals with open wound, swelling or infection. Fracture of radius ulna Radius ulna affection with open wound, swelling or infection.
CASTS AND MOLDS 29. Munsters or Fuenters Cast 30. Hanging Cast 31. Functional Cast 32. Shoulder Spica Cast
INDICATIONS Fracture of radius ulna with callus formation. Shaft of the Humerus Shaft of the Humerus with callus formation. Affections of outer portion of humerus and shoulder joints. Neck of the humerus Affections.
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