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

Apply splint correctly

What we do!

Collaboration with the Docs!

Monitor neurovascular status.

The 6 Ps of extremity assessment

Pain: Palpate the entire extremity for increase pain Paresthesia: Assess for burning, tingling, numbness Pallor: Note color and temperature and capillary refill Paralysis: Assess motor function (both active and passive Pulses: Palpate proximal and distal pulses 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 Two types: radial and ulnar

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 Ps 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.