yup, no traction, the extra length will not fit in the aircraft. Adjust Splint. later OSUdoc08 Membership Revoked Removed Please submit your request for a specific topic. I recommend that the results of this study be taken to heart and used to help persuade EMS programs to get religious about recording complete vital signs and leaving the run sheet at the trauma center every time a patient is delivered. These cases were less likely to involve penetrating injuries and more likely to involve car or motorcycle crashes. I too have used it about 2-3 times. Its metal, after all. Describe the functions of the muscular system. We present a case of skin complication. and Check for a pulse distal to the injury. and More info Close info. Correspondence: Joshua Nackenson, MD, NRP University of Texas Southwestern Medical Center Department of Emergency Medicine Dallas, Texas USA E-mail: World Association for Disaster and Emergency Medicine 2017. wowI must be getting old.was taught mast use for trauma in my emt-p program but used only occassionally in the field as they were starting to phase out in the early 90's can't say i agree with just giving high doses of narcs to cover up something that you can fix temporarily (pain anyway) with a traction splint. Indications EMR: Open or closed mid-shaft fractures of the femur in patients who are otherwise clinically stable Obtain Assistant. but, if you are in an aircraft and can't then i guess you can't, but I think you would agree that most of EMS is done on the ground. They consist of other injuries or fractures that could sustain further damage from traction. When a ratchet mechanism is used, do not apply undue traction to the. Division, Brookside Associates, Ltd. All rights reserved, These Nursing411 wings No patient should leave your trauma resuscitation room without splinting of all major fractures. Shannon, Brendan One reader has asked about thetiming of removalof these devices after they arrive at the hospital. In the 1960s, Glen Hare developed Hare traction splint, modifying full ring Thomas splint into half-ring splint by incorporating a ratchet mechanism with additional length adjustment mechanisms and improving the ischial pad. The vessels are small, and high image quality is extremely important. This is very interesting information for prehospital and ED providers. Add to Cart. Apply the Ankle Hitch to the Boot. Then grip the casualty's ankle and foot as shown in figure 3-1. Cant the splint degrade x-rays and hamper interpretation of the fracture images? Unfortunately, when it comes to removal, there are very few guidelines out there. Have the assistant position himself at the casualty's injured thigh and gently support the thigh above and below the fracture site. Procedural Protocols. 0000064709 00000 n Am J Emerg Med, 19:137-140, 2001. The initial response may be that the patient was sicker, and so they needed more intense care during transport with less time to record vitals. o. Questionable boast of an indispensable tool, American Academy of Pediatrics, American College of Emergency Physicians, American College of Surgeons Committee on Trauma, et al, Transient peroneal nerve palsies from injuries placed in traction splints, Thomas splint, calcaneus fracture, and compartment syndrome of the foot: a case report, Prehospital mid-thigh trauma and traction splint use: recommendations for treatment protocols, Femur fracture immobilization with traction splints in multi-system trauma patients, Significant rate of misuse of the hare traction splint for children with femoral shaft fractures, Early versus delayed application of Thomas splints in patients with isolated femur shaft fractures: the benefits quantified, A comparison between the effects of simple and traction splints on pain intensity in patients with femur fractures, The Thomas splint--a necessary tool in the management of battlefield injuries, National Association of Emergency Medical Technicians, American Academy of Orthopedic Surgeons, (AAOS), Nancy Carolines Emergency Care in the Streets, Population-based epidemiology of femur shaft fractures. The ischial ring of the splint should be seated where the thigh joins the buttocks (on the ischial tuberosity). Reference: Lack of Emergency Medical Services documentation is associated with poor patient outcomes: a validation of audit filters for prehospital trauma care. Most importantly . Traction splints are widely used for immobilisation of fractures of the lower limb. Instruct the assistant in his functions and provide help as needed. Hold all three straps in place. Ensure the distal secure is attached to the splint. A Descriptive Analysis of Traction Splint Utilization and IV Analgesia by Emergency Medical Services.Prehosp Disaster Med. trailer 877 42 Application of traction splints to the femur can be a bit tricky, mostly because of the various indications and contraindications. Forget the indications and contraindications. For a better experience, please enable JavaScript in your browser before proceeding. Description. one of those that I particularly remember was an 18 year old high school baseball player who suddenly stopped weird and broke his femur (freak accident). 0000001893 00000 n (A) Ratchet Traction Device Strap W S/Hook, Adult/Pediatric each. 1) Analgesia. d. The Sager traction splint is a unipolar split that can be used to align femur fractures. In 7 years I've used a hare traction splint for closed femur fractures maybe 3-5 times. Self-launch should never happen. startxref Traction Splints - Contraindications . Then grip the casualty's ankle and foot as shown in figure 3-1. View all Google Scholar citations 2021. 0000032106 00000 n Content may require purchase if you do not have access. Category: Splints. In any case,the objective is to minimize the total amount of time in the traction splint to avoid any further injury to other structures. Indications A suspected or obvious isolated fracture of the midshaft femur is an indication for traction splint. NackensonJ, BaezAA, MeizosoJP. ", (2) Crisscross the side straps high over the casualty's instep so the straps form an "X.". spine board makes the ultimate total body splint if done correctly. If I have the time and I think it would benefit the patient.then go for it. Hare Traction Splint. contraindications to traction splint placement are fractures that involve the knee, pelvis, or ankle, or that include damage to the sciatic nerve. EN. Secure Velcro Support Straps. EMS policy and the trauma center verification process requires that all trauma patients delivered to a trauma center must have a copy of the EMS run sheet. EQUIPMENT Feature Flags: { II. Expose the injured leg completely; examine the leg, check for pedal pulses, motor and sensory function. Item #600220. Specifically, these include: Unfortunately, when it comes to removal, there are very few guidelines out there. The splint has five straps, the ischial (top) strap and four Velcro leg support straps. The Hare traction splint can be applied by two people. Monitoring & Diagnostics. From field to hospital: When applied, Sager Splint model SX404 is radiolucent to all areas of a femoral fracture. They consist of other injuries or fractures that could sustain further damage from traction. And on the lateral view, the splint is well posterior to bones. yay! INDICATION Stabilizing an isolated femur fracture prior to definitive care. Get quality hare traction splint indications and contraindications at Alibaba.com at competitive prices. Hare Traction Splints. CAUTION: In the following instructions, the person helping you will be identified as the assistant. It reduces pain, bleeding, and soft tissue injury, and can keep a closed fracture from becoming an open one. Do not cause additional injury by removing it prior to imaging, either CT or conventional x-ray. 0000003835 00000 n They recommend that this be used to focus performance improvement efforts and hopefully improve survival. Statistically significant differences were found in the utilization of a TS and IV analgesia administration in the setting of blunt trauma when compared to penetrating trauma. Position yourself next to the casualty's injured leg at the tibial area. Indications Femoral shaft fracture Femoral traction splints are used to stabilize femur fractures prior to definitive care (eg, operative fixation). Assess injured limbs colour, warmth, movement and sensation. 0000031825 00000 n 0000010307 00000 n Unfortunately, there are lots of contraindications. This website is privately-held and not connected to any governmental agency. And in all cases, the splint should also be replaced immediately at the end of the study. Judge for yourself. Used it several times - all MVCs. A patented pulley system makes traction application easier than other devices, and a unique hitch allows use despite a foot amputation. View Hare traction splint 2 PowerPoint (PPT) presentations online in SlideServe. Click here or go to www.thetraumapro.com/ask. Femoral traction devices have been around for a long time. If you don't use a traction splint simply backboarding and whatever splints you have to immobilize would work. Locate Fracture Site. Upon recognizing the injury, Rescuer One should stabilize leg in. Of 134 blunt trauma patients, 50 (37.0%) were immobilized in traction, and of the 36 penetrating trauma victims, one (2.7%) was immobilized in traction. English Deutsch Franais Espaol Portugus Italiano Romn Nederlands Latina Dansk Svenska Norsk Magyar Bahasa Indonesia Trke Suomi Latvian Lithuanian esk Unknown The EMS patient care reports were assessed for physical exam findings and treatment modality. Original use of the traction splint, first popularized by Dr. Thomas during the First World War, included the use of the device for femur fractures resulting from gunshot wounds, which by definition are open fractures. NOTE: You will need to change your grip on the casualty's ankle and foot to allow the, assistant to apply the traction strap while you maintain your support. If the images are bad, then we risk having to give the patient another dose of both radiationand contrast. The most common physical exam finding was a deformity +/- shortening and rotation in 136 patients (80.0%), followed by gunshot wound (GSW) in 22 patients (13.0%), pain or tenderness in four patients (2.4%), and no findings consistent with femur fracture in three patients (1.7%). 0000001158 00000 n The QD-4 splint will adjust to accommodate pediatrics and adults. Heres a curbside consult from Peter Cole MD, Chief of Orthopaedics at Regions Hospital. There were 170 patients studied in the cohort. v) The elderly may not tolerate traction well, especially if there is a pre-existing condition such as arthritis or joint tenderness" 3. 0000075619 00000 n Buy hare traction splint indications and contraindications with amazing easy-to-use designs from trusted sellers. Demonstrate competency in applying a minimum of two (2) types of traction splints. Howland, Ian Ronald However, if its not covered by them, or you are getting concerned that the patients (or their legs) wellbeing is at risk, do the right thing! III. Step 15 Reassess PMSC's distal to injury on splinted leg. (4) Position the fourth leg support strap so it will secure the lower leg above the ankle. Data were analyzed descriptively and statistical differences were assessed using odds ratios and Z-score with significance set at P.05. There is an assistant. Bottom line:A perforated aluminum splint causes absolutely no artifact or image degradation. Howard, Ian Lucas BLS call for ALS assistance: This assist was called for in 17% of cases. Have the traction assistant apply the ankle hitch in the following manner: (1) Slide the three-ringed ankle strap under the heel of the casualty's boot with the padded side of the strap against the foot. Its been endorsed by the National Association of EMS Physicians and looks like a lot of thought has gone into it. 0000010930 00000 n Quantity. distributes medical information that may be useful to Description. Injury Severity Score was the same. Check for a pulse distal to the injury. Do not try to align the fracture fragments, anatomically. 0000002878 00000 n In 7 years I've used a hare traction splint for closed femur fractures maybe 3-5 times. Once the traction strap has been applied, do not release the traction. Other issues that may be a factor are EMS training and proficiency, leadership at the scene and enroute, and available staff and resources, among other things. New Products. ), The Thomas splint. Keep these tips in mind, but always adhere to your local protocols and procedures first. Unit of Measure Each . Contraindications Pelvic fracture They therefore concluded that simpler methods of immobilization with fewer complications may prove safer and equally effective, and when contraindications exist, the traction splints should be avoided. Once you have applied increased traction, maintain the traction. The hare traction splint is designed to be used on those patients. (1) Tighten the straps on the thigh above the fracture, on the thigh below the fracture, below the knee, and above the ankle. After, the strap is applied, your hands should be over the "X. Be sure to check out the upcoming 2014 conference materials at www.TETNG.org. The poor radiographic tech, who has no training in fracture immobilization and cant provide additional pain control on their own. I moved the blog to another site off of Tumblr several years ago. Emergency Disaster Support. iv) in the event of groin injury, the splint may be applied to the outside of the leg. The Trauma Professionals Blog has officially moved! Its length is adjustable via telescoping rods, and it has built-in straps to support the hip and leg at several points along its length. In my mind, this is a bit too simplistic. It is best to make an effort to splint the thigh and femur to the other leg. Hare Traction Splint Indications And Contraindications (1 products available) 1/6. Traction splinting has been proved to decrease morbidity and mortality in battlefield femur fractures. In the 1960s, Glen Hare developed Hare traction splint, modifying full ring Thomas splint into half-ring splint by incorporating a ratchet mechanism with additional length adjustment mechanisms and improving the ischial pad. Apply Manual Traction. Describe the functions of the skeletal system. 0000007095 00000 n English Deutsch Franais Espaol Portugus Italiano Romn Nederlands Latina Dansk Svenska Norsk Magyar Bahasa Indonesia Trke Suomi Latvian Lithuanian esk Unknown . Item #: 3020-27010. The set contains the metal Hare splint with straps and ratchet, an ankle hitch, padding materials, and a litter bar. Castle, Nicholas Raymond The views expressed here are those of the authors, and unless otherwise Hare Traction Splints. Contraindications for the use of traction splint: Injury is close to the knee Injury to the knee Injury to the hip Injury to the pelvis Partial amputation or avulsion with bone separation, distal limb is connected only by marginal tissue. The device has a traction unit at the ankle that should be applied first, before placement of the actual splint under the patient. m. Two parameters that are commonly used to monitor performance improvement (PI) in EMS are: The study looked at the impact of those criteria on patient survival. 0000006424 00000 n 6- 28 TRACTION SPLINTING NOTE: A traction splint is the splint of choice and is to be used only for a painful, swollen, deformed mid-thigh injury with NO lower leg injury. Item #600221. Most importantly, there is really only one indication for applying a traction splint to the femur: an isolated, relatively mid-shaft femur fracture. 2019. Your Price: Log in List Price: $239.99 EA. Specifically, these include: Pelvic or hip fracture (3) Bring the ends of the crisscrossed straps down to meet the center strap. (6) Position the splint next to the injured leg with the top of the splint even with the ischium on the casualty's injured side. In my mind, this is a bit too simplistic. It maintained bipolar traction with two steel rods on both sides of the limb. yup, no traction, the extra length will not fit in the aircraft. However, it mirrors what I see coming into our trauma center. JavaScript is disabled. 2008 Medical Education Once on the paid unit, we got to a call where the volleys had used a Sager on a guy - ~70, fell off a roof, open distal femur that had spiked into the ground (yeah, that's the image - guy upright from broken femur sticking into ground). Ltd., or any governmental or private organizations. transport from an e.r. Add to cart . Apply only enough traction, to align the limb to fit into the splint. The initial response may be that the patient was sicker, and so they needed more intense care during transport with less time to record vitals. The Hare traction splint can be applied by two people. Pharmaceuticals. g. Manually support and stabilize the injured limb to prevent any movement at the fracture site. 0000005158 00000 n Tan, Edward C.T.H. . CONDITION Apply a traction splint on a patient who has sustained an isolated mid-shaft femur fracture. The CT-6 is a Leg Traction Splint designed for Pre Hospital Care and Patient transport, specifically in combat scenarios. Although your friendly techs, radiologists, and orthopedic surgeons may moan, it wont hurt their ability to make decisions on the images. This study is the assessment of these injuries and the utilization of a traction splint (TS) in blunt and penetrating trauma, as well as intravenous (IV) analgesia utilization by Emergency Medical Services (EMS) in Miami, Florida (USA). This design allows the responder to elevate the leg and cradle it amongst the straps. All writings, discussions, Indications Femoral shaft fracture Femoral traction splints are used to stabilize femur fractures prior to definitive care (eg, operative fixation). NOTE: The information included below is designed to be used as a guide for an " Ischial" type traction splint. are people still using them for anything other than stabilization of multiple lower leg/pelvic fractures? noted, do not necessarily reflect the views of the Brookside Associates, Background. Figure 3-3. Applying a Hare Traction Splint (3 of 3) Connect loops of ankle hitch to end of splint as your partner continues traction. (B) Traction Splint, Ischial 2 Piece Strap, Pediatric, each. Instruct the assistant in his functions and provide help as needed. Compare. The necessary equipment will be adjacent to the patient or brought to the field setting. While maintaining traction, have the assistant use one hand to support the fracture site and slide the splint into position under the casualty's hip and limb with his other hand (see figure 3-4). Do not tighten the strap tight enough to impair circulation. In my mind, this is a bit too simplistic. Have the assistant release the ratchet, pull the traction strap over the top of the ratchet, and place the "S" hook so the hook hangs off the splint. IV & Drug Delivery. One reader has asked about the timing of removal of these devices after they arrive at the hospital. | PowerPoint PPT presentation | free to view . Traction though works really well though. I used the splint twice, once for a gsw and the other for a trampoline accident. There is brevity of evidence-based research on their efficacy. n. The Hare traction splint can be applied by two people. Render date: 2022-12-12T01:32:46.646Z Statistically significant differences were found in the application of a TS in blunt trauma when compared to penetrating trauma (OR=20.83; 95% CI, 2.77-156.8; P <.001). Bottom line: I have visited a number of states where EMS often does not leave their run sheet at all! Splinting techniques are used to treat musculoskeletal system abnormalities. Open femur fracture. The manufacturer's instructor manual for the Sager Traction Splint (page 36) offers the following contraindications: just used it for the first time, but not in the field. It is useful in certain situations, sometimes very. I have never used MAST trowsers in the field. Any femur fracture that has broken the skin What is a compound fracture? <]/Prev 218575/XRefStm 1535>> The STS applies traction from the hip and is infinitely adjustable. 2022. The Hare traction splint is a further adaptation of the Thomas splint. Product Features: . Consider appropriate analgesia. Not saying that anything is wrong with it though. "useRatesEcommerce": false What is the purpose of a traction splint? Place both hands under the casualty's thigh, one above the fracture site and one below the fracture site. Olaussen, Alexander He put them on a guy who cut his femoral with a chainsaw to get control of the bleed. I think it is great for helping to relieve pain of the bone fragments pulling towards one another by the huge hamstring and quad muscles. Equipment Buy Back Program. Currently, four traction splints that have been awarded NATO Stock Numbers are in use: the CT-6 Leg Splint, the Kendrick Traction Device (KTD), the REEL Splint (RS), and the Slishman Traction . A study looked at the impact of those criteria on patient survival. If I flew in a BK, sure, we could put one on if we had time. Sager Traction Splints are indicated in 93% of all femoral fractures (treats mid-shaft and proximal third fractures). Infection Control. I have never used it.but I am curious what you would do for a broken femur besides using the traction. Have the assistant open all five straps and position the four Velcro support straps in the following positions: (1) Position the first leg support strap (first strap below the ischial strap) so it will secure the thigh above the fracture site. 0000072356 00000 n They can help decide whether converting to some type of definitive traction is necessary, or whether it can be changed to a more conventional splint. (1) Have the assistant move to the ankle hitch and hold the traction straps again so that the three "D" rings are together. Thanks to Don Dustin from Mineral County EMS in Colorado for posing this question! And typically, when imaging an extremity with CT, we are looking at vascular runoff. You could see the spasms yield as we cranked on it. Traction is great for pain relief d/t quad contraction, and makes it easier to get the pt on a board like mentioned above, very very stable. Vttt-a2PB@BhnfaK "EO3Lggx&S\`e2%2na2b?V?#,gsT_!"@Ao3CA - b^ 5 controversy exists regarding whether a traction This video was presented at Trauma Education: The Next Generation last September. pretty cool call. Lack of EMS Documentation is Associated With Increased Mortality. But you certainly could if it were! Want to see a post on a specific topic? Regions is a Level I Adult Trauma Center, and has partnered with Gillette Children's Specialty Hospital to become the first Level I Pediatric Trauma Center in the Upper Midwest. (3) Bring the ischial strap over the top of the casualty's thigh; then secure and tighten the ischial strap (strap has a buckle). However, the software plug-in that accomplished that is not working so well, and cross-posts have become less and less frequent. (Log in options will check for institutional or personal access. The QD-4 splint will adjust to accommodate pediatrics and adults. Prepare splint [1]. Femoral Traction Splinting BLS PROCEDURE BP-08. It is the one thing besides childbirth that I have yet to do as an EMT. The medical leader secures the four Velcro support straps so the limb is securely held in the splint. Both the Sager and Hare traction splints apply that opposite force to the pelvis through either the Ischium or the pubic rami. } and Prepare Ratchet. The company that makes the Hare traction splint gives the sole indication as a suspected femur fracture, and the sole contraindication as an open femur fracture. Movement is the main cause of fracture related pain, hence why splinting is part of the routine care of almost all fractures. Model 441 is a combination kit containing a Model 443 pediatric splint and a Model 444 adult splint. Suspected femur fracture. Apply the support straps under calves, knees, thighs. Does volunteering as an EMT replace hospital volunteering? They found that the mortality in the group with missing data was over twice as high (10.3%) as it was in the group with complete date (4.5%). Most importantly, there is really only one indication for applying a traction splint to the femur: an isolated, relatively mid-shaft femur fracture. But does it really make a difference? Figure 3-1. Once the traction splint has been applied, the casualty is moved to the litter using the procedures given in paragraph 3-4. Documentation should be evaluated regularly, and all cases with any missing vital signs should be reviewed closely. I guess I"m just more interested in treating the source of their pain instead of just the pain. In any case, the objective is to minimize the total amount of time in the traction splint to avoid any further injury to other structures. So why does failure to record physiologic data translate into higher mortality? Has data issue: true Three studies used more than one type of traction splint, three exclusively used the Hare traction splint and two used the Thomas traction splint (Table 1). You have a simple tool; it's basically one of those steering wheel locks. Free Shipping Orders Over $100 Packaging. Effective Date: 04-01-2022 Revised Date: 04-01-2023 Page 1 of 1 . In the pre-hospital or austere setting, these benefits are much smaller and have a higher risk associated as well. However, there are a few more contraindications: What about the open fracture scenario? Overstretching the limb can cause further injury to the limb. Part 2: Metal Splints - Can You CT Scan Through Them? The STS was developed by Dr. Sam Slishman at the University of New Mexico to overcome many of the the operational difficulties of older traction splint designs. Hare Traction Splint Replacement Straps - ONLY. Trauma Center PI programs should work with EMS to analyze this data and look for the patterns that increase mortality. A fracture in which the bone has broken completely and pierced the skin Why would you NOT want to use a traction splint with exposed bone ends? This includes information on speaking engagements, full contact info, and access to my videos. e. A, After spontaneous . Ready Stock Medical Pinky Therapy Finger . I recommend that the results of this study be taken to heart and used to help persuade EMS programs to get religious about recording complete vital signs and leaving the run sheet at the trauma center every time a patient is delivered. More and more studies are now displaying that they do indeed aid in treatment if used properly with different protocols that as used at one time. hasContentIssue true. 0000000016 00000 n UPC 687299469062 . Eventual patientmortality was the samefor BLS calling ALS and ALS response alone. c. Most importantly . Femoral traction splinting may reduce pain and bleeding. Positioning the Hare splint under the casualty's limb. we ended looping it around the inside of the ankle cuff and attaching the hook to the bottom of the splint. $738.99 SKU SI008A Discount Code: Use code TAKE5 for 5% OFF Total Purchase. Check for a pulse distal to the injury. Some models do not have a ratchet mechanism to tighten the strap. 0000006451 00000 n Check the casualty's distal pulse. . endstream endobj 917 0 obj <>/Filter/FlateDecode/Index[29 848]/Length 48/Size 877/Type/XRef/W[1 1 1]>>stream (2) Slip the three "D" rings over the free end of the "S" hook. Specifically, these include: Pelvic or hip fracture 0000004013 00000 n Contraindications Fractures of ankle or foot His pain diminished considerably. d. Stabilize the Injured Leg. 0000072901 00000 n 0000047748 00000 n As you know, my mantra isquestion everything! Traction should only be released by a medical officer. If the strap is interfering with circulation, loosen the strap and check the pulse again. Pillay, Yugan They consist of other injuries or fractures that could sustain further damage from traction. My advice is to have your orthopedic surgeon evaluate as soon as imaging is complete. h1 0142hxvdtyC. As far as additional tissue damage, I would imaging it's pretty minimal. In the following instructions, the person helping you will be identified as the assistant. (1) Loosen the locking devices on the two metal rods of the splint so the bottom of the splint is free to slide. Why spend the extra time screwing around with the traction.get to the hospital. (2) Position the second leg support strap so it will secure the thigh below the fracture site. (4) Twist the center strap until it is even with the two side straps, all three straps can be firmly grasped, and the three "D" rings at the end of the straps are together (see figure 3-2). to another hospital, and the e.r. patients. Indications. Femoral traction devices have been around for a long time. 0 Students will learn the anatomy of musculoskeletal injuries, and will . (4) Check the casualty's distal pulse. 0000006288 00000 n Length is 5:23. The indications and contraindications listed above are only intended as a basic reference . Apply distal secure. Apply mechanical traction. 2017;32(6):631635. a. Differentiate between an open and closed painful, swollen, deformed extremity. The Slishman Traction Splint (STS) is an innovative traction device that solves many of the current problems with other tactical traction splints. View Product Details. Figure 3-2. 0000001734 00000 n 0000008788 00000 n In these situations, splinting the pelvis with a binder should be the priority, and the use of a traction splint is most likely contraindicated [7]. d. Stabilize the Injured Leg. The metal splint has a stirrup that lifts the splint off the ground. DynaMed HARE Traction Splints - SPLINT, TRACTION, DYNAMED, HARE, ANKLE STRAP - SI008A by Dyn-A-Med Products. The researchers speculate that documentation might be a good global measure of appropriate or inappropriate prehospital care that rolls all of these possible factors into one easily identifiable audit filter. %%EOF But what about imaging? 0000072643 00000 n The company that makes the Hare traction splint gives the sole indication as a suspected femur fracture, and the sole contraindication as an open femur fracture. Referring physician to receiving physician conversations must occur when considering transportation mode (air vs ground) for interfacility transfers, There must be good online medical direction from a physician, Offline medical direction must be based on protocols and policies developed by the, HEMS crews must have regular training opportunities. NOTE: Manual inline traction of the limb should be undertaken as soon as possible and . In the early 1900s, femur fractures were often fatal. There is only one true contraindication. (3) If the strap interferes with the blood circulation, loosen the strap and secure it again. Come to think of it, I've only known one person who ever used MAST. Not to be rude, but you obviously never seen air splints or know much about PASG. 2017. That' the way I do it. The Hare traction splint might split part of that applied force through the proxmial femur, but . Hare Traction - Putting It On, Taking It Off. Place Casualty on Litter. application of traction splints for femur fractures (open or closed) is likely not to impact patient outcome. she still had good PMS 30 minutes later, when we dropped her off. Continue to support the leg at the ankle until the remainder of the splint straps have been applied. Putting them in traction often eliminates much of the pain so you don't have to give them as much narcs. Traction splints may also reduce and/or decrease pain and bleeding due to femur fractures, particularly those that are shortened. For Hare Traction Splints: Shop Products. i. There are no contraindications. Metal Splints - Can You X-ray Through Them? Thats because it isnt there! Nackenson, Joshua Support the Lower Limb. Dress any open wounds on the leg before applying the traction splint. Traction Splints are used in prehospital care to immobilize and support fractures of a patient's femur. They found that 38% of patients had contraindications to traction use, most commonly a concomitant pelvis fracture. 0000008194 00000 n Inappropriate application Of the 10 studies included, seven discussed the application of the traction splint. Apply the Ischial Strap. Traction splinting has been the prehospital treatment of midshaft femur fracture as early as the battlefield of the First World War (1914-1918). No tractionmanage their pain. 19 yrs I have never used one. Apply proximal secure. Most importantly, there is reallyonly one indication for applying a traction splintto the femur: an isolated, relatively mid-shaft femur fracture. Hare Traction Splint. Log in for availability. Traction Splints - Contraindications . The Thomas Traction Splint, also commonly called the Thomas Half-Ring, was the first traction splint. So why does failure to record physiologic data translate into higher mortality? Other issues that may be a factor are EMS training and proficiency, leadership at the scene and enroute, and available staff and resources, among other things. 0000010761 00000 n accurate record of scene physiology (SBP, HR, RR, GCS), request by on-scene BLS for ALS assistance, Must utilize standardized field triage guidelines that should be applied consistently throughout your, Is blind to the insurance status of the patient. Hare traction splints. Look closely for the intimal flap in the image below: Cant see it? I agree that the traction splint should only be applied on femur fractures, known or suspected. It is primarily used on patients with mid-line femur fractures. Applying manual traction and lifting the leg. Apply sufficient traction to stabilize the leg to prevent movement at the site of the fracture. b. Partial breech extraction. EN. However, there are two scenarios when applying traction to an open femur fracture is warranted: Bottom line: Treat traction splints with respect. In my last post, I debunked the myth that using a pre-formed aluminum splint significantly degrades the quality of standard x-rays. Traction Splints. 0000007731 00000 n 3020-27010. Most importantly, there is really only one indication for applying a traction splint to the femur: an isolated, relatively mid-shaft femur fracture. kiel tutin kpop choreography list; show numbers in different ways worksheet; how to get into football manager; san bernardino county probation department phone number Unfortunately, there are lots of contraindications . Replacement Strap, Ankle, Adult, For Hare Traction Splint.1/EASI006. So i scouted around and found some images to share using one of these splints. Have used it.but not any more..a couple hundred mcgs of fentanyl usually does the job. These cases were less likely to involve penetrating injuries and more likely to involve car or motorcycle crashes. Load and go. Objectives (1 of 2). All resources are student and donor supported. In this situation, Sager Splints may be applied over MAST Trousers if treatment of the fractured Femur is indicated or desired. Place the bottom edge of the heel even with the lower edge of the sponge padding as shown in figure 3-1. 0000010553 00000 n Replacement Strap, Ankle, Adult, for Hare Traction Splint. A total of 4744 patients from the National Trauma Data Bank were analyzed. Apply increased gentle, longitudinal manual traction to the casualty's limb. who have suffered a suspected femur fracture. Absolute contraindications for traction splinting include: Fractures of ankle or foot and Partial amputation or avulsion with bone separation while only marginal tissue connects the distal limb. You are using an out of date browser. As you perform your survey of the casualty, cut or tear the pants leg to expose the injury and locate the site of the fracture. Obtain the Hare traction splint set. Position at medial side of injured leg. Additional exclusions were made in any prehospital care report that documented contraindications to the placement of traction: suspected fracture or injury to the pelvis, knee, lower leg, ankle, and/or foot. Femur traction is applied through the extension . All worked very well and it was very easy to apply. Documentation should be evaluated regularly, and all cases with any missing vital signs should be reviewed closely. All worked very well and it was very easy to apply. It was invented by Dr. Hugh Owen Thomas . 0000004400 00000 n A total of 4744 patients from the National Trauma Data Bank were analyzed. Applying mechanical traction with the Hare splint. medical professionals and those in training to become medical professionals. Create new Reorder List . Have the assistant adjust the telescoping splint to the right length and lock the rod in place using the following steps. In unison with the assistant, lift the casualty's injured leg so the splint can be slipped beneath the leg (see figure 3-3). . Splinting is an important part of the trauma resuscitation process. Davis, Samantha J Trauma 75(4):734-741, 2013. Mobilization splints using elastic traction are used to minimize joint contractures, to position joints, or to aid in postoperative positioning. Especially those pre-formed aluminum ones with the holes in them? The concern is that contaminated bone will be pulled back into the wound. However, the researchers controlled for this and found it was not a factor. There are several contraindications to the use of traction splints: -The patient has an open fracture -The patient has a suspected spinal injury -The patient has a suspected pelvic fracture -The patient has a suspected hip fracture -The patient has a suspected femur fracture -The patient has a suspected knee fracture thought those were a thing of the past. Controlled Substance Ordering. f. Unfortunately, there arelots of contraindications. A Descriptive Analysis of Traction Splint Utilization University of Texas Southwestern Medical Center Department of Emergency Medicine, Dallas, TexasUSA, Kings County Hospital/SUNY Downstate Department of Emergency Medicine, Brooklyn, New YorkUSA, University of Miami/Jackson Memorial Medical Center, Ryder Trauma Center, DeWitt Daughtry Family Department of Surgery, Miami, FloridaUSA, https://doi.org/10.1017/S1049023X17006859, Get access to the full version of this content by using one of the access options below. 0000009299 00000 n This is a retrospective study of patients who sustained a midshaft femur fracture in the absence of multiple other severe injuries or severe physiologic derangement, as defined by an injury severity score (ISS) <20 and a triage revised trauma score (T-RTS)10, who presented to an urban, Level 1 trauma center between September 2008 and September 2013. Reference:Lack of Emergency Medical Services documentation is associated with poor patient outcomes: a validation of audit filters for prehospital trauma care. I agree that the traction splint should only be applied on femur fractures, known or suspected. Traction splints may also reduce and/or decrease pain and bleeding due to femur fractures, particularly those that are shortened. I am more concerned about managing their pain. Proper splinting increases arterial blood flow, decreases pain and spasm, and lowers the risk of further injury from bone fragments. 0000001535 00000 n It has become an industry standard for patients requiring Hare style traction splinting. 877 0 obj <> endobj There are several different types of commercially made traction splints available. incorporate the white heart of international nursing with the. In some cases, CT scan may be more helpful and does not require splint removal. The It is written by Michael McGonigal MD, the Director of Trauma Services at Regions Hospital in St. Paul, MN. 0000064544 00000 n 37 unfortunately, such comorbidities are common with severe wilderness injuries, which makes it impossible or dangerous to anchor the traction splint. Brookside Associates Medical Education Division develops and The Trauma Professional's Blog provides information on injury-related topics to trauma professionals. Apply manual stabilization Published online by Cambridge University Press: Measure CSM and verbalize no contraindications. One of the most common types of traction splints is the Hare splint, which features metal rods with a series of adjustable straps for security. limb. FernoTrac Splints (splints) are traction splints designed to immobilize and provide traction for a patient's leg. Open and Position Support Straps. I agree that the traction splint should only be applied on femur fractures, known or suspected. (4) Once the traction has been applied by the traction strap, you can lean forward and relax your manual traction. To view the Terms of Service for this site, click here. A Sager Emergency Traction Splint is not contraindicated when MAST Trousers are used to immobilize the fractured Pelvis. The CT-6 helps relieve patient pain and prevents further damage to surrounding muscle and tissue while reducing the risk of death caused from severed arteries. We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Hare traction splints are used in the field or the emergency department for stabilization of femur fractures or subtrochanteric hip fractures and for transport to centers for definitive care. 15 August 2017. As posts were added to that site, they were usually cross-posted here. Although signs of femur fracture are recognized in the majority of cases of midshaft femur fracture, only 30% of patients were immobilized using a TS. If you want to use it, do. Have the assistant perform the following steps. SKU 600200 . All of my content is housed there, including a lot of material that never made its way to this site. Many would say its better pain relief than the amount of morphine you could give in the field. They can help decide whether converting to some type of definitive traction is necessary, or whether it can be changed to a more conventional splint. Instruct the assistant in his functions and provide help as needed. Explain the procedure to the patient. Applying a Sager Traction Splint (1 of 3) Expose the injured extremity and check pulse, motor, and sensory function. l. back in the day we used to use mast pants with a hare traction splint over them to stabilize femur or hip fx. Here are the factoids about the HEMS guidelines: Bottom line: We absolutely must take a critical look at our patient transport practices and procedures. In Stock. Please change your bookmarks so you can take advantage of the extra features found only on TheTraumaPro.com. -When Hare traction splints are properly applied, the patients foot should be upright with pain level decreased. Estimate the proper splint length. spine board makes the ultimate total body splint if done correctly. california emt-p aa degree able to use towards a 4 year? j. Lower leg or ankle injury Take appropriate body substance isolation precautions. Traction splints interfere with many litters, are by design only useable for 1 type of injury, and require a significant amount of highly specific training. You can also email me at TheTraumaPro@gmail.com. BLS call for ALS assistance: This assist was called for in 17% of cases. 0000032624 00000 n Adjust splint length. (5) Test the splint to make sure the lower part of the splint is securely locked and will not slip. Of 4,513 EMS runs, only 16 had mid-thigh trauma and 5 of these appeared to have a femur fracture. did not have a traction splint. Trauma Center PI programs should work with EMS to analyze this data and look for the patterns that increase mortality. The Velcro straps provide support for the leg and secure the leg to the splint. Of these patients, victims of blunt trauma were more likely to receive IV analgesia (OR=6.23; 95% CI, 1.42-27.41; P=.0067). Manufacturer Dick Medical Supply . The company that makes the Hare traction splint gives the sole indication as a suspected femur fracture, and the sole contraindication as an open femur fracture. Here are some knee images with one of these splints on: Amazingly, this thin aluminum shows up only faintly. 0000073249 00000 n $33.44. Item #600230. 0000005696 00000 n 0000002737 00000 n Specifically, these include: I did find one interesting study from 1999 that looked at how useful these splints really were. Hostname: page-component-5959bf8d4d-m7p82 Meizoso, Jonathan P. I have used it only a couple of times for isolated injuries.If they are in a bad car wreck or fall.Time is Golden as we all know. for this article. Contraindications. After the limb is in position, have the assistant remove the hand supporting the fracture site and prepare to secure the limb to the splint. I learned a number of things while reviewing the literature to answer this question. xref Close this message to accept cookies or find out how to manage your cookie settings. However, the researchers controlled for this and found it was not a factor. it worked, but caused the strap to push down on the foot. A study of elastic mobilization splinting in 51 nonsurgical rheumatoid arthritic patients done by Convery et al.7,8 and Li-Tsang et al.21 suggested that hand function was not improved and the . Injury Severity Score was the same. Slishman Traction Splint, Compact (STS-C) By: TRI-TECH FORENSICS INC. The one patient I have ever had with a broken femur also had knee involvement and it was contraindicated. I've never worked for a place that had MAST pants on the rigs. until the splint is in place and providing the traction. 0000003389 00000 n Positioning the ankle hitch of a Hare splint. (2) Place padding around the groin area and where the ischial strap will cross the thigh. Apply Traction Using the Splint. But what about a study that provides much more detail, such as CT scan? i remembered it well enough from class to use save one problem: there was no ring on the ankle cuff upon which to latch the hook (that is, the hook attached to the strap connected to the crank). Adjust the thigh strap of the splint. 0000004891 00000 n The population was dichotomized between trauma type: blunt versus penetrating. The main indications for splinting are to temporarily immobilize a limb for pain and spasm, to decrease swelling, and to minimize further potential soft-tissue or neurovascular injuries associated with contusions, sprains, lacerations, fractures . Carefully tighten ratchet to the point that 4.25.2 Hare Traction Splint Expose the injured area. Adult and Pediatric Sizes Available. NOTE: Traction and lift can be applied by leaning back. (2) Lay the splint parallel to the casualty's uninjured leg with the top of the splint even with the bottom of the casualty's buttocks (at the ischium). As such, they have a much broader range of application and use than other traction splints. Place the splint along the inner thigh. Lower Leg Into Splint. h. -Compare to original findings and note any changes. Ludick, Beverley Dawn In the end, I'm not saying that traction splinting isn't without benefits. Contraindications Pelvic fracture Quantity Quantity. Ankle hitch applied to the casualty. Traction splints may also be used in ankle and knee injuries. If the fracture pattern is complex, it may be helpful to temporarily remove it, but this should only be done by a physician who can ensure the fracture site is handled properly. Airway & Oxygen Delivery. Are Femoral Traction Splints Okay In Open Fractures? It also provides a more comfortable ankle strap and a small winch that makes it much easier to apply and adjust traction force. Indications Suspected femur fracture Contraindications The injury is within 1-2 of the knee or ankle The knee is injured The hip is injured The pelvis is injured 0000064614 00000 n Obtain Splint. Intravenous analgesia was administered to treat pain in only 35 (22.0%) of the patients who had obtainable IV access. Continue providing support and stabilization as the traction assistant applies the ankle hitch and splint. Fit the ankle pads to the patient's ankle. Have the assistant perform the following steps. The type of traction splint utilised was not disclosed in two studies. The traction is then applied with a rathcet below the foot, providing excellent INLINE traction. They still teach MAST in the ole South, but I never used it in 6 years. CAUTION: And who ends up doing it? In the field, open femur fractures are contraindications to traction splint application Significant injuries to the knee Bottom line: In general, splints should not be removed during the imaging process for acute trauma. Sets with similar terms Procedure #26 Transfer to wheelchair 15 terms kimmarcum LONG BONE IMMOBILIZATION 10 terms lyingsunset Each splint features adjustable length, adjustable leg straps, an ankle wrap, a thigh pad, and a heel stand. Examples are the Hare, Sager, and Lots splints. It may not display this or other websites correctly. Replacement Strap, Ankle, Adult, For Hare Traction Splint Made in the USA. Vergunst, Arie A. So after two days of pros and cons about helicopter EMS (HEMS), we lead up to this. traction just seems to ease the pain caused by the freakishly horrible muscle spasms. However, there are a few more contraindications: Position the support straps under calves, knees, thighs. I remember my partner using a 4X4 to knock some dirt, mud, and grass off the end before they put the traction on. They consist of other injuries or fractures that could sustain further damage from traction. (3) Tighten the traction strap to provide enough traction to maintain the limb's alignment (see figure 3-5). Baez, Amado A. Eventual patient mortality was the same for BLS calling ALS and ALS response alone. Custom Kitting. traction just seems to ease the pain caused by the freakishly horrible muscle spasms. Then grip the casualty's ankle and foot as shown in figure 3-1. For most fractures, the images obtained are more than adequate to define the injury and formulate a treatment plan. correct, the post was regarding my not using one. This design allows the responder to elevate the leg and cradle it amongst the straps. Curaplex. Whilst none of the available traction . CT scan techs have told me that there would be too much artifact using any kind of metal splint. Journal of the American College of Surgeons, 210(2):220-227, 2010. If there are other fractures in the foot or ankle traction may not be effective, because traction splints require support on strap sites to be able to apply traction. All units come as a complete kit with straps, ankle hitch and carrying case included. The American College of Surgeons Committee on Trauma, Emergency Medical System subcommittee, has released a set of guidelines on appropriate use of HEMS. (2) Check the distal pulse after tightening each strap. 0000010831 00000 n Click here or go to www.thetraumapro.com/ask. Unfortunately, there are lots of contraindications . This was the experience in only one city (Evanston, IL) for one year. Uses a regional dispatch system. Reference: Prehospital midthigh rauma and traction splint use: recommendations for treatment protocols. Be sure to register now if you want to get continuing education credit for it! Philipsen, Sarah P.J. The hare traction splint is designed to be used on those patients who have suffered a suspected femur fracture. The 3 Month (100 Day) MCAT Study Schedule Guide: 2022 Edition. I learned a number of things while reviewing the literature to answer this question. hb```b``}k @Q @re ^8``X\*9-QpBEsJddv&EnL3tBEuz99=&89H].-$QpQ@&3 What are contraindications for a traction splint? Trusted by major EMS agencies including Boston EMS, Dallas Fire-Rescue, LA County Fire, and FDNY. Journal of the American College of Surgeons, 210(2):220-227, 2010. However, little standardization of equipment and training exists within the United States Armed Forces. Seemed to work well, and we took him to the trauma center. It maintained bipolar traction with two steel rods on both sides of the limb. 918 0 obj <>stream It is especially good for basics who do not have the luxury of morphine on the rig. There is minimal impact on interpretation of the tibial plateau. 0000072874 00000 n However, there are a few more contraindications: Reference:Appropriate use of Helicopter Emergency Medical Services for transport of trauma patients: Guidelines from the Emergency Medical System Subcommittee, Committee on Trauma, American College of Surgeons. Hare Traction Splint (Bipolar Traction Splint) The Hare is a bipolar traction splint, which means it uses two external poles to support the injured leg. Bowles, KellyAnn IV. Background: Femoral fracture is a common battlefield injury with grave complications if not properly treated. Keep the top of the splint even with the ischium (the lower bone of the pelvis). These injuries have a high mortality rate and are often associated with multi-system injury [7,14]. Mechanical traction reduces the possibility of vascular and nerve damage; Wide elastic support straps maintain the injured leg within the frame of the splint, helping to provide in-line traction; Heel stand instantly locks into place for support but folds flat for storage; Available in adult and pediatric sizes, or as a kit Physiologic data: About 28% had at least one missing physiologic data point, with respiratory rate being most commonly missed. k. 0000009832 00000 n Hare Traction: The Orthopaedic Surgeons Perspective. With the bone ends exposed (pierced the skin) the risk on infection is great. %PDF-1.4 % If the strap. Solutions & Services. However the anatomy of the femur makes application of the flexible aluminium/foam-padded splints, inflatable splints or plaster backslabs impractical and ineffective. Total loading time: 0.217 (1) Make sure the ischial ring is seated on the ischial tuberosity. Applying a Sager Traction Splint (2 of 3 . (3) Pull on the lower part of the splint until the bottom of the splint is 8 to 12 inches beyond the bottom of the casualty's foot. To ensure even-handed application of best practices, our state trauma systems are going to have to step up and address this issue so the right patient will get to the right hospital at the right time, safely and cost effectively. Some of my orthopedic colleagues insist that the splint be removed in the x-ray department before obtaining images. On the tib-fib above, the holes are a little distracting on the AP view, but still allow for good images to be obtained. 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