IMMOBILIZATION SKILLS -- TRACTION SPLINTING

This station is designed to test your ability to properly immobilize a mid-shaft femur injury with a traction splint. You will have an EMT assistant to help you in the application of the device by applying manual traction when directed to do so. You are required to treat only the specific, isolated injury. The scene size-up and initial assessment have been accomplished on the victim and during the focused assessment a mid-shaft femur deformity was detected. Ongoing assessment of the patient's airway, breathing, and central circulation is not necessary. You may use any equipment available in this room. You have (10) ten minutes to complete this procedure. Do you have any questions?

Takes or verbalizes body substance isolation precautions
Directs application of manual stabilization of the injured leg
Directs the application of manual traction
Assesses motor, sensory, and distal circulation

THE EXAMINER ACKNOWLEDGES PRESENT AND NORMAL

Prepares/adjusts splint to the proper length
Positions the splint at the injured leg
Applies the proximal securing device (e.g., ischial strap)
Applies the distal securing device (e.g., ankle hitch)
Applies mechanical traction
Positions/secures the support straps
Re-evaluates the proximal/distal securing devices
Reassesses motor, sensory, and distal circulation

THE EXAMINER ACKNOWLEDGES PRESENT AND NORMAL

THE EXAMINER ASKS THE CANDIDATE HOW HE/SHE WOULD PREPARE THE PATIENT FOR TRANSPORT

Verbalizes securing the torso to the long board to immobilize the hip
Verbalizes securing the splint to the long board to prevent movement of the splint

CRITICAL CRITERIA:

Loss of traction at any point after it is assumed
Did not reassess motor, sensory, and distal circulation before and after splinting
The foot is excessively rotated or extended after splinting
Did not secure the ischial strap before taking traction
Final immobilization failed to support the femur or prevent rotation of the injured leg

Secures leg to splint before applying mechanical traction

IF THE LEG IS ELEVATED AT ALL, MANUAL TRACTION MUST BE APPLIED BEFORE ELEVATING THE LEG. THE ANKLE HITCH MAY BE APPLIED BEFORE ELEVATING THE LEG AND USED TO PROVIDE MANUAL TRACTION.