Standards Procedure (Skill)
Clinical Indications: Levels: EMT-B, EMT- D,
EMT-I, EMT-P
Ø Immobilization of an extremity for transport, either due to suspected fracture, sprain, or injury
Ø Immobilization of an extremity for transport to secure medically necessary devices such as intravenous catheters
Procedure:
a. 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 the placement of the splint.
b. Remove all clothing from the extremity.
c. Select a site to secure the splint both proximal and distal to the area of the suspected injury, or the area where the medical device will be placed.
d. Do not secure the splinting device directly over the injury.
e. Place the splint and secure with Velcro, straps, or bandage material (e.g., kling, kerlex, cloth bandage, etc.) depending on the splint manufacture and design.
f. Document pulses, movement and sensation of the splinted extremity. If there has been a deterioration of any of these three parameters, remove splint and reassess the patient.
g. If a closed femur fracture suspected and there is no evidence of pelvic fracture or instability, the following procedure may be followed for placement of a femoral traction splint:
1. Assess neurovasculsar function and status of injured extremity.
2. Second rescuer to hold manual traction and stabilization (manually pull until the patient feels some relief).
3. Place the ankle device on the ankle.
4. Measure the traction splint by using the uninjured leg and pull splint out approximately 4-6 inches past the foot and lock in place.
5. Placed the proximal end of the traction splint under the patient’s buttock on the injured side (isheal bone area), being careful to avoid any open wounds or placing too much pressure on the genitalia. Make sure the splint extends proximal to the suspected injured area, if not reassess for pelvic involvement.
6. The extremity should rest on the support bands, placement of a cravat or bandage material in the groin area may be necessary for patient comfort. Secure the device in the groin area with the provided strap.
7. Attach the ankle device to the traction crank and slowly crank until resistance is met. Secure the support bands to the patient’s leg avoiding the injured area, knee and ankle.
8. Reassess alignment, pulses, sensation, and motor function. If there has been deterioration of any of these three parameters, release the traction and reassess.
9. Document the procedure, time and patient response, to include evaluation of pre and post assessment of pulses, sensation and motor function in the ACR
Certification Requirements:
Successfully complete an annual skill evaluation including the indications, contraindications, technique, and possible complications of the procedure.