1. Splints are used to immobilize and support injured parts of the musculoskeletal system like fractures, sprains, strains, and dislocations. They alleviate pain and allow injuries to heal properly while minimizing complications. 2. Different types of splints include rigid splints, cervical collars, Thomas splints, Braun splints, and spine boards. Splints come in various sizes and are applied according to the specific injury. 3. After applying a splint, the patient's vital signs, circulation, sensation, and pain levels must be monitored closely for complications.

1. Splint
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2. Splint
– USE TEMPORARY TO SUPPORT OR IMMOBALIZE INJURED PART OF THE MUSCULO-SKELATAL
SYSTEM
– APPLIED IN MANAGEMENT OF FRACTURE ,SPRAIN STRAIN,DISLOCATION
– A splint alleviates pain and allows the injury to heal in proper alignment.
– It also minimizes possible complications, such as excessive bleeding into tissues, restricted
blood flow caused by bone pressing against vessels, and possible paralysis from an unstable
spinal cord injury.
– In cases of multiple serious injuries, a splint or spine board allows caretakers to move the
patient without risking further damage to bones, muscles, nerves, blood vessels, and skin

3. Special considerations
– At the scene of an accident, always examine the patient completely for other injuries. Avoid unnecessary
movement or manipulation, which might cause additional pain or injury.
– Always consider the possibility of cervical injury in an unconscious patient. If possible, apply the splint before
repositioning the patient.
– If the patient requires a rigid splint but one isn't available, use another body part as a splint. To splint a leg in
this manner, pad its inner aspect and secure it to the other leg with roller gauze or cloth strips.
– After applying any type of splint, monitor vital signs frequently because bleeding in fractured bones and
surrounding tissues may cause shock. Also monitor the neurovascular status of the fractured limb by assessing
skin color and checking for numbness in the fingers or toes. Numbness or paralysis distal to the injury indicates
pressure on nerves. (See Assessing neurovascular status.)
– Transport the patient to a hospital as soon as possible. Apply ice to the injury. Regardless of the apparent
extent of the injury, don't allow the patient to eat or drink anything until the physician evaluates him.
– Indications for removing a splint include evidence of improper application or vascular impairment. Apply gentle
traction, and remove the splint carefully under a physician's direct supervision

4. TYPE OF SPLINT
– 1 RIGID SPLINT
– 2 CERVICAL COLLAR
– 3 THOMAS SPLINT(TRACTION SPLINT)
– 4 BRAUN SPLINT (TRACTION SPLINT)
– 5 SPINE BORD

5. RIGID SPILINT
– A rigid splint can be used to immobilize a fracture or dislocation in an extremity,
as shown at right. Ideally, two people should apply a rigid splint to an extremity.

6. THOMAS SPLINT
– A traction splint immobilizes a fracture and exerts a longitudinal pull that
reduces muscle spasms, pain, and arterial and neural damage. Used primarily
for saft of femoral fractures,

7. Cervical collar
– Cervical collars are used to support an injured or weakened cervical spine
and to maintain alignment during healing.
– Made of rigid plastic, the molded cervical collar holds the patient's neck
firmly, keeping it straight, with the chin slightly elevated and tucked in
– Designed to hold the neck straight with the chin slightly elevated and tucked
in, the collar immobilizes the cervical spine, decreases muscle spasms, and
relieves some pain
– it also prevents further injury and promotes healing. As symptoms of an
acute injury subside, the patient may gradually discontinue wearing the
collar, alternating periods of wear with increasing periods of removal, until
he no longer needs the collar

8. Spine bord
– A spine board, applied for a suspected spinal fracture, is a rigid splint that
supports the injured person's entire body. Three people should apply a spine
board.

9. BRAUN SPLINT
– It is a metal frame which rests on the bed and support the leg and the femur
just above the knee.

10. Cast
– A cast is a hard mold that encases a body part, usually an extremity, to provide
immobilization without discomfort. It can be used to treat injuries (including fractures),
correct orthopedic conditions (such as deformities), or promote healing after general or
plastic surgery, amputation, or nerve and vascular repair
– Casts may be constructed of plaster, fiberglass, or other synthetic materials. Plaster, a
commonly used material, is inexpensive, nontoxic, nonflammable, easy to mold, and
rarely causes allergic reactions or skin irritation. However, fiberglass is lighter, stronger,
and more resilient than plaster. Because fiberglass dries rapidly, it's more difficult to
mold, but it can bear body weight immediately if needed

11. Contraindications for casting
– skin diseases
– peripheral vascular disease,
– diabetes mellitus,
– open or draining wounds,
– susceptibility to skin irritations.
– However, these aren't strict contraindications; the physician must weigh the
potential risks and benefits for each patient

12. HANGING ARM CAST SHORT ARM CAST
Short leg cast
One and one-half hip-spica
Single hip-spica
Shoulder spica
Long leg cast

13. Equipment
– Tubular stockinette casting material plaster rolls plaster splints (if necessary)
bucket of water sink equipped
–
with plaster trap linen-saver pad sheet wadding sponge or felt padding (if
necessary) cast scissors, cast saw, and cast spreader (if necessary) pillows or
bath blankets : rubber gloves, cast stand, or adhesive tape.
– Gather the tubular stockinette, cast material, and plaster splints in the
appropriate sizes. Tubular stockinettes range from ³(5 to 30.5 cm) wide; plaster
rolls, from (5 to 15 cm) wide; and plaster splints, from ³ (7.5 to 15 cm) wide.
Wear rubber gloves, especially if applying a fiberglass cast

14. Special considerations
– Use a cast stand or your palm to support the cast in the therapeutic position
until it becomes firm to the touch (usually 6 to 8 minutes).
– To check circulation in the casted limb, palpate the distal pulse and assess the
color, temperature, and capillary refill of the fingers or toes. Determine
neurologic status by asking the patient if he's experiencing paresthesia in the
extremity or decreased motion of the extremity's uncovered joints. Assess the
unaffected extremity in the same manner and compare findings.
– Elevate the limb above heart level with pillows or bath blankets, as ordered, to
facilitate venous return and reduce edema. Make sure pressure is evenly
distributed under the cast, to prevent molding

15. CONTI……
– Instruct the patient to notify the physician of any pain, foul odor, drainage, or
burning sensation under the cast. (After the cast hardens, the physician may cut a
window in it to inspect the painful or burning area
– A fiberglass cast dries immediately after application. A plaster extremity cast dries in
approximately 24 to 48 hours; a plaster spica or body cast, in 48 to 72 hours. During
this drying period, the cast must be properly positioned to prevent a surface
depression that could cause pressure areas or dependent edema. Neurovascular
status must be assessed, drainage monitored, and the condition of the cast checked
periodically.
– After the cast dries completely, it looks white and shiny and no longer feels damp or
soft. Care consists of monitoring for changes in the drainage pattern, preventing skin
breakdown near the cast, and averting the complications of immobility.
– Patient teaching must begin immediately after the cast is applied and should
continue until the patient or a family member can care for the cast.

16. CONTI….
– Never use the bed or a table to support the cast as it sets because molding can result, causing
pressure necrosis of underlying tissue. Also, don't use rubber- or plastic-covered pillows before the
cast hardens because they can trap heat under the cast.
– If a cast is applied after surgery or traumatic injury, remember that the most accurate way to assess
for bleeding is to monitor vital signs. A visible blood spot on the cast can be misleading: One drop of
blood can produce a circle 3 (7.6 cm) in diameter.
– Casts may need to be opened to assess underlying skin and pulses, or to relieve pressure in a
specific area. In a windowed cast, a specific area is cut out to allow inspection of underlying skin or
relieve pressure. A bivalved cast is split medially and laterally, creating anterior and posterior
sections. One of the sections may be removed to relieve pressure while the remaining section
maintains immobilization.
– The physician usually removes the cast at the appropriate time, with a nurse assisting. (See
Removing a plaster cast.) Tell the patient that when the cast is removed, his casted limb will appear
thinner and flabbier than the uncasted limb. In addition, his skin will appear yellowish or gray from
the accumulated dead skin and oils from the glands near the skin surface. Reassure him that with
exercise and good skin care, his limb will return to normal

17. SLING
– sling: bandage used to support an arm
– Made from a triangular piece of muslin, canvas, or cotton, a sling supports and
immobilizes an injured arm, wrist, or hand, thereby facilitating healing.
– It may be applied to restrict movement of a fracture or dislocation or to
support a muscle sprain.
– A sling can also support the weight of a splint or help secure dressings

19. CLAVICLE STRAP
APPLICATION
Also called a figure-eight strap OR bandage, a clavicle strap reduces and
immobilizes fractures of the clavicle. It does this by elevating, extending, and
supporting the shoulders in position for healing, known as the position of
attention. A commercially available figure-eight strap or a elastic bandage may
serve as a clavicle strap. This strap is contraindicated for an uncooperative patient.

20. SWATHE
– APPLYING A SWATHE
– To further immobilize an arm after applying a sling, wrap a
folded triangular bandage or wide elastic bandage around
the patient's upper torso and the upper arm on the injured
side. Don't cover the patient's uninjured arm. Make the
swathe just tight enough to secure the injured arm to the
body. Tie or pin the ends of the bandage just in front of the
axilla on the uninjured side.