Page 10 - Orthopedic Casts and Splints2

Performance Steps

22. Check alignment of Bryant's traction and child's extremity.
a. The center clamp bar is directly over the child's hips.
b. Each pulley on the center clamp bar are above the outside of the child's hips and aligned
with the pulleys at the foot of the bed.
c. If center clamp bar or pulleys are not in alignment go to step 8.
d. If center clamp bar and pulleys are in alignment go to step 23.
23. Check child's capillary refill/pulse.
a. Squeeze child's toes and nail beds will turn white
b. Release patient's toes and nail beds will return to pink .
c. Place finger on the dorasalis pedis( top of foot ) to check for normal pulse 100-140 beats
per minute(BPM).
CAUTION: If capillary refill is delayed for more than 2 seconds inform physician and follow physician's
order.
24. Inspect overhead traction frame and bed.
a. All clamps are tightened and locked.
b. Bed rails are upright and locked.
c. Bed wheels are in the locked position.

25. Inspect traction equipment.
NOTE: Traction principles promote the effectiveness of traction. Any type of friction will reduce the
efficiency of traction and hinder the pull and cause further discomfort to the patient.
a. The weight carrier is hanging freely w/o touching the bed/floor.
b. All knots are secured (tapped)
c. All traction cords are centered on the track of the pulleys.
d. All traction cords are hanging freely w/o touching the bed or frame.
NOTE: Traction equipment is checked daily to promote effective medical care to the patient.

26. Give parent(s) verbal instructions on Bryant's traction.
a. Inform parent(s) to press the nurse call button on the either of the bed rails for assistance, if
needed.
b. Bryant's traction should only be removed by the nursing staff.
c. Inform parent(s) keep child calm and avoid his/her moving around as much as possible to
prevent problems.

Performance Measures GO NO GO
1. Received the order from the physician ( reviewed if in writing ). —— ——
2. Gathered equipment. —— ——

3. Assembled materials. —— ——
4. Checked serviceability of overhead traction frame and bed. —— ——

5. Identified self to parent(s). —— ——
6. Explained procedure to parent(s). —— ——

7. Positioned the child. —— ——
8. Set up overhead traction frame for crib or orthopaedic bed. —— ——

9. Prepared the child's uninjured leg and malleolus.. —— ——
10. Checked child's capillary refill and pulse. —— ——
11. Applied skin adherent to uninjured leg. —— ——

7