Page 26 - Orthopedic Casts and Splints2

Performance Steps
CAUTION: To reduce the possibility of the traction cord slipping and causing further injury to the patient
use a non slip knot(e.g.up and over, down and over, up and through).
d. Thread opposite end of traction cord through pulley directly at the foot of the bed.
e. Tie a non slip knot to the hook on the weight carrier.
18. Place a pillow lengthwise under the injured leg to elevate the heel off the bed.
CAUTION: It is necessary for the heel to be off the bed to reduce bed sores and skin related problems
(e.g. ulcers).

19. Apply weight plates to the weight carrier .
CAUTION: Always inform patient prior to adding or removing weight plates.

NOTE: Physician's order will determine specific amount of weight plates to be used.
20. Elevate or raise the foot of the bed until traction cord is parallel to the floor.
NOTE: The bed is elevated or raised to provide counter traction which will assist in reducing muscle
strain of the patient's injured leg.

NOTE: If bed is non electric manually raise(gatchet) the foot of bed. If bed is electric press button on
control panel.

NOTE: The physician's order will indicate the bed elevated requirement.

21. Check single clamp bar alignment with the patient's injured leg.
NOTE: If single clamp bar at foot of bed is not aligned with 2nd and 3rd phalanges remove weight
plates and go to step 15. If the heel is touching the bed, remove weight plates and go to step 18. If
single clamp is aligned correctly go to step 22.

22. Check patient's capillary refill of both feet.
a. Squeeze patient's toes and nail beds will turn white .
b. Release patient's toes and the nail beds will return pink .
CAUTION: If capillary refill is delayed for more than 2 seconds inform physician and follow physician's
order.

23. Inspect overhead traction frame and bed.
a. All clamps are tightened and locked.
b. Bed rails are upright and locked.
c. Bed wheels are locked.

24. Inspect traction equipment.
NOTE: Traction principles promote the effectiveness of traction. Any type of friction will reduce the
efficiency of traction, 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. The traction cord is centered on the track of the pulley.
d. The traction cord is hanging freely w/o touching the bed or frame.
NOTE: Traction equipment is checked daily to promote effective medical care to the patient.
25. Give patient verbal instruction on Buck's traction.
a. Inform patient to press the nurse call button on the side of the bed rails for assistance .
b. Patient should only remove Buck's traction boot with physician's permission.
c. The Buck's traction boot or adhesive vent foam strap should not impede circulation to the foot
and toes.

Performance Measures GO NO GO
1. Received the order form the physician ( reviewed if in writing). —— ——

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