Page 32 - Orthopedic Casts and Splints2

Performance Steps
CAUTION: The patient will be experiencing a high level of pain, always have an assistant for placement
of the Thomas splint.
b. Place injured leg on padded Thomas Splint.
c. Secure ischial ring strap to patient.
NOTE: Additional padding may be used under the strap for patient comfort.
d. Tie a non slip knot to the end of spreader block.
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.
e. Thread opposite end of traction cord through pulley directly at the foot of the bed.
f. Tie a non slip knot to spreader bar at patient's knee .
g. Thread opposite end of traction cord through pulley directly above the patient's injured knee
through the pulley at the foot of the bed.
h. Tie a non slip knot to end of the Thomas splint .
i. Thread opposite end of traction cord through pulley directly above the patient's injured foot
through the pulley at the foot of the bed.
j. Tie all traction cords to individual weight carriers at the foot of the bed.
28. Apply weight plates to the weight carriers.
CAUTION: Always inform patient prior to adding or removing weight plates

NOTE: Physician orders will determine specific amount of weight plates that will be used.
a. Apply weights to traction weight carrier.
b. Apply weights to counter traction weight carrier.
c. Apply weights to balanced traction weight carrier.
NOTE: Traction weight is always applied first followed by counter traction weight.
29. 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 and assist in alignment 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 elevation requirement.

30. Check position of the single clamp bars.
a. The single clamp bar is proximal to the hip.
b. The single clamp bar is distal to the foot.
c. The single clamp bar is aligned with the 2nd and 3rd phalanges of the injured foot.
NOTE: If single clamp bars are not in alignment , remove weights and go to step 12-19.

31. Check position of Thomas Leg Splint and Pearson attachment.
a. The Thomas Leg Splint must be suspended off the bed.
NOTE: No measurement is needed. The splint must not be in contact with the bed.
b. The Pearson attachment must be centered to the patient's injured knee.
NOTE: If Pearson attachment is not bisecting the knee, remove weights and go to step 20 b.
32. 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 nail beds will return pink .
CAUTION: If capillary refill is delayed for more than 2 seconds inform physician and follow physician's
order.
33. 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.

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