Page 360 - Orthopedic Casts and Splints2

Performance Steps
NOTE: Webril or felt may be used. Padding is used to reduce any chaffing that may occur while arm is
in traction .
9. Check patient capillary refill.
a. Squeeze the patient's fingers and the nail beds will turn white.
b. Release the patient's fingers 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.

10. Apply skin adherent to injured arm.
NOTE: Use tincture of benzoin/mastisol adhesive in conjunction with adhesive /non adhesive vent
foam straps.
a. Ask patient if they have ever had a skin rash after use of benzoin or after eating shell fish.
NOTE: If patient is unable to answer, ask family member. If family member is not present use a
substitute application ( mastisol ).
b. If no known allergies exists apply tincture of benzoin to the medial/lateral aspect of the
injured arm beginning one finger width below the cubitum space and ending at the wrist.
c. If known allergies exists apply mastisol in the same manner.
11. If using the Nelson finger exerciser go to step 13.

12. If using the adhesive vent foam strap with spreader block go to step 14.
13. Apply and secure adhesive vent foam strap with Nelson finger exerciser to injured arm.
NOTE: The adhesive vent foam strap should rest 1 inch distal to the cubitum space.
a. Have the patient hold the handle of the Nelson finger exerciser .
NOTE: The square end of the Nelson finger exerciser should point toward the head of the bed, with the
patient's thumb aligned with the humerus.
b. Place vent foam strap on the spreader block portion of the Nelson finger exerciser and
measure 1 inch distal to the cubitum space.
c. Fold down and hold excess ends of the vent foam strap while continuing to wrap the elastic
bandage until the vent foam strap is completely covered and secure with clips.
d. Tape the elastic bandage between the clips.
e. Remove the clips and dispose in trash receptacle.
14. Apply and secure adhesive vent foam strap with spreader block to injured arm.
a. Apply the vent foam strap from the posterior side of the elbow, up beyond the tips of the
fingers ending on the anterior side opposite from the start.
b. Fold down and hold excess ends of the vent foam strap while continuing to wrap the bandage
until the vent foam strap is completely covered and secure with clips.
c. Tape the elastic bandage between the clips.
d. Remove the clips and dispose in trash receptacle.
e. Slide spreader block into the top of the vent foam strap.
f. Have patient rest arm on bed.
15. Secure 44 inch single clamp bar to the long bar on the overhead frame.
a. Align and attach the single clamp bar with the patient's injured shoulder
b. Angled the single clamp bar at a 90 degree angle to the floor.

16. Secure (2) pulleys to the distal end of the single clamp bar.
17. Adjust the patient's position.
NOTE: Nursing personnel may be used with patient positioning.
a. Place the patient's feet in the corner opposite of injured arm.
b. Have patient move injured arm(humerus) off the bed.
NOTE: The patient's humerus should be hanging freely. If the humerus is resting on the bed, the
traction will not be effective.

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