Page 361 - Orthopedic Casts and Splints2

Performance Steps

18. Tie traction cord to Nelson finger exerciser/ spreader block.
a. Remove 4 -6 feet of traction cord from the spool.
b. Cut traction cord in half.
c. Tie non slip knot to the end of the spreader block.
NOTE: 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 pulleys on the single clamp bar and tie to weight
carrier.
19. Place canvas sling on top of biceps muscle.
20. Insert spreader bar ends in perforated holes on the canvas sling.

21. Attach weight carrier to spreader bar
22. Apply weight plates to weight carrier.
Caution: Always communicate to the patient prior to adding or removing weight plates.
23. Elevate or raise the bed on the affected side.
NOTE: The physician's order will indicate the bed elevation requirement.
24. Check single clamp bar alignment with the patient's injured arm.
NOTE: If single clamp bar at the side of the bed is not aligned with the humerus go to step 15 and
repeat to obtain alignment.
25. Measure injured arm at a 90 degree angle to the floor with goniometer.
a. Place the stationary arm of the goniometer in the horizontally, bisecting the lateral aspect of
the humerus.
b. Place the moving arm of the goniometer in the horizontally, bisecting the lateral aspect of the
forearm and the 2nd and 3rd phalanges.
c. Place the protractor of the goniometer on the olecranon process ( elbow) .
d. Set olecranon process until goniometer measures 90 degrees of flexion.

26. Check traction and arm alignment/angles and adjust if necessary.
a. The elbow is flexed at a 90 degree angle.
b. Single clamp bar is aligned with the patient's injured humerus.
c. Adjust pulley's as needed.
27. 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.
28. Inspect overhead traction frame and bed.
a. All clamps are tighten and locked.
b. Bed rails upright and locked.
c. Bed wheels are locked.
29. 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 carriers are hanging freely w/o touching the bed, floor or frame.
b. All knots are secured ( tapped ).
c. All traction cords are centered on the pulley tracks.
d. All traction cords are hanging freely w/o touching the bed,floor or frame.
NOTE: Traction equipment is checked daily to promote effective medical care to the patient.

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