Page 44 - Orthopedic Casts and Splints2

Performance Steps
c. 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.
d. Tape the elastic bandage between the clips.
e. Remove the clips and dispose in trash receptacle.
f. Slide spreader block in between vent foam strap and the hand.
g. Have patient rest arm on bed or across chest.
15. Secure 44 inch single clamp bar to the long bar on the overhead frame.
a. Align and secure the single clamp bar with the patient's injured shoulder
b. Angle the single clamp bar at a 45 degree angle to the floor.
NOTE: The bar will start off at a 45 degree angle. Upon Dunlop traction completion , the arm not the
bar is measured at a 45 degree angle.
16. Secure (2) pulley attachments three to four inches apart to the distal end of the single clamp bar.

17. Tie traction cord to Nelson finger exerciser/ spreader block and weight carrier.
a. Remove 4-6 feet of traction cord from the spool.
b. Cut traction cord at measured length.
c. Tie a non slip knot to the end of the Nelson finger exerciser/spreader block.
d. Thread traction cord through pulleys on single clamp bar
e. Tie a non slip knot to the weight carrier.
18. Place canvas sling on top of biceps muscle.

19. Insert spreader bar ends in perforated holes on the canvas sling and attach weight carrier.
NOTE: The patient's humerus should be hanging freely. If the humerus is resting on the bed, the
traction will not be effective.
20. Apply weight plates.
CAUTION: Always inform patient prior to adding or removing weight plates.
NOTE: Physician's order will determine specific amount of weight plates needed.

21. Elevate or raise the bed on the affected side.
NOTE: The bed is elevated or raised to provide counter traction which will assist in alignment of the
fracture and reduction of muscle strain to the patient's injured arm.

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.
22. Measure injured arm at a 45 degree angle to the floor with goniometer.
a. Place the stationary arm of the goniometer horizontally, bisecting the lateral aspect of the
humerus.
b. Place the moving arm of the goniometer vertically , 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 45 degrees of flexion.
NOTE: If arm is not at 45 degrees of flexion, remove weight and go to step 15 b and repeat to obtain
alignment
23. Check single clamp bar alignment with the patient's injured humerus.
NOTE: If single clamp bar is not aligned with injured humerus, remove weights and go to steps 15 and
16 and repeat to obtain alignment.

24. Check patient's capillary refill of hands.
a. Squeeze the patient's fingers and the nail beds will turn white.

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