Page 49 - Orthopedic Casts and Splints2

Performance Steps
CAUTION: Always have the same gender chaperone available when patient's clothing need to be
removed. Give clothing items to family member or nursing personnel.
d. Inspect both lower extremities for any skin conditions ( e. g. cuts, abrasions, lacerations or
skin rashes ).
NOTE: Inform nurse if skin conditions are present before continuing.
e. Pad the medial/lateral aspects of the iliac crest.
NOTE: Webril or surgipads may be used. Padding is used to reduce any chaffing that may occur while
the patient's lower extremity is in pelvic traction.
9. Check patient's capillary refill of both feet.
CAUTION: Prior to starting and finishing any procedure on a patient, circulation is always checked
prior to traction, splinting or casting application.
a. Squeeze the 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.
10. Measure patient's waist for pelvic traction belt sizing .
NOTE: A variety of measuring devices may be used. The patient may be asked waist or hip size, a
variety of pelvic belts may be fitted to the patient or a tape measure may be used.
a. Measure around the crest of the ilium(outside of hip)
b. Obtain correct sized belt and place on work cart/station for later use.
11. Secure (2) cross clamps to the center of each vertical double clamp bar at the foot of the bed.

12. Secure single plain bar to cross clamps.
a. Insert one end of the plain bar in the clamp bar holder and lock in place.
b. Place opposite bar end in cross clamp holder, adjust bar and lock in place.
CAUTION: The ridges of the bar and clamps must be in alignment to prevent the traction frame from
coming apart and putting the patient at risk.

13. Secure (2) 5 or 9 inch single clamp bars( horizontal) to cross bar at foot of bed.
a. Secure 1st single clamp bar lateral to the right femur and pelvis.
b. Secure 2nd single clamp bar lateral to the left femur and pelvis.
14. Secure pulley attachment to each single clamp bar.

15. Apply pelvic traction belt to patient.
NOTE: Nursing personnel may be used with application of pelvic belt .
a. Nursing personnel releases back panel straps on pelvic belt.
b. Technician palpates for the patient's greater trochanter.
CAUTION: Prior to placing your hands on a patient, inform the patient what you are doing and why
you are doing it.
c. Place pelvic belt under patient's legs.
NOTE: The belt has a curved and straight edge . The curved end is pointed up when applying the belt
to a patient.
d. Technician and nursing assistant slide belt above greater trochanter.
CAUTION: Proceed cautiously when sliding the belt.
e. Technician adjusts belt proximal to the middle of the patient's back with bottom of belt 1 inch
above the patient's greater trochanter.
f. Technician secures the back panels ends to the belt.
g. Technician secures the pelvic belt together.
CAUTION: The Pelvic belt is not applied like an abdominal binder.
h. Assess the patient breathing by asking them questions to determine if the belt is restricting
air flow.
NOTE: If patient is experiencing airway management problems, open the corset. Inform physician and
follow physician's order.
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