Page 55 - Orthopedic Casts and Splints2

Performance Steps
CAUTION: Always have the same gender chaperone when patient's personal property/clothing are to
be removed.

NOTE: Give clothing/property to family member or nursing personnel.
c. Inspect head for any skin conditions ( e. g. cuts, abrasions, lacerations or rashes ). Inform
nurse if skin conditions are present before continuing.
9. Check patient's capillary refill.
CAUTION: Prior to starting and finishing any procedure on a patient, circulation is always checked.
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. Secure 5 or 9 inch single clamp bar to the middle of the crossbar at head of bed in aligned with
patient's head.

11. Secure pulley to single clamp bar.
12. Apply head halter to patient.
a. Disconnect the chin portion from the head halter.
b. Slide the posterior portion of the head halter under the patient's head resting it on the
occipital region.
CAUTION: To reduce further injury to the patient, slide the halter with nursing assistance if needed..
c. Place cuff portion on chin.
d. Place padding under halter to both temporal regions.
NOTE: Additional padding reduces chafing of the skin while the head halter is on.
e. Attach chin straps to the side of the head halter.
CAUTION: Tighten one strap at a time inspecting that the patient has an open airway. If patient is
experiencing difficulties breathing reduce the tension of the straps.
f. Tighten or loosen the straps as needed.
13. Insert spreader bar ends to the D rings on the side of the head halter.

14. Tie traction cord to spreader bar and weight carrier
a. Tie a non slip knot to the loop on the spreader bar.
b. Thread opposite end of traction cord through the pulley on the single clamp bar.
c. Tie non slip knot to the hook on the weight carrier.

15. Apply weight plates to the weight carrier.
CAUTION: Always inform the patient when adding or removing weight plates.

NOTE: Physician's order will determine the specific amount of weight plates that will be used.
16. Elevate or raise the head of 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 of the patient's injured spine..

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.

17. Check and adjust fit and angle of head halter.
a. The technician will ask the patient if one side of the head halter has a greater pull than the
other.
NOTE: If there is greater pull, remove weight plates and adjust the straps until the patient feels the
same pull on both sides.
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