Page 7 - Orthopedic Casts and Splints2

Performance Steps
(1) Secure and align two pulleys, one at each end of 36 inch center clamp bar, directly
above the outside of the patient's hips.
(2) Secure and align two pulleys , one at each end of the center clamp bar, at foot of crib.

9. Set up overhead traction frame for a orthopaedic bed.
a. Attach (4) cross clamp bar holders to traction frame.
(1) Secure (2) cross clamps to each long plain bar .
NOTE: The cross clamps are secured at the child's hip level.
(2) Secure (2) cross clamps to the middle of each single clamp bar at the foot of the
bed.
NOTE: The cross clamps are aligned with the cross clamps at the child's hips
b. Secure plain bar to each cross clamp bar over child hips.
(1) Place one end of plain bar in the cross clamp bar holder, adjust the bar and lock.
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.
(2) Place opposite end of plain bar in clamp bar holder and lock clamp.
c. Secure plain bar to cross clamp bars at foot of bed.
(1) Place one end of plain bar in the cross clamp bar holder, adjust the bar and lock
clamp.
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.
(2) Place opposite end of plain bar in clamp bar holder and lock clamp.
d. Secure single clamp bars to plain bar at foot of bed aligned with child's legs.
e. Secure pulley attachments to single plain bars.
(1) Place (2) pulley attachments above the outside of the child's left and right hips.
(2) Place (2) pulley attachments to the single clamp bars at foot of bed aligned with the
pulley's at the child's hip.
10. Prepare child's uninjured leg and malleolus(ankle).
NOTE: Always begin Bryant's traction with the uninjured leg/hip first to reduce movement of injured
leg/hip, prevent rotation, and provide stabilization of the injury. When removing or adjusting Bryant's
traction reverse the process and begin with the injured leg.
a. Place examination gloves on hands.
CAUTION: Always practice Body Substance Isolation techniques (BSI ) prior to applying traction,
splints, or cast to patient.
b. Remove child's shoes and socks.
NOTE: Give shoes and socks give to family member or nursing personnel.
c. Inspects both legs/hips for any skin conditions(e.g. cuts,abrasion,lacerations or skin rashes).
Inform nurse if the above are present before continuing.
d. Pad both medial and lateral malleolus with webril or felt .
NOTE. Webril or felt may be used. Padding is used to reduce any chafing that may occur while the
child's legs are in Bryant's traction.
11. Check child's capillary refill/pulse.
a. Squeeze child's toes and nail beds will turn white .
b. Release child's toes and nail beds will return to pink .
c. Place finger on the dorasalis pedis(top of foot) to check for normal pulse 100-140 beats per
minute(BPM).
CAUTION: If capillary refill is delayed for more than 2 seconds or BPM is below 100 inform physician
and follow physician's order.
12. Apply skin adherent to child's uninjured leg.
Note: The technician should use tincture of benzoin/mastisol adhesive in conjunction with
adhesive/non adhesive vent foam straps.
a. Ask parent (s) if child has ever had a skin rash after use of benzoin or after eating shellfish.

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