Miles and Matt, with the help of Dr. Rodrigo Bones, exemplify and explore splinting lower extremity injuries, particularly ones of the knee or Tibia/Fibula. Learn more or sign up for a class at bit.ly/bpm59715
As we continue investigating the NREMT Skills sheets and breaking down each skill into multiple videos we hope to prepare EMT students around the nation for the NREMT Exam. We also want these instructional videos to serve as a practicing tool for already registered and practicing EMTs/other medical professionals. If you have any questions about the content or suggestions for future videos, drop us a comment below or reach us on out contact page at bestpracticemedicine.com/supp...
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Transcript:
Hi, this is Miles with Best Practice Medicine. In today's video, we'll be continuing our exploration of splinting immobilization of the lower extremities. Remember, when performing any splinting intervention, we begin with manual stabilization of the injured part, followed by initial assessment of the patient's circulation, sensation, and movement.
Remember to always expose the injured site, if possible, by removing or cutting away clothing in order to adequately assess the patient's injury. When removing a patient's clothing, it's important to consider exposure to the environment. I've cut Rodrigo's pants here along the side, allowing me easy access to expose and assess the injury site, but I can also flip the pants back over to cover and keep him warm in a cold environment.
Once again, we have Matt, who's kindly volunteered to be our patient as well as videographer. Let's go over what it means when we say we'll immobilize the structures above and below the injured part. For a knee injury, this means we'll immobilize the femur as well as the tibia and fibula. For a tib-fib injury, we need to immobilize the knee joint and the ankle joint. And for an injury to the femur, we need to immobilize the knee joint as well as the hip joint.
A commercial splitting device can be used, placed around the extremity using padding to fill voids and preserve a position of comfort for the patient. Actually I want to do a little bit of oppositional push there.
Can you feel that toe I'm touching?
Yep.
Can you wiggle them for me? Any numbness or tingling down there?
No.
Cool. That's fine.
If the patient's most comfortable with his knee in a flexed position, you can pad underneath the knee to fill the void and provide adequate support.
So in this example, we have a commercial splinting device with straps that secure to the patient's leg. We have towels and foam blocks to provide padding of voids in a position of comfort. And we've used cravats to supplement our straps, one of which wasn't long enough to go all the way around the patient's extremity.
Another common device for extremity splinting are padded board splints. These are placed next to the tissues needing to be immobilized, and padded and secured following the principles we've already demonstrated in this video. Another hyper lapse?
Yeah.
Sweet.
And can you feel that toe I'm touching?
Yep.
Can you wiggle them for me? Push down. Push up. Any numbness or tingling?
No.
I'm going to reach in and see if I can feel the pulse, okay? Cool.
The methods we've demonstrated are adequate for most injuries to the lower extremity. However, injuries to the femur may require special considerations. For one, if this bone is broken, we need to immobilize not only the knee joint but also the hip joint, which usually requires immobilization on a long spine board. Certain femur fractures require splinting using a traction device. Stay tuned for an upcoming video in which we'll detail the indications, contraindications, and application of traction splinting.
We hope you found this video informational and useful to your clinical practice. Tune in next time for more from BPM-TV, and as always, thanks for watching.