Great video and the instructor didn't talk to fast...and loved the humor at the end...

@BestPracticeMedicine

3 жыл бұрын

We're glad you enjoyed it!

Video Transcript: Hi. This is Miles, with Best Practice Medicine. In our video today, we're going to continue our discussion on extremity splinting, focusing on the lower arm, wrist and hand. One of the key principles of extremity splinting is to immobilize not only the site of the injury, but also neighboring tissues. For a long bone injury, the principle is to immobilize both the joint below and above the site of the injury. For an injury to a joint, you immobilize the long bone above and below. Common materials used for extremity splinting include triangular bandages or cravats, roller gauze, Coban, Sam splints, ace bandages, or commercial splinting devices. However, as a provider, you're not limited to these options for splinting materials. You can use your judgment to improvise from materials available at the scene, especially in a back country setting. A Sams splint is commonly used to immobilize injuries to the wrist and forearm. The strength of the splint comes from its cylindrical channel shape. Key points to pay attention to, is the continuation of the channel, all the way up to the hand portion of the splint. When preparing a Sam splint to immobilize an arm or wrist, make a roll at one end, for the patients hand to rest on, to preserve position of function. Another aspect to pay attention to is whether to place the role on top, or on the bottom of the plane of the splint. Most patients work best with the roll on top, preventing the formation of a gap or void of the patient's wrist. If the rolled portion is placed on the bottom, a patient's hand may naturally slide forward, as the fingers wrap around the material, and create a large void, which will need to be filled later. It's important to keep in mind that every patient's anatomy is slightly different. You should use whatever method works best to achieve the desired result. Using the patients non-injured extremity, or if you're of similar size and build, your own same side extremity, form a channel by gently pushing the material up to match the patient's arm. I like to fold one layer at a time. Sam splint material folds easier when it's thinner and prevents the application of excessive force to the patients tissues. Once a close approximation of the patient's forearm has been achieved, position the splint on the injured extremity and gently custom mold without displacing their tissues, to achieve a close fit, watching out for any voids and filling if necessary. After this initial channel has been formed, bring the second layer of splint up and form it to the first, providing more structural support. Once the splint has been formed to match your patient's arm, secure it using Coban, ace bandage, or other material. When applying the securing material, wrap loosely at first, adding tension on more superficial layers, making it easier to adjust if it appears the securing material is limiting the patient's circulation. If the injury is the patient's wrist, make sure that both the bones of the forearm and the metacarpal bones of the hand are effectively mobilized. If the injury is to the patient's forearm, we'll immobilize the joint of the wrist, as well as the elbow joint, using a sling and swath. When immobilizing a finger, the same principles of immobilizing the tissues above and below the injured part apply. This can be accomplished using a splinting material such as a tongue depressor, or other improvised object, and securing with tape, or Coban. You can choose to wrap only the injured extremity, or you may include one or more adjacent fingers in the wrap, to perform a buddy splint and help reduce movement of the injured tissues. If necessary, you can continue the wrapping all the way up into the patients hand and wrist. As with the application of the Sam splint, it's important to wrap gently to prevent cutting off circulation to the patient’s fingers. If the patient’s finger is immobilized, you can check distal CSM, by squeezing the patient's nail bed, and watching how long it takes the capillaries in the nail bed to return to their pink color. Capillary refill time of less than two seconds is normal in most healthy adults. It's important to remember that every splinting intervention begins with manual stabilization of the injured part, followed by initial assessment of the patient's CSMs, and ends with reassessment of the patient's CSMs. Familiarity with commercial and improvised splinting materials is important for effective extremity immobilization. However, the most important takeaway from this video is a solid understanding of the fundamental principles of extremity immobilization by splinting. We hope you've enjoyed this episode of BPM TV and found it informational and helpful to your clinical practice. Looking forward to seeing you next time. As always, thanks for watching.

new subscriber. very informative, many thanks UK

Is there any trick to wrapping the splint yourself? I just broke my dominant arm and I have no one at home with me to re apply the wrapping after I take a shower. I managed to get it back on but it definitely doesn’t feel as tight as when my doctor put it on. Every video I can find just skips past that part, or fast forwards like yours does.

woo, those veins