TCS splinting

Basic Principles of Splinting Note presence of skin breakdown,bruising, rash, and/or irritation. Assess patient pain status andgive analgesic per MD order. Assess extent to which patientwill be able to use splintedextremity. The extremity should be exposedcompletely before the splint is applied. Skin lesions should be cleaned,repaired, and dressed before the splintis applied. The patient’s ability to remove theirclothes with the splint in place shouldbe taken into account before the splintis applied. The joints above and below a fractureshould be immobilized. Fractures shouldn’t be splintedcircumferentially in an acutesituation, especially if the patienthas impaired sensation, excessiveswelling, or circulatoryinsufficiency. Neurovascular status should beevaluated before and after theapplication of a splint.Splints alwaysshould be ofappropriate size andshape. (OCL shouldbe wide enough tocover approximately1/3 to ½ of thecircumference of theextremity, it shouldnot overlap.)The heel and elbows andall bony prominencesshould be paddedadequately: paddingshould be placed betweenthe digits to preventmaceration; extra paddingshould be placed over thefracture site.Maceration can occurwhen the skin is wet ordamp. The skin softens,turns white, and can easilyget infected with bacteriaor fungi. Stockinette and padding should be appliedevenly and smoothly to prevent waddingand lumping. To prevent stiffness and loss of function,the involved joints should be splinted in aposition that considers soft tissuestructures. Inspect condition of skin around edges ofcast. If skin irritation is evident, petal the edgeof the cast by overlapping strips of tapeover the edge- this area is susceptible topressure and friction.3