SLF - Year 2 OSCE prep

CAM Walker (heel wedge)

Injury: Achilles tendon rupture

Education: Time frame, Ankle strap first, Don’t get wet, Loose clean sock with no bumps or replace liner every day after showering if it gets wet

DON: Inner liner first, Add the heel wedge, Add the plastic outer shell, Ensure foot is at the back, Ankle strap first, Test fit during mobilisation with physio

Cervical Collar (philli)

Short-term immobilisation

Injury: Suspected or proven injuries while in the hospital

Education: The device must be worn 24/7 for x amount of time. It can only be removed by a chosen carer or healthcare professional to clean the collar with a wet cloth for hygiene purposes.

DON: Hold up the front of the collar to assess the size, place the back part under the patient’s neck/back and then put the front bit on, scooping up to the neck. Do the straps up tightly and assess the fit in a sitting position.

CAM Walker

Injury: Fibula Fracture, Tibia Fracture, Stress fractures, Avulsion fractures and soft tissue trauma in the ankle, feet and toes

Education: Time frame, Ankle strap first, Don’t get wet, Loose clean sock with no bumps or replace liner every day after showering if it gets wet, Hygiene

DON: Inner liner first, Add the plastic outer shell, Ensure foot is at the back, Ankle strap first, Test fit during mobilisation with physio

Anti-Flexion Brace

Cash = men or Jewett = women

Injury: Spinal fracture

Education: Must be worn 24/7, including in the shower. After showering, a clean T-shirt or singlet should be worn underneath, and any liners on the device need to be replaced and washed. This can only be done lying down and with the chosen carer or healthcare professional present.

DON: The device has now been adjusted to your specifications so you will only need to unclip the back strap on the side to remove the device and then re-clip it back on

Hinged Elbow Brace

Injury: Biceps Tendon Rupture, Ligament Tears

Education: The device is to be worn 24/7. Don’t get it wet in the shower; use a bag to cover it. Over the next few weeks, we will slowly increase ROM using this dial on the side. Don’t play with it; I’ve set it at a particular degree to prevent bending/straightening of the elbow while it heals, and moving this could delay or prevent healing.
DON: If you need to take it off make sure to put the straps on in order as shown by the numbers on the device

Wrap Around Knee Brace

Injury: OA, long-term management for unstable knees due to past ligament injury

Education: When putting the brace on, make sure the straps are firm but not uncomfortable. The brace should be worn directly on the skin

DON: Wrap it around the knee with the patella in the hole

Post-op Footwear

Injury: Foot Fractures, Soft tissue foot injuries, Post-foot surgeries

Education: Place the foot inside the shoe with the heel at the back. Do the straps up firmly but without it being uncomfortable. Keep the shoe dry. When taking the device off, look at the skin on your foot for redness or irritation. If any of these appear, the straps may be done too tight.

DON: Foot in shoe, straps done up

Broad Arm Sling

Injury: Arm injury

Education: Use the sling to keep your arm supported and elevated to prevent swelling

DON: Put your arm in and the strap over your head

Shoulder Abduction Brace

Injury: Rotator cuff injury or surgery

Education: To be worn 24/7. Don’t get the device wet; instead, use a regular sling or a mesh sling when showering. The clips on the side have been adjusted to allow some movement side to side but please don’t change these because this will affect the healing process

DON: Place the arm in the arm holder, strap around the waist, then strap over the shoulder.

Knee Unloader

Injury: Osteoarthritis, Meniscus tear

Education: Increase wear over weeks, starting with 2 hours a day and eventually being able to use the device for a full 8-hour day. Don’t get the device wet

DON: ???

Cervical Collar (Aspen/Miami J)

Injury: Broken neck,

Education: The device must be worn 24/7, including when showering but the liners can be changed afterwards with the assistance of the chosen carer or healthcare professional to stabilise the head. Remove one liner at a time so it’s not confusing which liner goes where in the device.

DON: ensure the head is stabilised, hold up the front piece of the device and adjust the size appropriately, slide the back piece under the neck/back, scoop up the front piece in position and attach it to the back piece securely. Check the swallow and firmness of the device and readjust if needed.

Presure Relief Orthosis

Injury: Risk of pressure injuries

Education: These are to be worn when the patient is lying down for long periods or is at risk of pressure injuries. Do up the straps, but not too tight.

DON: Place the foot in the device and fasten the straps. The device should be longer than the toes to prevent pressure injuries from the sheets.

Knee Immobiliser (zimmer)

Injury: Patella tendon rupture, Patella dislocation, Post-ligament surgery

Education: Wear 24/7. Keep dry. The device should be worn directly on the skin under any clothing, with the patella situated in the hole.

DON: Slide under the leg and align the brace with the patella, contour the metal bars to the shape of the leg and do up the strap below the knee, then above the knee and so on.

Wrist hand orthosis

Injury: Simple Distal Radius Fracture, Carpal Tunnel Syndrome, De Quervain's Tenosynovitis (WHO - Spica)

Education: Keep the cast dry in the shower with a bag over it; the device can be carefully removed to clean the wrist and hand with a wet cloth. When this is done, the skin should be checked for any redness or signs of pressure injuries.

DON: Place the wrist in the cast and do up the straps below the injury, above the injury and so on.

Bed Resting AFO

Injury: Prevention of calf muscle and Achilles tendon contracture

Education: The foot should be in a 90° position. The straps should not be done so tight that they leave marks on the skin because then they will cause pressure injuries.

DON: The device should be placed on the foot, and the straps around the ankle should be done first, then around the shin and then the straps that hold the foot in a 90° position.

Hinged Knee Brace

Injury: PCL, MCL or LCL injury, Short-term ACL injury,

Education: Wear the brace 24/7 and keep it dry with a bag in the shower (if they already have a Zimmer, they can use this for showering). The device should be placed directly on the skin with clothing over the top. Assess the skin for pressure injuries and adjust straps accordingly

DON: Slide the brace under the leg, contour the metal to the shape of the leg and fasten the straps in order according to the number labelling; adjust the dial for the ROM according to the doctor's orders.