Clinical Skill Assessments - Femoral Traction Splint (Slishman) and Chest Decompression (Cannula)

Flashcards covering clinical skill procedures, marking rubric definitions, indications, contraindications, complications, equipment specifications, and steps for applying a Slishman femoral traction splint and performing cannula chest decompression.

Skilful Practice

The seamless application of skill with no errors.

Disorganised Practice

Practice that does not follow recommended practice or sequencing.

Inefficient Practice

Practice that does not add value or use time efficiently.

Unsafe Practice

Practice indicating the student is unrehearsed, unfamiliar with equipment, or unable to identify and solve problems.

Critical Error

Any omission or action that has the potential to do harm to the client or negatively impact client outcomes, including frequent prompting ($>2$ prompts) or an inability to identify/remedy issues post prompt.

Proficient Practice Rating

Performance that met criteria standards in all aspects demonstrating safe, skilful, efficient and considered practice, earning $5$ marks.

Femoral Traction Splint (Slishman) Indications

Femoral fractures involving the shaft.

Femoral Traction Splint (Slishman) Contraindications

Fracture/dislocation of the knee.

Femoral Traction Splint Complications

Iatrogenic injury.

Open Wound Irrigation Requirement (Femoral Traction Splint)

Ensuring open wounds have been irrigated with $\text{NaCl} \ne 0$ equal to or greater than $\text{2 litres}$ ($\neq 2\text{ litres}$ of NaCl) and dressed prior to application.

Ankle Strap Positioning (Slishman Splint)

Applied firmly just superior to the lateral malleolus on the affected limb, ensuring that the end cap is positioned laterally with the opening facing cephalad.

Distal Thumb Screw (Slishman Splint)

The black thumb screw loosened to extend the pole to the desired length and fastened once achieved.

Proximal Thumb Screw (Slishman Splint)

The red thumb screw/clamp loosened to allow pulling of the traction cord to apply traction, and fastened to maintain traction before releasing the cord.

Mid-Leg Strap Placement (Slishman Splint)

Attached to the splint and fastened to the patient's leg, distal to the knee.

Chest Decompression (Cannula) Indications

Cardiac arrest with suspected chest trauma, or suspected tension pneumothorax.

Chest Decompression (Cannula) Contraindications

Nil in this setting.

Chest Decompression Insertion Site

The 2nd intercostal space, midclavicular line in the affected hemithorax/es.

Chest Decompression Insertion Angle & Landmark

Inserted at a $90\text{-degree}$ angle, just superior to the border of the 3rd rib.

Chest Decompression Stop Point

Stop inserting the cannula when a release of air is identified, or a sudden loss of resistance is felt.

Cannula Gauge for Weight 15-50 kg

$14$ gauge cannula.

Cannula Gauge for Weight <15 kg

$16$ gauge cannula.

Chest Decompression Complications

Infection, pneumothorax (if initial diagnosis is incorrect), perforation of structures within the chest (e.g., heart, lungs, major blood vessels), and intercostal neuralgia.