BC Provincial Examination Guidelines - Fracture Management: Traction Splint

Distal Assessment: Assess distal circulation, sensation, and function prior to and during intervention.
Cold Application: Apply cold, if appropriate, keeping ice on for $10\,\text{minutes}$ and off for $5\,\text{minutes}$ .
Analgesia Administration: Provide analgesia if not contraindicated.
Patient Positioning: Ensure that the patient is placed in a supine position with the injured leg positioned directly in line with the body.
Manual Stabilization: Maintain continuous manual stabilization after movement and reassess the distal pulse.

S - Size: Place the splint directly beside the injured leg to measure standard sizing.
T - Thigh: Secure the thigh strap or bandage firmly in place.
A - Ankle: Apply the ankle harness positioned above the malleoli.
P - Padding: Ensure adequate padding is provided for comfort and pressure prevention.
L - Lbs. (Traction): Apply traction according to specific fracture specifications (Note: Once traction is applied, do NOT release traction):
- Closed, mid-shaft fractures: Apply $10\%$ of the patient's body weight to a maximum force of $15\,\text{lbs.}$ ( $7\,\text{kg}$ ).
- Open, mid-shaft fractures: Apply a maximum force of $5\,\text{lbs.}$ .
E - Elevate: Elevate the bottom of the Sager splint to align the Sager neutral with the leg (placing a shoe under the wheel works effectively).
S - Straps: Stabilize the limb to the splint by applying $3$ elasticized straps. Place a blanket between the legs and strap the legs together.

Traction Reassessment: With each movement, reassessment of primary ABCs (Airway, Breathing, Circulation), or evaluation of vital signs, traction must be continuously reassessed and corrected if necessary.