Fat embolism and fat embolism syndrome also can occur intraoperatively while repairing a long bone fracture. If the blood sample was taken from a site close to the area of the fracture, the incidence is closer to 95. Make sure to explain why a splint was indicated for the patient. In one study, about 67 of orthopedic trauma patients have fat globules in their blood. Documentĭocument your findings and interventions carefully, including the status of CSM before and after applying the splint. Analgesics such as morphine sulfate or fentanyl should be administered by qualified providers and according to protocol. Splinting may help reduce the discomfort. Continue to evaluate CSM every few minutes during transport. If the patient complains of worsening pain, or there is a loss of CSM, readjust the splint carefully to see if it might have been applied too tightly. This helps to immobilize the break itself and may help the patient reduce accidental movement of the injury. Immobilize the joints above and below the fracture site.
This makes the splint more secure, improves comfort and may decrease the pain associated with the injury. Pad the splint so that the voids are filled between the extremity and the splint itself. Otherwise, you may need to splint the joint in the position it was found. A joint such as an elbow or knee may be more difficult to straighten try to do so carefully if no resistance is felt. In addition, it will be easier to shape the splint to the injury. Doing so may help improve CSM and reduce the chance of further injury. If possible, apply mild traction to the distal extremity and straighten it prior to applying the splint. In an angulated fracture, where the extremity is misshapen, there may be a loss of CSM due to compression or other soft tissue damage at the fracture site. Asking the patient to wiggle his fingers or toes can help confirm that motor-neuro pathways are intact. Check for sensation by squeezing a finger or toe and asking if the patient can sense the pressure. Circulation can be checked by finding distal pulses or checking for capillary refill on the affected extremity and compare it to the unaffected side. Since its inception over a decade ago, the ‘diamond concept’, a conceptual framework of what is essential for a successful bone healing response, has gained great acceptance for assessing and planning the management of fracture non-unions. Prior to applying a splint, determine if there is adequate circulation, sensation and motor response past the injury site. Long bone non-union continues to be a significant worldwide problem. Here are seven important points to remember when splinting an extremity fracture: 1. In turn, this might reduce the pain that results from the soft tissue injury surrounding the fracture. The splint must often be adapted to provide maximum support to the injured extremity. Rarely do manufactured splints exactly fit the presenting injury. Check and document circulation after splint application and throughout patient transport.
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