Does any EMT here use a traction splint?

[ASDIC]

I have never used it....but I am curious what you would do for a broken femur besides using the traction.

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[beanbean]

19 yrs I have never used one. The one patient I have ever had with a broken femur also had knee involvement and it was contraindicated. It is the one thing besides childbirth that I have yet to do as an EMT.

Why wouldn't you want to use one? You could splint the femur as you would any other long bone if you couldn't use the Hare splint.

 

[deleted6669]

back in the day we used to use mast pants with a hare traction splint over them to stabilize femur or hip fx

 

[12R34Y]

In 7 years I've used a hare traction splint for closed femur fractures maybe 3-5 times. All worked very well and it was very easy to apply. spine board makes the ultimate total body splint if done correctly. traction just seems to ease the pain caused by the freakishly horrible muscle spasms.

later

 

[OSUdoc08]

I have never used it....but I am curious what you would do for a broken femur besides using the traction.

i've used it twice-----car wreck & a sports injury

 

[mikegoal]

twice for me too

 

[DSM]

I have used it only a couple of times for isolated injuries....If they are in a bad car wreck or fall....Time is Golden as we all know. Load and go. If I have the time and I think it would benefit the patient....then go for it.

 

[12R34Y]

one of those that I particularly remember was an 18 year old high school baseball player who suddenly stopped weird and broke his femur (freak accident). He was in excruciating pain, but a little nitrous and the hare traction and he was golden for the trip to the hospital. You could see the spasms yield as we cranked on it. His pain diminished considerably. on the way to the hospital we would complain again and I'd crank a little more and he'd get better. pretty cool call.

later

 

[Dukes]

I used the splint twice, once for a gsw and the other for a trampoline accident. If you don't use a traction splint simply backboarding and whatever splints you have to immobilize would work. Traction though works really well though. Many would say its better pain relief than the amount of morphine you could give in the field.

 

[Apollyon]

Once on the paid unit, we got to a call where the volleys had used a Sager on a guy - ~70, fell off a roof, open distal femur that had spiked into the ground (yeah, that's the image - guy upright from broken femur sticking into ground). I remember my partner using a 4X4 to knock some dirt, mud, and grass off the end before they put the traction on. Seemed to work well, and we took him to the trauma center.

The rest of the story...turns out, it shouldn't have been used, since the guy had a proximal fracture (and, therefore, comminuted, and the splint shouldn't have been used), and, about a year later, when I talked to one of the volleys, he said, "Oh, that guy died a few weeks later!". My assumption was sepsis.

Other time I've seen it were the local municipals here about 2 months ago - sure was a fracture, and the splint did wonders.

 

[hospPA]

I think it is great for helping to relieve pain of the bone fragments pulling towards one another by the huge hamstring and quad muscles. It is especially good for basics who do not have the luxury of morphine on the rig. It is useful in certain situations, sometimes very. I have never used MAST trowsers in the field.
Pat

 

[12R34Y]

I've never worked for a place that had MAST pants on the rigs. thought those were a thing of the past. are people still using them for anything other than stabilization of multiple lower leg/pelvic fractures?

later

 

[M4ttjabz]

I've never worked for a place that had MAST pants on the rigs. thought those were a thing of the past. are people still using them for anything other than stabilization of multiple lower leg/pelvic fractures?

later

Both MAST trousers and the correct application of a traction splint are taught in Virginia B classes, well atleast mine. It's pretty fun to see how long a healthy subject can put up with adding additional traction, in class, we almost pulled a classmate's leg completely off, not on *purpose* ofcourse.

-Matt

 

[bemused]

Traction is great for pain relief d/t quad contraction, and makes it easier to get the pt on a board... like mentioned above, very very stable. Used it several times - all MVCs.

They still teach MAST in the ole South, but I never used it in 6 years. Come to think of it, I've only known one person who ever used MAST. He put them on a guy who cut his femoral with a chainsaw to get control of the bleed.

 

[deleted6669]

wow...I must be getting old....was taught mast use for trauma in my emt-p program but used only occassionally in the field as they were starting to phase out in the early 90's......

 

[dgmedic]

I have never used it....but I am curious what you would do for a broken femur besides using the traction.

Have used it....but not any more.....a couple hundred mcgs of fentanyl usually does the job.

 

[12R34Y]

can't say i agree with just giving high doses of narcs to cover up something that you can fix temporarily (pain anyway) with a traction splint.

If it is indicated it should be placed unless strange circumstances. That is what they will do in the trauma bay before it goes to the OR.

If you can significantly reduce their pain by traction (which it does) then you can avoid giving patient tons of narcs which as we all know have side effects etc....

later

 

[flighterdoc]

I have never used it....but I am curious what you would do for a broken femur besides using the traction.

I've used various traction splints many times... My preference is the Sager bi-lateral, but have used the KTD more or less original Hare, and even the originial half-ring splint with a couple of triangulars ("cravats") and "spanish windlass" (stick to tighten the triangular for traction). I used to have a WWI era full-ring splint but gave it to a museum. I carry a KTD, it's about the size of a liter bag of fluid and weighs less.

The environment was always wilderness rescue - and mid-shaft femur fx's. Any hip or knee involvement and the pt gets secured to a full-length board and then secured into a stokes.

The alternative (back in the day) was to use triangulars or duct tape to secure the fx'd leg to the nl leg. Not a particularly good choice.

 

[flighterdoc]

Traction is great for pain relief d/t quad contraction, and makes it easier to get the pt on a board... like mentioned above, very very stable. Used it several times - all MVCs.

They still teach MAST in the ole South, but I never used it in 6 years. Come to think of it, I've only known one person who ever used MAST. He put them on a guy who cut his femoral with a chainsaw to get control of the bleed.

The only time I ever used MAST was for hip fx's - provided good stabilization.

 

[bemused]

Have used it....but not any more.....a couple hundred mcgs of fentanyl usually does the job.

I'm all for pain management, but do you really transport femur fractures w/o traction stabilization? Seems like the risk of further tissue & vasculature trauma would be too great to not use traction 😕

 

[bemused]

Quote:
Originally Posted by bemused
Traction is great for pain relief d/t quad contraction, and makes it easier to get the pt on a board... like mentioned above, very very stable. Used it several times - all MVCs.

They still teach MAST in the ole South, but I never used it in 6 years. Come to think of it, I've only known one person who ever used MAST. He put them on a guy who cut his femoral with a chainsaw to get control of the bleed.



Quote:
Originally posted by flighterdoc
The only time I ever used MAST was for hip fx's - provided good stabilization.

Not the typical use of the MAST, but apparently this was a rather large injury, not controlled by dirct pressure, and the patient was rapidly exsanguinating. I love it when medics use their head to solve problems in unique ways!

 

[Oats]

I too have used it about 2-3 times. I think it's a great device... 👍 👍

 

[Daedalus]

They still teach MAST in the ole South, but I never used it in 6 years. Come to think of it, I've only known one person who ever used MAST. He put them on a guy who cut his femoral with a chainsaw to get control of the bleed.

They tell us what the PASG is here in CA, and some very general indications/contraindications, then we are told to never use it lol. As if our scope wasn't limited enough in LA county
and no - never used traction

 

[dgmedic]

yup, no traction, the extra length will not fit in the aircraft. No traction...manage their pain. That' the way I do it. If you want to use it, do. I am more concerned about managing their pain. As far as additional tissue damage, I would imaging it's pretty minimal. Why spend the extra time screwing around with the traction....get to the hospital. If I was in a position to place on while en route, possibly....it gets an injury priority just like everything else. Not saying that anything is wrong with it though.

- dg

 

[12R34Y]

I guess I"m just more interested in treating the source of their pain instead of just the pain. Putting them in traction often eliminates much of the pain so you don't have to give them as much narcs. but, if you are in an aircraft and can't then i guess you can't, but I think you would agree that most of EMS is done on the ground.

later

 

[FoughtFyr]

yup, no traction, the extra length will not fit in the aircraft.
- dg

Depends on the aircraft...

- H

 

[dgmedic]

correct, the post was regarding my not using one. If I flew in a BK, sure, we could put one on if we had time.

 

[sanford_w/o_son]

yay! just used it for the first time, but not in the field. transport from an e.r. to another hospital, and the e.r. did not have a traction splint. i remembered it well enough from class to use save one problem: there was no ring on the ankle cuff upon which to latch the hook (that is, the hook attached to the strap connected to the crank). we ended looping it around the inside of the ankle cuff and attaching the hook to the bottom of the splint. it worked, but caused the strap to push down on the foot. she still had good PMS 30 minutes later, when we dropped her off.

today i felt medically useful, and did something the average (and better-paid)taxi-/semitruck-driver couldn't!

 

[bandaidsNhoses]

hmm..as a door chock to our office..