Splinting is a common procedure in immediate medical care, involving the application of an external device to stabilize and protect an injured body part. This intervention is primarily utilized for musculoskeletal injuries like suspected fractures, dislocations, or severe sprains before a patient receives definitive treatment. A splint works by immobilizing the injured area, which helps reduce movement of bone fragments or damaged joints. The general goal of this initial stabilization is to lessen a patient’s pain and prevent the injury from becoming worse during transport or while waiting for further medical evaluation.
The Fundamental Purpose of Splinting
Splints are applied to achieve several immediate medical benefits for a patient with an unstable injury. Primarily, immobilization of the injured limb helps to significantly reduce pain by limiting the movement of bone ends or damaged soft tissues. This restriction of motion provides comfort, especially during movement or transport to a medical facility.
The procedure also serves to prevent further damage to surrounding structures, such as nerves, blood vessels, and skin, that could be torn or compressed by unstable bone fragments. Stabilizing a broken bone reduces the chance of a sharp bone end severing a major artery or causing nerve injury. Maintaining the limb in a position of rest protects the soft tissue envelope and prepares the patient for subsequent treatment. Stabilizing the injury also reduces the risk of closed fractures becoming open fractures, minimizing the potential for infection and significant blood loss.
Different Types of Splints Used
Healthcare providers use a variety of splint types, each designed to suit the specific location and nature of the injury. Rigid splints are constructed from materials like plaster, fiberglass, or wood, providing substantial support for long bone fractures or unstable joint injuries. These splints are often custom-made or molded to the patient’s anatomy to maximize stability.
Soft splints, such as slings, pillows, or blankets, are used for minor injuries, like sprains, or as a temporary measure for comfort. Specialized devices include air splints that inflate to provide uniform pressure, or vacuum splints that conform to the limb’s shape when air is removed. Traction splints are used almost exclusively for mid-shaft femur fractures; they apply a steady pull to the leg to reduce muscle spasm, align bone fragments, and decrease pain.
The Nursing Process of Application
The process begins with a careful assessment of the injured limb. Before applying the splint, the nurse must perform a neurovascular check (CSM check), which evaluates circulation, sensation, and motor function distal to the injury site. This baseline assessment establishes the limb’s condition and confirms the presence of pulses, warmth, and the patient’s ability to move their fingers or toes.
After the initial assessment, the extremity is gently positioned, ideally in anatomical or functional alignment unless this causes increased pain. Splinting materials are prepared by applying layers of protective padding, such as cotton or stockinette, directly against the skin to prevent pressure sores. The splint material, whether plaster or fiberglass, is applied over this padding and must extend past the joints both above and below the fracture site to ensure complete immobilization.
The nurse secures the splint with an elastic wrap, wrapping firmly enough to maintain stability without compromising blood flow. Following application, the CSM check must be immediately repeated to ensure the splint has not caused neurovascular compromise. Finally, patient education instructs the patient to monitor for signs of restricted circulation, such as numbness, tingling, pallor, or worsening pain, and to seek immediate attention if these symptoms appear.
Key Differences Between Splints and Casts
Splints and casts are both devices used for orthopedic immobilization, but they differ significantly in their construction and application. A splint is a non-circumferential device, meaning it does not fully wrap around the circumference of the injured limb. This design allows for the inevitable swelling that occurs following a musculoskeletal injury, minimizing the risk of complications such as compartment syndrome.
A cast, in contrast, is a rigid, circumferential wrap that completely encircles the limb. Casts provide superior, long-term immobilization and are reserved for definitive treatment of stable fractures after acute swelling has subsided. Splints are the preferred method for temporary stabilization in emergency departments because they are easier and faster to apply and can be easily loosened or adjusted to accommodate fluctuating swelling.