Application of splints is a fundamental skill in emergency and orthopedic care, used to immobilize injured bones or joints, reduce pain, and prevent further damage.
Definition
Application of an immobilizing device to stabilize a broken bone or injured body part from moving and to protect it from further damage to body.
Purposes for Application of splints
- To support body part.
- To correct or prevent deformity.
- To provide stabilization.
- To enable application of traction.
- To provide first aid for fractured limb.
- To provide an erect posture for weight bearing.
- To manage sprains and strains.
Articles
- Splints.
- Cotton for padding.
- Bandage.
- Adhesive.
Procedure
| Nursing actions | Rationale | |
| 1. | Before procedure Explain procedure to the patient. | Helps in obtaining cooperation of the patient. |
| 2. | Collect articles at bedside. | Saves time and energy. |
| 3. | Provide privacy and position to the body part in its functional position. | Promotes comfort and good body mechanics. |
| 4. | During procedure Check distal pulse and record. | |
| 5. | Separate skin surfaces and pad adequately. | Prevents maceration of skin surface. |
| 6. | Pad bony prominences or hollow areas if present. | Avoids friction and prevents necrosis. |
| 7. | Immobilize joint above and below involved area. | |
| 8. | Secure splint with bandage and strap away from injured area. | |
| 9. | Check neurovascular status. | Identifies the neurological and circulatory complications at an early stage. |
| 10. | Instruct patient and relative to inform about any discomfort or change in color of skin. | |
| 11. | Remove and reapply splint if pain persists and swelling appears. | Pressure can compress the nerves and blood vessels of the area. |
| 12. | For patients who go home after splint application, give instruction for care at home. Discharge teaching: Splint should be worn as per doctor’s instruction. Splint should be kept dry, clean and dirt free all times. While bathing, the splint can be protected from water using large plastic bags secured at the top end; use waterproof shield or holding the area outside the bathtub or shower. Use hair dryer on the cool setting to dry the splint in case it gets wet. Hot or warm setting should not be used to avoid burns. Splint should be kept away from open flames, heaters, prolonged sunlight. Do not cut or tear the splint. Exercise all nearby free moving joints, parts not secured by the splint. Elevate the part of body that is in the splint to reduce swelling. Promptly inform the doctor in case of tingling or numbness, severe pain not relieved with medicine, tightly or loosely applied cast, swelling, paleness or cyanosed fingers or toes of the affected area, pressures sores and blisters. | |
| 13. | Document date and time of splinting, type of splint applied and purpose of applying such a splint, change in character of skin after applying, any discomfort felt by patient and action taken to relieve discomfort. | Documentation of procedure helps in identifying the problems patient has developed. |
Post-Application Care
- Elevate the limb to reduce swelling
- Monitor for signs of compartment syndrome: pain, pallor, pulselessness, paresthesia, paralysis
- Educate patient on:
- Splint care and hygiene
- Activity restrictions
- When to seek help (e.g., increased pain, tightness, discoloration)
Document:
- Type and site of splint
- Time of application
- Neurovascular status
- Patient’s response and education provided
Special Considerations
- Use child-friendly language and distraction techniques
- Respect modesty and cultural norms during positioning
- Involve caregivers in home care instructions
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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