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Pediatric Traction Splints


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#1 DECFRN

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Posted 18 December 2011 - 02:54 PM

What are you folks using for femur fractures on those kids who are too small for the standard pediatric "Hare" style traction splint? I have heard good things about the Sager splint, but have no personal knowledge of it. Any feedback would be appreciated. Thanks. :D


David
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#2 jpd9191

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Posted 01 January 2012 - 02:32 AM

We use the Sager splint for peds on the ski patrol due to sizing ranges. The hare splints work better for transporting a patient down the hill and are faster to apply (opinion), but the splint juts out and does not fit into all helicopters well. However, the size range is better on the single pole Sager and fits most of our kids, not the 2 to 3 year-olds flying down the hill, but small children. Much better than two ski poles, cravats, duct tape, rope, and a branch.


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#3 BackcountryMedic

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Posted 01 January 2012 - 03:24 AM

Most kids do fine with a good splinting (no traction) in a litter or a vacuum mattress (best). If you effectively immobilize the hip and the legs there is little need for traction, especially when you consider that kid thigh muscles are not as strong as adults.

If you must have a traction splint try the KTD (http://www.buyemp.co...traction-device). Very compact, light and effective. Works on adults and pedis.
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"If everybody is thinking alike, then somebody isn't thinking" - Patton

#4 pureadrenalin

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Posted 02 January 2012 - 01:08 PM

Most kids do fine with a good splinting (no traction) in a litter or a vacuum mattress (best). If you effectively immobilize the hip and the legs there is little need for traction, especially when you consider that kid thigh muscles are not as strong as adults.

If you must have a traction splint try the KTD (http://www.buyemp.co...traction-device). Very compact, light and effective. Works on adults and pedis.


+1. KTD works great for everyone. Faster than the hare, and fits in a heli.
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#5 JLP

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Posted 11 January 2012 - 05:05 PM

+1. KTD works great for everyone. Faster than the hare, and fits in a heli.


Bearing in mind that I don't see a lot of kids, I was thinking - I am wary of traction in (small) kids because, first, it's usually not necessary given the low muscle mass in kids. More importantly for me, given the greater delicacy of structures, especially nerves and vessels, I would be concerned about the increased of doing more harm than good. If you goof and put an extra 5-10 pounds traction on an adult by mistake, the patient will likely tell you, but also the resiliency of adult anatomy means that it likely won't do a lot of harm. An accidental extra 5-10 pounds traction on a 4 year old will damage many structures - nerves, small blood vessels, ligaments, hip joint and muscles, etc. What are people's thoughts? Am I overcautious about this?
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#6 jpd9191

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Posted 12 January 2012 - 05:00 AM

Bearing in mind that I don't see a lot of kids, I was thinking - I am wary of traction in (small) kids because, first, it's usually not necessary given the low muscle mass in kids. More importantly for me, given the greater delicacy of structures, especially nerves and vessels, I would be concerned about the increased of doing more harm than good. If you goof and put an extra 5-10 pounds traction on an adult by mistake, the patient will likely tell you, but also the resiliency of adult anatomy means that it likely won't do a lot of harm. An accidental extra 5-10 pounds traction on a 4 year old will damage many structures - nerves, small blood vessels, ligaments, hip joint and muscles, etc. What are people's thoughts? Am I overcautious about this?




Over cautious...?...no, not at all. I have applied traction once to a 5 year old, no one younger. The poor kid lost all CMS and slight traction within a cardboard splint restored blood flow. Backcountrymedic is correct, good splinting and immobilization cures almost all under 100 pounds or so.
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#7 jpd9191

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Posted 12 January 2012 - 05:00 AM

Bearing in mind that I don't see a lot of kids, I was thinking - I am wary of traction in (small) kids because, first, it's usually not necessary given the low muscle mass in kids. More importantly for me, given the greater delicacy of structures, especially nerves and vessels, I would be concerned about the increased of doing more harm than good. If you goof and put an extra 5-10 pounds traction on an adult by mistake, the patient will likely tell you, but also the resiliency of adult anatomy means that it likely won't do a lot of harm. An accidental extra 5-10 pounds traction on a 4 year old will damage many structures - nerves, small blood vessels, ligaments, hip joint and muscles, etc. What are people's thoughts? Am I overcautious about this?




Over cautious...?...no, not at all. I have applied traction once to a 5 year old, no one younger. The poor kid lost all CMS and slight traction within a cardboard splint restored blood flow. Backcountrymedic is correct, good splinting and immobilization cures almost all under 100 pounds or so.
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#8 yourAVERAGEmedic

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Posted 01 February 2012 - 03:53 AM

traction splints over all have limited use. They are designed for isolated mid-femur FX. There is was a recent study released in the Journal of Prehospital Emergency Care that found a very high complication rate with their use. I fully support good full-extremity splinting over a traction splint in most cases.
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Kevin Collopy, BA, FP-C, CCEMT-P, NREMT-P, CMTE


#9 DECFRN

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Posted 26 June 2012 - 01:59 AM

traction splints over all have limited use. They are designed for isolated mid-femur FX. There is was a recent study released in the Journal of Prehospital Emergency Care that found a very high complication rate with their use. I fully support good full-extremity splinting over a traction splint in most cases.

Hi Gang,
Just a little follow up to my original question. I hadn't seen the JPEC study mentioned above, but in some recent cases utilized the vacuum splint. What a great device! It adequately immobilized the two patients for the 1.5 to 2 hr. ground transports back to our facility. Pt's remained neurovascularly intact, and remained in their position of comfort. Thanks to all who responded!


David
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