Short Arm Splinting

00:07 Hello, welcome to the Skills on Point intro to Splinting Course.

00:11 In this video, we'll be showing you how to do a short arm splint with a 3M Scotch cast.

00:19 My name is Michael Karg.

00:20 I'm a physician assistant working in orthopedic trauma as an independent contractor for skills on Point.

00:26 We're going to teach you some tips and tricks today on how to appropriately apply a splint using this material.

00:34 One, the first thing when we're talking about splinting, what we want to do is have all of our materials close by and ready.

00:40 As you see on the table here, I have a bucket of water, lukewarm.

00:44 I have an ice wrap.

00:46 I have our splint material.

00:48 Always wear gloves with fiberglass so you don't get it on your skin.

00:51 And last but not least, we have some stockinette.

00:54 So we're prepared.

00:56 Everything's ready for the patient.

00:58 We're almost ready to apply the splint as we approach.

01:01 This patient has a distal radius fracture.

01:04 What we want to do first is to measure out our splint.

01:08 So I like to use Stockinette because once we break this seal, this splint material starts to cure and harden.

01:16 So you don't want to open it too early.

01:18 That's why we have everything ready as well.

01:20 What I'm going to do for this patient is measure out a short arm splint. Got the appropriate length.

01:30 I have my scissors ready.

01:36 I'm going to cut a thumb hole for a short arm splint.

01:48 And this X is like a barrier between a splint material and the patient's skin.

01:55 What you want to be cognizant of for distal radius fracture the distal crease distal palmar crease for a distal radius.

02:04 You want the patient to still be able to move their fingers, still be functional somewhat.

02:09 And then all the bony prominences that we have, we have the radial styloid, the ulnar styloid and kind of the base of the wrist. So we don't want to have those bony promises exposed to hard fiberglass. Now we're about ready.

02:23 Okay, don your gloves.

02:29 This stuff is really cool.

02:32 It's already comes pre-padded for you.

02:37 This is this specific fiberglass is 3x12.

02:41 Perfect for almost any forearm.

02:45 Thumb spike.

02:46 Distal radius fracture has padding on both sides.

02:52 So you're protecting the patient's skin along with this stockinette.

02:57 This is already starting to cure.

02:59 But to finish curing, we dunk it in water.

03:02 Immerse it completely.

03:04 Lukewarm water.

03:13 Squeeze out the excess water and then you want to have a place to where you can kind of smooth it out to get out all the excess water.

03:26 From here on there.

03:27 I'm ready to apply the splint.

03:29 Always, when you're splinting a patient, you want to have them in the most anatomic neutral position possible.

03:35 Depending on your fracture, you don't want to have somebody with their wrist flexed for two weeks while you're trying to treat a fracture because then it could cause pain and discomfort.

03:43 So we have our splint.

03:47 Be cognizant.

03:48 You can see at this view that she's able to still flex her fingers. I'm a little bit short of the stockinette padding that we have a little bit long down here, so we could always fold that over.

04:02 Ace wrap.

04:14 And there's my distal palmar crease, so we're not covering that.

04:17 She's able to move her fingers, not too tight with the ace wrap. You don't want to cause any compartment syndrome or anything like that. And I got this fancy ace wrap that sticks upon itself. So no clips or tape or anything necessary.

04:34 And if I'm trying to hold something, I'm easy right here.

04:37 It's nice and easy.

04:38 As you see, there's good padding around.

04:41 Like we talked about the thumb radial styloid.

04:44 Nothing along the ulnar Styloid.

04:46 This is pretty much good to go right here.

04:49 Kind of hold it. Tell the patient it's going to get warm.

04:52 Watch for them to have any complaints, any changes in neurovascular status, radial median ulnar nerve and watch them for 5 or 10 minutes until it gets hard and we're all done.

05:02 Short arm splint.