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Balance Skeletal Traction Script, Lecture notes of Nursing

Manuel S. Enverga University Foundation (MSEUF)Nursing
Prof. Dario Sumande

SCRIPT AND GUIDE - BST BALANCE SKELETAL TRACTION - CHECKLIST

Typology: Lecture notes

2023/2024

Available from 09/06/2024

kirsteen-irish-esplana
kirsteen-irish-esplana 🇵🇭

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BALANCE SKELETAL TRACTION
Traction- is the act of pulling and drawing which is associated with counter
transaction
INDICATIONS:
For the affection of the hip and femur
Purposes:
S-support
P-prevent or correct deformity
I-immobilization
R-reduce fracture
R-reduce muscle pain and spasm
M-maintain good body alignment
APPLICATION OF TRACTION
1. Verify/check doctor’s order to know the patient, the site of affection, and to
check the weights to be used
2. Inform the patient about the need and purpose of the purpose of the procedure
to allay patient’s anxiety and to elicit cooperation
3. Preparation
a. Identify the different part of the orthopedic bed
Balkan frame
4 vertical bars
2 horizontal bars
1 diagonal bar
Straight or cross bar
1 curved bar
Firm mattress
Fracture board
b. Gather equipment’s needed for BST:
Thomas Splint
Pearson’s attachments
Rest Splint
3 cord/ropes/sashes
5 Slings
5 Safety pins/paper clips
pf3
pf4

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BALANCE SKELETAL TRACTION

Traction- is the act of pulling and drawing which is associated with counter transaction INDICATIONS: For the affection of the hip and femur Purposes: S-support P-prevent or correct deformity I-immobilization R-reduce fracture R-reduce muscle pain and spasm M-maintain good body alignment APPLICATION OF TRACTION

  1. Verify/check doctor’s order to know the patient, the site of affection, and to check the weights to be used
  2. Inform the patient about the need and purpose of the purpose of the procedure to allay patient’s anxiety and to elicit cooperation
  3. Preparation a. Identify the different part of the orthopedic bed  Balkan frame  4 vertical bars  2 horizontal bars  1 diagonal bar  Straight or cross bar  1 curved bar  Firm mattress  Fracture board b. Gather equipment’s needed for BST:  Thomas Splint  Pearson’s attachments  Rest Splint  3 cord/ropes/sashes  5 Slings  5 Safety pins/paper clips

 3 Pulleys  Weights  Traction Weight – 10% of patient’s body weight  Suspension Weight – 50% of the traction weight  Steinman’s pin holder  Feet board  Overhead trapeze

  1. Assemble the Thomas splint and Pearson’s attachment  Estimate/measure the length of the thigh to ensure that the screws of the Pearson’s is in line with the knee.  The Pearson’s attachments must be under the Thomas splint
  2. Mount the Thomas and Pearson’s on the rest splint
  3. Apply the slings  Start from the medical side to lateral side, secure both ends together, fan fold nicely on the lateral aspect and secure with a pin or clip  Observe the Principles in Sling Application: a. Not too tight and not too loose b. One (1) inch distance in between the slings to promote aeration or ventilation c. Popliteal area and heel portion should be free from any slings d. Smooth and right side should come in contact with the patient’s skin to avoid friction and irritation e. Two (2) longer and wider slings for the thigh portion (Thomas) and the three (3) for the leg area (Pearson)
  4. Tie the thigh rope (shortest) on the medical upright of the Thomas with a slipknot and secure the other end of the rope at the screw of Pearson
  5. Insertion of the apparatus under the affected extremity Three manpower needed:  1 st^ person to insert the whole apparatus under the affected extremity  2 nd^ person to perform manual traction to be released after the attachment of the traction weight on the third pulley is secured  3 rd^ person to support and lift the affected extremity This is to be done simultaneously at the count of three (3) Instruction to the patient: Hold on the trapeze, flex the unaffected leg and at the count of three (simultaneous with the insertion of the apparatus) will lift the buttocks of the affected side
  6. Check the principles of sling application are followed; check the alignment; and make necessary adjustments. Adjust also the Pearson’s attachments if not aligned with the patient’s knee
  1. Hang the suspension weight on the 1st^ pulley
  2. Completely remove the suspension rope
  3. Loosen the thigh rope on the lateral aspect of the ischial ring and secure the loose end on the screw of the Pearson’s
  4. Apply manual traction on the Steinman pin holder
  5. Remove the traction weight
  6. Remove the traction rope from the third pulley and secure the loose and on the rest splint with a clove hitch knot; another knot on the Thomas and the Pearson’s attachment NURSING CARE OF PATIENTS’ WITH CARE
  7. Assessment – asses the patient as to level of understanding, consciousness
  8. Provision of the general comfort a. Skincare – head to toe, focus on sponging of the affected extremity b. Changing linen, slings c. Provide bedpan as needed d. Perineal Care
  9. Assess for the potential complication a. Upper respiratory – PNEUMONIA -provide bronchial tapping and teach deep breathing exercises b. Bedsore – good perineal care, proper skin care, turning or positioning/lifting of buttocks once in a while c. Urinary and kidney problem – good perineal care, increase fluid intake d. Bowel complication – fear of apparatus, no privacy lack of fluids, perineal care e. Pin site infection – observe for S/S infection – loosening pin tract, pus coming out, foul smelling drainage/pin site, fever f. Deformity – contracted knee, atrophy of muscles, foot drop joint contractures
  10. Provision of exercise: a. ROM exercises with the use of trapeze b. Deep breathing exercises c. Static quadriceps exercises – alternate contraction and relaxation of quadriceps muscles d. Toes pedal exercises
  11. Nutritional status – depending on the status of the patient – encourage patient to increase intake of foods rich in fiber, protein, vitamin C and calcium; increase fluid intake
  12. Psychological aspect – fear of unknown, fear of death, fear of the apparatus, fear of losing job, financial fear
  13. Provision of supportive therapy – offer books top read; discover interest; encourage listening to radio or watching movies/televisions if available
  14. Spiritual aspect- know his religion, encourage relatives to read him verses from the bible
  15. Diversional activities – logic games/crossword puzzle