Name:
Sherman: Simon’s Emergency Orthopedics 8e Video A-3B
Description:
Sherman: Simon’s Emergency Orthopedics 8e Video A-3B
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/7b136e7f-f24a-4cf6-9812-30046825c5d1/thumbnails/7b136e7f-f24a-4cf6-9812-30046825c5d1.jpg?sv=2019-02-02&sr=c&sig=VgS3dF06L6Ek54Ief9Cq1l4ZgdU07zPo6WnCx9%2Bk5cw%3D&st=2024-04-27T22%3A46%3A53Z&se=2024-04-28T02%3A51%3A53Z&sp=r
Duration:
T00H07M03S
Embed URL:
https://stream.cadmore.media/player/7b136e7f-f24a-4cf6-9812-30046825c5d1
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/7b136e7f-f24a-4cf6-9812-30046825c5d1/A-03B20Sherman_7e.mov?sv=2019-02-02&sr=c&sig=HdpQnkpXcHktJ43%2Fv%2Fh7LHQwEpzjodNCDGn9ByGtYpE%3D&st=2024-04-27T22%3A46%3A53Z&se=2024-04-28T00%3A51%3A53Z&sp=r
Upload Date:
2022-02-27T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
I want to show you how to do plaster splint material. Most of the splinting we do in the emergency department today is with fiberglass. Plaster splint materials are nice when you have a fracture that needs to be reduced, it's unstable. Most orthopedists and those interested in orthopedists feel that plaster is useful in this situation. So what do you need to put on a plaster splint?
You need a Webril, or sometimes called cotton padding, although it's made of a synthetic material to pad the extremity. You need the plaster material, which comes in long strips. It also comes in rolls, so you unroll it and make the flat strips with the roll. And you need, lastly, an elastic bandage and some warm water. So what I do to start is you want to measure out the splint that you're going to put on.
And so in this case, we're going to put on an ulnar gutter splint. And an ulnar gutter splint's going to go on the ulnar surface of the extremity, the upper extremity. And it's going to include the fifth and fourth digit in the forearm. So usually I use some Webril padding to measure out the length of the splint that I want.
And, again, if I was going to use the plaster roll, I would roll that plaster out, back and forth, until I had about 10 to 12 sheets of the plaster. In this case, I've pre-laid out some plaster that is approximately 10 sheets in thickness. I go ahead, and I'm going to dip this in when I'm ready to use it. But before I do so, I want to pad the extremity.
So it's always a good idea, when you're padding, you want to pad bony prominences. So just take a little bit of the Webril off, and in this case, put it in between the fourth and fifth digits to pad those digits. And then wrap the rest of the fingers. So we're just going to be around the fourth and fifth digit. And, if you can, you want the fingernails to be visible.
And you don't have to wrap this around perfectly. It's OK if it tears, if you put additional Webril around. And oftentimes you'll get a fold, and that's OK. Just smooth it out as best you can. If you need to tear it, you can do so as the upper extremity gets wider.
And again, anywhere like around the radial styloid, where there's more of a bony prominence, you can pad that area with a little additional Webril. OK. Once there's significant padding, then you can go ahead and wet the plaster.
You can use gloves or not. What you want to do is dip the plaster in the water, and then squeeze out the excess. And then I like to hold it up and fill in the gaps, just to help strengthen the plaster. OK, any additional, just squeeze it out, and then flatten.
Now it's ready to be applied to the extremity. What you can do to sort of protect it and make it easier to take the plaster off is put a couple layers of the Webril on either side. And this will just make the splint easier to remove when you're done.
And go ahead, if you would, and just hold it right there against this hand. And then the last thing you have to do is put the elastic bandage on. And you always, when you put a splint on, you want to go from the most distal location to proximal. So starting at the fingers, put the splint on again.
If you can visualize the fingertip, that's good. Lift your thumb up. Thank you. And if you'll hold that up, perfect.
You don't want to put the ACE bandage on too tight, maybe stretching just a little bit. If you do put it on too tight, it can cause compartment syndrome. And then lastly, you want to position the extremity-- the plaster has not dried yet-- so you want to position the extremity how you're going to ultimately want it to be.
So in this case, the MCP joints are going to be bent 60 to 90 degrees. The PIP and DIP joints are generally straight, fully extended. And then the wrist is going to be extended about 20 degrees. So position it how you want it to ultimately dry. It takes about 10 to 15 minutes for it to dry. Tell the patient that they will feel some warmth as the plaster dries.
It does give off some heat. So that's another reason why extra cotton padding is a good idea, to help protect the skin. And that's it for putting on a plaster splint.