# Maryland Splint Trouble



## Blueorchid (Nov 29, 2008)

Hello all

So I'm obviously new to this forum. I'm an EMT-B student taking classes in Maryland and I have a question for the seasoned vets out there. I'm taking my licensure test in December and I know splinting is obviously going to be a part of the test. I'm fairly good with learning all of the splints and I can apply them well enough except for one small problem...

With the two board bent knee splint I know one partner has to hold stabilization while the other ties the cravats under the knee joint, and above and below the injury site. My problem (and that of all the other girls in the class) is that we're required to hold both boards at the same time and my hands simply aren't large enough. I can wrap my arm around the bottom part of the boards and hold the top with my hands but I was told by my teacher that would be an auto-fail on the test. 

Does anyone have any advice on how to do this splint if you have small hands? Or can explain it in nice easy steps? In a real life situation I'm obviously going to ask for assistance but I refuse to fail the test because I'm simply not built to hold two boards together- I know there are EMT-Bs smaller than me...

Any help would be appreciated- thanks!


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## Ridryder911 (Nov 29, 2008)

Maryland still uses board splints? Wow! I haven't seen those in decades. 

R/r911


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## NJN (Nov 29, 2008)

Ridryder911 said:


> Maryland still uses board splints? Wow! I haven't seen those in decades.
> 
> R/r911



We still carry them, I was trained to use them during my basic class, but i still like my Velcro splints better.


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## rhan101277 (Nov 29, 2008)

NJNewbie196 said:


> We still carry them, I was trained to use them during my basic class, but i still like my Velcro splints better.



I haven't been trained to use them, we were trained on various size velcro splints but we were told sometimes you have to make do with whatever.  I think we also have some foam splints.

On one other note off topic, I used a Littman Stethoscope today and it was so much more impressive acoustically that my generic one.  I could actually hear my pulse through my shirt and undershirt, needless to say I was impressed.  This was the Littman Lightweight S.E. II which is the cheapest.


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## mycrofft (Nov 29, 2008)

*OP, have your instructor show the "girls" how to do it at break.*

Take him or her aside and ask for five minutes or less, go as a group, and have the instructor take one of you and exactly go through it. If a percived group (i.e., girls with little hands) are not passing, then there can be issues to raise.
Yes, really!


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## nick (Nov 30, 2008)

The boards should be long enough for you to slightly "bend" them enough so that you can hold them at either end. First hold one end of the two boardswith one hand, for the other end use a thigh or your side to hold one board, push the other toward you and grab it that way.

You may not have to do the bent-knee. It can be any of one of several different skills as you know.

Here is a link to the MIEMSS website on the EMT-B practical

http://www.miemss.org/home/EMTBPracticalExamination/tabid/150/Default.aspx


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## Clibby (Nov 30, 2008)

In my class we learned/teach how to use all the different splints including the boards. For the bent knee, you have two hands. You can hold stabilization by holding the two boards tight against the leg with your thumb and possibly the index finger at the side of the board; one hand above and below instead of holding the ends. Use the other fingers and the pressure from the board to continue to stabilize the leg. Can you use a towel or a blanket under the knee to assist in stabilization? I don't really see where the problem lies unless you only can use one hand or they have some distinct way of teaching it. What do they teach you to do and what are your materials? 

It sounds like they require you to hold the ends of the board which wouldn't provide the best stabilization unless the space under the knee is secured with a ladder splint, blanket, or something similar.


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## rmellish (Nov 30, 2008)

I can't honestly say I've ever used a board splint in a bent knee configuration


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## nj_stranger (Nov 30, 2008)

OK - let's see if I can explain this so it might help...

Take one of the boards and tie the cravat to it so you have an equal amount of cravat hanging off on either side of the knot. Put the splint on the outside of the knee so the knot is on the outside of the board. Pass both ends of the cravat under the knee so you can now hold the outside split against the knee by holding the cravats.

Does that help?


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## Clibby (Nov 30, 2008)

Honestly I would never splint a knee like that, it would be unbelievably painful for a real knee injury. Anyway, here is a video describing the Maryland knee splinting technique. Just be sure to use long enough board. (Which I also find unnecessary)

http://www.emstube.com/video/42/Bent-Knee-Splinting


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## Clibby (Nov 30, 2008)

Just to clarify, since I can't edit. My first post was describing a different way to splint which is taught near me (similar to an elbow splint), so disregard it. Just make sure you are communicating with your partner and the boards are long enough that they bend. Other than that, there really isn't any special technique that will make it easier.


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## Blueorchid (Nov 30, 2008)

To those that are astounded we might be tested on this...yeah I didn't really think it was a practical splint to learn either, but who am I to decide what EMT-Bs should and should not know?

However- thank you guys for the video and the MIEMSS explanation of the test. Both are useful regardless and I think the best thing will be to ensure that the boards are nice and long so there's less of a challenge in holding the ends together. Since I have the longer arms between me and my partner I guess I'm going to be the one holding while she ties the cravats...communication is key!

That or we'll get lucky and I won't get this splint at all...I'm keeping my fingers crossed.

Thanks again!


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## Ridryder911 (Nov 30, 2008)

I wonder if they test on the Thomas half ring traction splint as well and maybe the Sylvester resuscitation method too? 

R/r


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## mycrofft (Nov 30, 2008)

*Hey-yay-yay...watch how youse talks about the Thomas!*

I love training martinets. "The knee must be at a fifty-nine and one half degree angle and the splints made of Cedar of Lebanon wood". As bad as Honda mechnics.
Learn what they want you to do, do it, then in a pinch remember what NOT to do, namely, create pressure to cause injury, and fail to immobilize or take subsequent Cir/Sense checks.

I like using Medirip for splinting stuff like that, nonskid, no knots, and you can get almost any angle.


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## BossyCow (Dec 1, 2008)

We still teach the board splint in wilderness fa. I'm not sure how your instructor would take it, but I teach people to use the pt for an extra set of hands while splinting bandaging etc. If the pt is conscious, asking them to 'here, hold this right there' is certainly acceptable.


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## bonedog (Dec 1, 2008)

I cann't remember what went first wooden splints or Holger-Nielsen AR....


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## mycrofft (Dec 1, 2008)

*I just splinted a broken tib fib two hours ago.*

2 ABD's, SAM splint, two 18 inch pieces of 4" medirip...voila. I saw the xrays with the splint on; edge-on it is a radioopaque thin line, straight through and it doesn't appear.

OP, let us know how this comes out for you!


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## mycrofft (Dec 3, 2008)

*tib fib postscript: he's back. Getting way off OP*

Maybe a bone condition, three fx in ten years and no appreciable callus, just barely knit even with ORIF in the last three years (fx #2).


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## Sasha (Dec 3, 2008)

Reading the title I thought there was something called a "Maryland Splint"


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## Scout (Dec 3, 2008)

What splints are ye using sasha?

box, blow up , vacume, sam? other


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## Sasha (Dec 3, 2008)

Scout said:


> What splints are ye using sasha?
> 
> box, blow up , vacume, sam? other



We use box, and vacuum. I love the vacuum splints! <3 They make all others obsolete.


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## Scout (Dec 3, 2008)

have to agree,


Do you have a probelm keeping it hard some of the time?


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## Sasha (Dec 3, 2008)

Scout said:


> have to agree,
> 
> 
> Do you have a probelm keeping it hard some of the time?



No. Ours are pretty good at staying put and staying firm!!


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## BossyCow (Dec 4, 2008)

Scout said:


> have to agree,
> 
> 
> Do you have a probelm keeping it hard some of the time?



The valves need to be checked. If your vacu splints are losing air, they made need repair or replacement.


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