# Traction Splint...Yes or No?



## Mike97 (May 16, 2021)

Happened to see this on LiveRescue the other day.  Looks like patient has GSW to leg and broken femur with some significant bleeding.  Would you have used a traction splint in this case?  Why or why not?

(Starts at 11:00)


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## DrParasite (May 16, 2021)

interesting... possibly, but unlikely.  

I would use the traction splint to pull the femur ends apart, which are causing the pain because the thigh muscle is pulling the two ends together however, in this case, the breaking of the femur was caused by a bullet, which likely damaged the muscle as it went through.  if I pulled on that muscle, would I be causing more damage to the already damaged muscle?  I also thought it was impressive that she was able to stand (with assistance) after being shot in the leg with a femur injury.  The paramedic keeps changing position with his partner, and he mentions he's going to hold traction as they are getting out, so I can't imagine it feels that good having the traction constantly being released.  

Further, the paramedic says it's bleeding pretty badly, so badly that he has to hold pressure on it during the transport.... hemorrhage control would likely be my priority, and I would try to do a pressure bandage.  if it was bleeding that badly, I'd be thinking of TQ.

I'd also point out that no one is wearing seatbelts in the back of the truck (including the cameraman, who is seen wearing jeans), but I've done the exact same thing if when I was in their position.


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## Akulahawk (May 16, 2021)

Hemorrhage control would also be my priority. Once that is accomplished, then I can move on to other things, such as providing pain control or limb immobilization. If the best option I have at that time is to use a traction splint, then I'll use it but my goal isn't to pull bone ends apart to provide pain control, it would be to use the traction splint as a splint to keep the limb relatively stable and immobile during transport. I can get the same physical result using other things as a splint, so pulling out a traction splint isn't my go-to, it's just one way to accomplish limb stabilization. Bleeding control is far more important.


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