# Traction splints - tips of the trade?



## fm_emt (Jan 25, 2006)

We're going to be tested on both the Sager & Hare traction splints in class. I got the chance to try out both of them last night, and I wanted to know if any of you had any tips or things to keep in mind. 
One of the reasons I'm asking is because they both seem fairly straight forward to operate and my brain keeps saying "You're missing something.."


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## emtff376 (Jan 25, 2006)

Ahhh, traction splinting.  We use the sager, hare, thomas and the KED brand of traction.  Love them all for different reasons.

Big thing to remember is that sager can be used for bilateral femurs and the hare isn't designed for it.  Disadvantage of the sager is you have to know the person's approximate weight to apply appropriate traction (although every protocol here says "mech. traction equal to manual traction")

Here's my mental check list for traction (for the hare)

bsi/ss/etc.
determine it is mid-shaft
check CMS distal to the injury
have someone take c-spine
have someone manually stabilize above and below the injury
apply ankle hitch
apply manual traction until pt feels relief
measure splint against good leg and adjust to fit
lift injured leg and slide splint under leg
apply ischial strap
apply mechanical traction
apply straps
check CMS distal
backboard them
check CMS again
transport

that sounds right to me... (I did one friday, but using a different splint).


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## FFEMT1764 (Jan 25, 2006)

and dont forget that it must be a midshaft femur fx to use the hare...if its a femur head fx the hare is useless...i go with the inverted ked trck for femur heads and hips.


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## Ridryder911 (Jan 25, 2006)

Tips for testing.. 

maintain traction at all times... be sure to place ankle hitch prior to traction..(other wise positioning hands can be tricky

be sure you have PLENTY of padding on the ischial bar...

thigh strap is secure

invert the straps so you can undo them more rapid and won't stick on carpet...


After you are through.. don't forget to check stability of splint as  well as PMS...

God luck,
R/R 911


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## TTLWHKR (Jan 25, 2006)

I have often used it to immobilize the tib/fib fractures, with out the use of traction.


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## ffemt8978 (Jan 25, 2006)

The Sager is good, especially for bilateral femur fx's.  The Hare is good for long transport time.  But nothing beats the KTD for field work.  Simple to use, fast to apply, and traction does not have to be maintained while applying (although it does make the patient feel better).


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## Stevo (Jan 25, 2006)

i'm ok with either

anyone here ever use the Thompson 1/2 ring?

oh and, just as an aside, watch what you jam up into a patients crotch, i know it's an _uhmm_ minor point , but hey customer service is the whole game....

~S~


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## MMiz (Jan 25, 2006)

One of my partners had the traction splint applied to her in EMT class.  I'm sure you've all practiced on real people.  Unfortunately they applied too much traction... they had to drive her to the hospital :unsure:


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## TTLWHKR (Jan 25, 2006)

Stevo said:
			
		

> i'm ok with either
> 
> anyone here ever use the Thompson 1/2 ring?
> 
> ...


 
Thomas Half Ring.

Yes. My father has dozens of them, and probably every ambulance with in 50 miles of his house has a box of them too.


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## SafetyPro2 (Jan 25, 2006)

We use the Sager on our rigs, but I train on the Hare when I do ARC classes, so I'm good with both.

One tip that we were hammered on when I was in my EMT class was "Anchor, Anchor". In other words, make sure the two extreme ends are secured prior to securing the middle straps. Also, of course, make sure the middle straps are either side of the suspected fracture so that you're not putting one right across the wound.


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## emtff376 (Jan 26, 2006)

Stevo - I am most comfortable with the Thomas, since it was the first traction splint I learned.  Next would be the Hare, then the sager.

We have one of the KTDs. That's what I used on Friday.  It is definitely quick and easy to apply.


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## FFEMT1764 (Jan 26, 2006)

we have the hare and the sager...but if we get a true femur fx we have to keep in mind what will fit in the helicopter....we DO NOT ground transport femur fx unless the weather is too bad for flight- pts dont like 45 minute ground times with a broken femur bleeding into the thigh...that whole if you run out of fluid the pump stops thing...


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## fm_emt (Jan 27, 2006)

Cool, thanks for the responses, guys. :-D


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## FFEMT1764 (Jan 27, 2006)

Glad to provide ya with the info!


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## fm_emt (Mar 23, 2006)

Yup. we do our NR practical testing stuff tonight. I think I have both the Sager and the Hare down pretty good. I'll let y'all know what happens when I'm finished. heh.


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## podmedic@mac.com (Mar 23, 2006)

Don't forget to make sure the partner holding traction is in a position they can hold for a while.:unsure: 

A trick that was showed to me a few years back was to take traction with your arms extended and then lean back to let your body weight maintain the traction and not your arm and shoulder muscles.  This takes a bit of practice but will save you if you get a big patient with a relatively heavy leg.


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## Stevo (Mar 23, 2006)

> Stevo - I am most comfortable with the Thomas, since it was the first traction splint I learned. Next would be the Hare, then the sager.
> 
> We have one of the KTDs. That's what I used on Friday. It is definitely quick and easy to apply.



we 'evolved' here to the Sager, emtff376, yet i've no clue as to a KTD

anyone wanna help this dinosaur out ?

~S~


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## ffemt8978 (Mar 23, 2006)

Stevo said:
			
		

> we 'evolved' here to the Sager, emtff376, yet i've no clue as to a KTD
> 
> anyone wanna help this dinosaur out ?
> 
> ~S~



[FONT=Arial, Helvetica][SIZE=-1]The KTD can be applied by a single rescuer and folds down to fit into a 12”x6” pouch.   The lower extremity traction system is made up of a folding snap-out aluminum pole, color-coded elastic leg straps, adjustable ankle hitch, and adjustable groin strap.  This allows it to be sized to almost any patient, and doesn't require you to lift the leg to apply it.  Very easy to use, and very compact storage (in a bag approx. 12" x 6").[/SIZE][/FONT]


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## TTLWHKR (Mar 24, 2006)

*Ktd*


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## Jon (Mar 24, 2006)

I spoke with an EP&R rep today.... costs less than $150!!!


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## TTLWHKR (Mar 25, 2006)

Ebay........


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## ffemt8978 (Mar 27, 2006)

TTLWHKR said:
			
		

> Ebay........



You should just put that in your signature line.


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## IVgal (Aug 14, 2007)

"the disadvantage of the Sager is knowing the spprox. weight of the patient" 

What about the 'awe' factor? Or no more than 15 lbs? The thing about Sager too is that you don't have to maintain manual traction throughout transportation - and it fits within the bodies silouhette, better for boarding. Not to mention it doesn't cut off the feeling to your legs like a Hare (the SI nerve under the back of the leg gets piched in a Hare) - Nor does the Sager act as a turnicate like the KTD if applied too tight. 

There's a new Sager too - the Sx405, that's the total fraction response system. It can be converted into a regular splint too, not just a traction splint. 

Did you know that KTD shows you how to apply traction to the arm...??? I thought traction was only ever applied to the femur???


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## ffemt8978 (Aug 14, 2007)

The KTD was originally designed for wilderness EMS, where it may be several hours/days before you can get your patient out.  Traction can be applied to any limb if required, but is generally (and by protocols) only done to the femurs.


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## IVgal (Aug 14, 2007)

So KTD is designed for wilderness, where removal might take hours/days... and if they KTD restricts flow of the femoral artery and acts as a turnicate... bye-bye leg? 

I just attended a conference for the western division ski patrol association and the general consensus was KTD for immediate extrication - simple, light-weight etc etc... most of the patrolmen there didn't seem to care that they could possibly damaging the femur further by cutting off circulation, or possibly causing more damage by moving the broken femur (soft tissue/nerve/artery damage) if the top strap is too tight... I do understand that time is of the essance, but what about the patient? 

Sorry, I'm just trying to understand why they wouldn't go with a superior product that might take an extra minute to apply if it means he gets to keep his leg...


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## Ridryder911 (Aug 14, 2007)

If any device causes circulatory obstruction, it was usually because it was placed improperly by the rescuer. The thigh/inguinal strap is only supposed to be taught enough to prevent slippage and placement for traction to occur. It is no different in design than the first original Thomas half-ring splint , then the Hare, Sager, etc.. Proper padding is the key on any splint. 

Basically all tractions splints are equal in how they operate, rather it is just the mechanics and materials that makes the difference. 

When properly splinting, any extremity in-line traction's is supposed to occur, (for long bones) to prevent ends from lacerating nerves, muscle, tissue and of course artery and venous vessels. As well, in by doing so, reduces muscular spasms and prevention of nerve damage, especially in large muscle groups such as the quadriceps. 

R/r 911


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## IVgal (Aug 14, 2007)

I'm pretty sure my problem with the KTD/CT-6 is that there is no padding, no base to assist with stationing the strap at the top. 

And you're right - any trained prefessional should be able to apply a traction device without turning it into a turnicate. There is still alot of ignorance out there though.


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## Rattletrap (Aug 14, 2007)

I kinda find this topic interesting. I have been very active in EMS for 18 years and have applied a traction splint on one patient and that was a month ago.

I was taken aback that my partner did not know how to put one on someone. I have been certified in West Virginia and have been tested on it every two years as part of the recert skills exam. I am also certified in Ohio where I currently live and once you get your card you can just do continuing education and recert.  i have since discovered there are many in Ohio who have been around awhile and have no clue how to apply a traction splint.


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## ffemt8978 (Aug 14, 2007)

IVgal said:


> So KTD is designed for wilderness, where removal might take hours/days... and if they KTD restricts flow of the femoral artery and acts as a turnicate... bye-bye leg?
> 
> I just attended a conference for the western division ski patrol association and the general consensus was KTD for immediate extrication - simple, light-weight etc etc... most of the patrolmen there didn't seem to care that they could possibly damaging the femur further by cutting off circulation, or possibly causing more damage by moving the broken femur (soft tissue/nerve/artery damage) if the top strap is too tight... I do understand that time is of the essance, but what about the patient?
> 
> Sorry, I'm just trying to understand why they wouldn't go with a superior product that might take an extra minute to apply if it means he gets to keep his leg...



Which would you rather carry with you 20 miles into the wilderness?  The KTD was not designed for every scenario, but as a compact alternative to those who can't carry their ambulance with them.


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## IVgal (Aug 14, 2007)

There are other compact traction splints out there. I do understand the need for something small and light weight. But if you're going to put someone in traction for an extended period of time, it would be best to put them in something that would maximized pain relief and the threat of bleeding out. KTD and the Farteck CT-6 are ok products, but not the most effecient. Of course this is just my opinion.


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## Ridryder911 (Aug 14, 2007)

If you are talking about EMS traction splints being used for longer than a few hours;  all of them are crap! They can produce damage to the sciatic nerve as well provide poor traction due to muscular spasms, and really only providing about 10% of the body weight is not a significant amount to do anything. Again, all we are attempting or goal is to prevent neurovascular injuries. 

The reason we even use traction splints is to prevent injuries, such as I have described. It is not a traction device for reduction or even keeping alignment of the distal ends of the fracture site from moving. Definitely, not anything such as a fixation device and bucks traction, with *weights*. 

All of our traction splints are temporary devices until surgical intervention or other methodologies can be utilized. 

R/r 911


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## ffemt8978 (Aug 14, 2007)

IVgal said:


> There are other compact traction splints out there. I do understand the need for something small and light weight. But if you're going to put someone in traction for an extended period of time, it would be best to put them in something that would maximized pain relief and the threat of bleeding out. KTD and the Farteck CT-6 are ok products, but not the most effecient. Of course this is just my opinion.



True, but your original post was talking about the Sager, which is what I was comparing the KTD to.


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## june (Sep 9, 2007)

Glad to provide ya with the info!
:unsure:


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## certguy (Sep 9, 2007)

Boy , there's something out of the past . I haven't even heard of a thompson half ring since the early 90's . I've always used a hare , though the more I use a Sager , the more I like it for bilateral use and not tying up both partners . 

                       CERTGUY

Remember ; Murphy's an optimist with a sense of humor .


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## rmellish (Sep 11, 2007)

A little bit of backtracking, but make sure the splint isn't longer than necessary, just slightly longer than the foot with the Hare, or until correct traction weight with the Sager (we don't use them anymore)., pt.s dont seem to like having the ambulance door shut on their fractured leg.


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