slishman traction splint contraindications

Nicholas M. Studer, MD, EMT-P; Seth M. Grubb, BS; Gregory T. Horn, MD; Paul D. Danielson, MD, FACS, FAAP. This allowed for greater stabilization during medical evacuation through rough terrain and better conservation of limited supplies than the previously-used plaster-of-Paris spica. 2. The Carbon Fiber Traction Pole Does not conduct heat away from the patient, nor does it transfer cold to the patient as an aluminum pole will. Participants had a very negative outlook on the RS. Over 5000 femoral fracture casualties were treated in the last 9 months of the war by the British Army alone. As these low hanging fruit decrease in incidence due to improved care, attention must also turn to lesser contributors in order to minimize morbidity and mortality. The STS is Not Contraindicated in Lower Leg Injury or Amputation - While other traction splints are contraindicated with lower leg injury or amputation, the STS unique design allows the ankle strap to be alternately positioned proximal to the calf or patella. A second survey was conducted after students had received instruction and placed all devices on the manikin without assistance in timed trials. Subjects had previously trained on traction splints an average of approximately 6 times. No long transport delays. The traction pole instantly adjusts for adult or pediatric use! This display was not visible to the participant, but participants could note lengthening of the shortened limb and improvement of deformity if the correct traction was applied. With the bone ends exposed (pierced the skin) the risk on infection is great. The STS's improved labeling and superior red color coding enable quicker patient femur fracture stabilization and application. The views expressed in this article are those of the authors and do not necessarily reflect the official position or policy of the U.S. Army, Department of Defense, or U.S. Government. Which traction splint are you the most confident in your ability to properly apply? Looking for replacement parts? This allows femur traction to still be applied and leaves the lower leg accessible for other splinting or bandaging * Lightweight and compact - it takes up little space in vehicles or aircraft and can easily be strapped to jump bags and backpacks * One size fits all the STS works with both adults and peds. Notably, Royal Army Medical Corps surgeons with the 202 Field Hospital reported successful use of the Thomas splint for treatment of seven casualties with femoral fractures in the first week of Operation Iraqi Freedom and strongly advocated for continued use. ITS ALL ABOUT TRACTION. However, size, weight, and the requirement to have assistance with application remove its relevance from the battlefield; This is too bulky and heavy. It was common for participants who failed to obtain traction with one device to fail to do so with multiple devices. It had the greatest participant confidence in their ability to apply the splint and that it would effectively treat femoral fracture. The substantial blood loss frequently associated with femoral fractures might require transfusion before entry into the medical evacuation system.3 Those casualties presenting with extremity wounds are more likely to be injured by gunshot (20.5% versus 11.5%) and to have a higher Injury Severity Score (21.4% versus 11.9%) than those injured elsewhere in the body.6 Nonbattle-related injuries such as motor vehicle accidents and falls may also result in femoral fractures. * Improved X-Ray Translucency * The traction pole is made from x-ray translucent carbon fiber. Quickly adjusts to patient. Four step application process in rapid and easy. SLISHMAN TRACTION SPLINT Manufactured by Tri-Tech Forensics, Inc. dba Rescue Essentials under U.S. When extricating or hoisting the splint stays safely contained within the board, litter or basket. Background: Femoral fracture is a common battlefield injury with grave complications if not properly treated. A review of the Joint Theater Trauma Registry indicated that approximately 2% of those wounded in combat in Iraq and Afghanistan from October 2001 through January 2005 sustained a femoral fracture. Carry case for the adult QD, TIII and TII traction splints. However, the population included in this study generally represented the typical enlisted field medical provider for the Armed Forces, and thus their opinion is of the most practical value. Thus, participants could not improve their performance by completing a prior iteration with another splint, as is possible for the other devices. It has a smaller footprint and no longer extends beyond the patients foot. Which traction splint do you believe is overall most appropriate for battlefield use? Brief standardization training on traction splinting was delivered via PowerPoint slides using the instructions for use provided by the manufacturer. The STS was developed by Dr. Sam Slishman at the University of New Mexico to overcome many of the the operational difficulties of older traction splint designs. Individual t-tests reveal these differences with comparisons between each device STS versus KTD (p = .19), STS versus CT-6 (p = .0028), STS versus RS (p < .0001), CT-6 versus RS (p = .032), and KTD versus RS (p < .0001). Femur traction is applied through the extension of the pole . Emergency Medical Products (EMP) carries a variety of immobilization and extrication equipment to meet your needs. Death on the battlefield (20012011): implications for the future of combat casualty care. Fifty-three participants completed two surveys and a single timed trial with each traction splint. If your agency requires you to carry two traction splints, two STS splints can be carried for bi-lateral splinting of peds and adults * Traction mechanism accessible during transport-If traction adjustment is needed while enroute, the STS traction adjustment is accessible at the patients hip, not jammed up against the door or airframe at the patient's foot. If your agency requires you to carry two traction splints, two STS splints can be carried for bi-lateral splinting of peds and adults. The innovative STS design has the traction mechanism positioned at the patients hip. The Slishman Traction Splint weighs 21 ounces (595 grams) in the case. No longer may first responders expect immediate evacuation of the wounded to surgical care within the Golden Hour. Combat medics and corpsmen may be required to manage the critically injured for indefinite periods, much like their counterparts in Americas previous wars. When extricating or hoisting the splint stays safely contained within the board, litter or basket. Total failures for each splint included multiple iterations where participants requested termination of the event prior to attempting full application of the device due to a high level of frustration with their skills. It had a full-ring ischial pad and used cravats in a clove hitch around the ankle (later a special attachment to the combat boots sole was developed) to pull traction on the femur. However, the treatment of femoral fracturesonce a major emphasis of battlefield care has received scant attention. Kit comes complete with all straps, ankle hitch and carry case. The Thomas splint was invented by Welsh physician and bone-setter Hugh Owen Thomas in 1875 for the treatment of tuberculosis of the knee. They are also available in both Aluminum Ratchet and Injection Molded configurations. One Size Fits All -The STS works with both adults and peds. Background: Femoral fracture is a common battlefield injury with grave complications if not properly treated. Testing showed no significant difference between the quantities of traction applied between splints, with all splints applying adequate traction. It can be used on patients with lower leg amputations and can be applied bilaterally. As with many other procedures, such as cricothyrotomy and tourniquets, the priority is different on the battlefield than in the civilian sector. It did not examine time to application or provider preferences. Adopted by major EMS agencies including Fire Department of New York (FDNY), Boston EMS, Dallas Fire-Rescue and LA County Fire. The STS (3.98/5) was also rated the highest as the device that best treated a suspected femoral fracture compared with the CT-6 (3.70/5, p = .00229) versus the RS (3.70/5, p = .00363) and the KTD (3.34/5, p < .0001). Battlefield extremity injuries in Operation Iraqi Freedom. 3. Insist on the best. One or more straps may be provided for securing the traction splint to the patient. Ideally suited for search and rescue, special operations, military medics, wildland firefighters, backcountry skiers, or anyone trying to minimize pack weight and cube space. Made in USA. Four step application process is rapid and easy. They are not adjustable in length, but do come in both Pediatric and Adult Sizes. Interested in our award-winning Slishman Traction Splints? However, as the military, and its Special Operations Forces in particular, adapts to fighting in a less-developed operational environment, the concept of Prolonged Field Care has surfaced. Which traction splint do you have the most training experience with? Statistical analysis of the times between these four groups is significantly different (ANOVA, F factor of 8.529 and p < .01). Sign up to hear about new product launches, deals, events, CEUs and other educational resources. One in five (20%) had treated a femoral fracture in some setting. Femur traction is applied through the extension of the pole segments creating a pushing force on the ankle strap instead of pulling distally from the foot. the KTD as part of the Expeditionary Medical Support (EMEDS) system.11 See Table 1 for a summary of splint specifications. In a low-volume urban EMS system in Illinois, only five of 4513 (0.11%) patients seen in 1 year presented with injuries suspicious to field personnel for femoral fracture. With failing times removed, the average student still applied the STS the fastest (225.3 seconds), followed by the KTD (258.7 seconds), then the CT-6 (301.3 seconds) and finally the RS (351.9 seconds). Traction Mechanism Accessible During Transport -If traction adjustment is needed while enroute, the STS traction adjustment is accessible at the patients hip, not jammed up against the door or airframe at thepatient's foot. While few disagree that traction splinting is an effective treatment for femoral fracture, controversy exists in the civilian sector over whether this treatment can be delayed during the projected Golden Hour or less that exists as patients move from the prehospital phase of care to that of the hospital. Another review of 3141 patients indicates a 14% mortality following the intervention of the Thomas splint. is very easy to repackage and store. It takes up little space in vehicles or aircraft and can easily be strapped to jump bags and backpacks. Unfortunately, the generalized poor performance and overall low confidence with traction splinting slightly decrease the value of the participants subjective comments. Due to these pressures asserting lack of recent evidence, the latest Equipment for Ground Ambulances policy statement by the American College of Surgeons Committee on Trauma and others lists femoral traction splints as merely optional for civilian EMS. From field to hospital: When applied, Sager Splint model SX404 is radiolucent to all areas of a femoral fracture. Unfortunately, it has proved difficult to evaluate these hypotheses in the civilian setting, and the data available in the military setting remain much the same as it was prior to the recent conflicts. The carrying case dimensions are 56cm x 7.6cm x 7.6cm. -Evaluation of Commercially Available Traction Splints for Battlefield Use, Journal of Special Operations Medicine Volume 14, Edition 2/Summer 2014, Dimensions:23" H x 3" W x 3" D (packaged)Dimensions: 45.5" H x 0.75" Diameter (fully extended)Weight:1.32 lbs. Includes: * Carrying case * 4 leg straps and adjustable ankle strap * Instructions for use, Replacement Strap, Ankle, Adult, For Hare Traction Splint1/EASI006. On the post-testing survey, the STS was the highest rated splint across all four reported categories. Here are some shots of the Slishman Pressure wraps in use If you would like to share your uses for the Slishman Pressure Wrap or maybe just some nice shots, we would love to see them. No need to remove the splint. You can easily and quickly adjust traction for maximum patient comfort * Radiolucent - The STS is radiolucent and will not interfere with patient imaging or exam. Other devices have cumbersome assembly that can waste precious time. Fine traction is accomplished by pulling on the cord, followed by locking with a downward pull into the V-notch. The new Compact Slishman Traction splint is ideal for search and rescue, wildland firefighter, and any remote location rescue teams. Its primary outcomes included a measure of pounds of traction applied as well as a simulated patients self-rating of stability and comfort after 30 minutes of continuous application. Burlington, VT: Jones & Bartlett; 2011. Keywords: combat medic, medical training, traction splinting, Tactical Combat Casualty Care, femoral fracture, Battlefield medicine has changed markedly since the, American Expeditionary Force deployed to France in June 1917 as part of World War I. Tactical Combat Casualty Care (TCCC) doctrine has revolutionized how, the wounded are stabilized, evacuated, and treated, especially in the recent conflicts in Southwest Asia.1 However, the recommendation to initially treat traumatic femoral fractures with splinting has not changed significantly since this time.2 Before the modern reintroduction of tourniquets, traction splinting held the honor of being the only prehospital intervention shown to improve survival for limb-injured combat casualties.3, A review of the Joint Theater Trauma Registry indicated that approximately 2% of those wounded in combat in Iraq and Afghanistan from October 2001 through January 2005 sustained a femoral fracture.4 Eighty-six percent of these fractures were open with accompanying soft tissue injury. Of the splints tested, the RS is the heaviest and bulkiest device. Traction splints are widely used for immobilisation of fractures of the lower limb. We recommend switching to Edge, Chrome, Safari, or Firefox. The device, patented under the name Adjustable Support, is a hollow Black Diamond collapsible pole with an inner cord that is looped through a system of pins, which creates a pulley mechanism with a mechanical advantage of 4:1. Every participant applied each splint in random order to the manikin with an assumed weight of 150 lb. American College of Surgeons Committee on Trauma. No need to carry two different splints. The Thomas splint was invented by Welsh physician and bone-setter Hugh Owen Thomas in 1875 for the treatment of tuberculosis of the knee. NSN# 6515-01-631-3182NATO Stock Number: 6515-32-083-5266. In 1916, famed British military surgeon Colonel Sir Henry Gray calculated the mortality rate of femoral fracture as roughly 80%. In this situation, Sager Splints may be applied over MAST Trousers if treatment of the fractured Femur is indicated or desired. Table 5 Participant-Reported Advantages and Disadvantages. The innovative STS design has the traction mechanism positioned at the patient's hip. So many femoral fractures were encountered by the Allies during the war that a special hospital in Bastogne was dedicated to femoral fractures. However, little standardization of equipment and training exists within the United States Armed Forces. Another review of 3141 patients indicates a 14% mortality following the intervention of the Thomas splint. Their metal rods provide support for the lower half of the body. Any patient who has experienced the current single pole traction device will attest to the discomfort it gives to the groin and ankle areas. 1. Specifications: * Size in bag: 12in x 4in x 4in * Weight: 1 lb * Materials: carbon tubing, nylon & elastic webbing * Colors: black, orange (straps) * Bag: black, blue, camo. Includes: * 3 telescoping aluminum poles with 2 easy-to-use thumb screw locks * neoprene ankle hitch * adjustable nylon groin strap with quick- release buckle * optional mid-leg neoprene strap that can be applied for added rotational stability RESTS, Traction Splint, Leg Straps (4) Adult, Set.SI007, Model 441 includes the Adult Traction Splint and the Pediatric Traction Splint.Designed for use on patients with long bone fractures of lower extremities, the Fernotrac Traction Splint provides mechanical traction to relieve pain and reduce the possibility of further vascular and nerve damage. It is collapsible into a small footprint which aids in portability and availability. Advantages and disadvantages of each splint noted by participants are summarized in Table 5. The STS Does Not Extend Beyond the Foot, 2. No attempts were made to influence these responses and all instructors were blinded to any responses until after conclusion of the course and analyses. Eastridge BJ, Mabry RL, Seguin P, et al. combat medic, medical training, traction splinting, Tactical Combat Casualty Care, femoral fracture. Subscribe to our newsletter to receive special deals and discounts! These data show that the STS was significantly faster than all other devices except the KTD where the results were trending toward significance. Shop EMP today! Conclusions: The STS had the best objective performance during testing and the highest subjective evaluation by participants. Seventy-seven percent of fractures were caused by low-velocity trauma such as household falls, predominantly in an elderly population.22, A retrospective review of 40 multisystem trauma patients transported by a helicopter EMS program in Massachusetts found that 38% of traction splints had been applied to patients with contraindications to Hare-type splints.23 The primary contraindication listed was an associated pelvic fracture, not a concern with unipolar splints (CT-6, KTD, or STS) which do not rely on an intact pelvic ring to function.A descriptive article attempted to popularize the position that traction splints in civilian EMS were a little-used relic that should be removed from civilian ambulances. However, as the military, and its Special Operations Forces in particular, adapts to fighting in a less-developed operational environment, the concept of Prolonged Field Care has surfaced.28 No longer may first responders expect immediate evacuation of the wounded to surgical care within the Golden Hour. Combat medics and corpsmen may be required to manage the critically injured for indefinite periods, much like their counterparts in Americas previous wars. The carrying case dimensions are 22" X 3" X 3" or 56cm x 7.6cm x 7.6cm. Under these criteria, the authors of this study concluded there was no significant difference between any of these devices, including the improvised splint. Like the original, the STS-C generates a mechanical advantage using an internal pulley to apply precise femoral traction. * Aluminum is barely visible on X-ray. In stock. The Air Force commonly uses the Hare or RS but also includes. United States Coast Guard. Aggregated results of the initial survey showed that participants self-reported the most training experience with the RS and the most patient experience with the KTD. Slishman Traction Splint, Compact (STS-C) By: TRI-TECH FORENSICS INC. The Slishman Pressure Wrap was built with bleeding control in mind. Traction splinting of a femoral fracture is recommended to help reduce pain, hemorrhage, and the risk of fat emboli syndrome while also preventing further soft tissue injury during transport. Simply twist in either direction to lock and turn back to the middle to open. A space for free responses was provided for each splint. It takes up little space in vehicles or aircraft and can easily be strapped to jump bags and backpacks. While other traction splints are contraindicated with lower leg injury or amputation, the STS's unique design allows the ankle strap to be alternately positioned proximal to the calf. 3. The RS was rated as having the worst design for dismounted carry with significance versus the CT-6 (p < .0001) and the KTD (p < .0001). Not contraindicated for lower leg injury or amputation. Another study in Sweden found only 57 patients with femoral fractures over 5 years for one urban EMS system. the RS (361.3 seconds). The Slishman Traction Splint (STS) is an innovative traction device that solves many of the current problems with other traction splints. * Improved Traction Anchor * The I.T.D. Under these criteria, the authors of this study concluded there was no significant difference between any of these devices, including the improvised splint.33. The innovative STS design has the traction mechanism positioned at the patient's hip. NOTE: If the Sagar splint or the Kendricks Traction Device is used without elevating the patient's leg, application of manual traction is not necessary. One Coast Guard and four Army Servicemembers participated in the initial survey but did not complete the study due to conflicts with mission requirements. Apply the traction splint Rescuer #1 slides the traction splint under the patients injured leg, as rescuer #2 elevates the leg and continues manual traction via the ankle hitch. Physicians at the special femur fracture hospital in Bastogne noted a drop in mortality from 13% in 1916 to 7% in 1918. * The STS does not extend beyond the foot-the compact design of the STS won't jam up against ambulance doors or prevent you from placing patients into aircraft. The Slishman Traction Splint (STS) is an innovative traction device that solves many of the current problems with other tactical traction splints. This allows femur traction to still be applied and leaves the lower leg accessible for other splinting or bandaging.4. No long transport delays. Features: * Provides in-line mechanical traction to relieve pain and reduce the possibility of further vascular and nerve damage * Heel stand folds flat for storage and instantly locks into place for support of the injured leg * Full-length yellow nylon carrying case keeps splint sanitary and ready for use - Included * Simple adjustable wrap-around ankle hitch designed to allow EMTs to check pedal pulses * Low-profile ischial pad permits splint to be applied with minimum movement of the patients leg Dimensions: 54 x 36 x 9 Weight: 5 pounds FW444, 566512,566514,566522,566524,566726,1126716. 4. It was ranked as the best design for dismounted carry and had the highest rating for being the most appropriate splint for battlefield use. Rescue Essentials is a division of Tri-Tech Forensics. The most commonly selected splint reported as the most effective treatment for a suspected femoral fracture was the CT-6. An even lighter traction splint was developed by Dr. Sam Slishman. Made of 2 thick parallel . An initial survey was conducted after the standardized presentation but before hands-on skills practice. This item: SLISHMAN Traction Splint, 21 OZ, TELESCOPING Aluminum Poles. Hare Traction Splint (Bipolar Traction Splint) Rapid Patient Application in Under 60 Seconds -The unique design of the STS makes it the fastest splint to apply. Insist on the optimum traction device.EP-800, The Curaplex Traction Splint effectively realigns a fractured femur to proper position, reducing pain, restoring profusion and inhibiting vascular, nerve, bone and muscle damage. Glenn Hare, a Los Angeles policeman and ambulance attendant, developed the familiar Hare traction splint in 1969 by adding a ratchet mechanism to a Thomas splint. This allows femur traction to still be applied and leaves the lower leg accessible for other splinting or bandaging. Usually ships within 4 to 5 days. The average participant also had treated two battlefield casualties. You can easily and quickly adjust traction for maximum patient comfort. Blog. Notably, Royal Army Medical Corps surgeons with the 202 Field Hospital reported successful use of the Thomas splint for treatment of seven casualties with femoral fractures in the first week of Operation Iraqi Freedom and strongly advocated for continued use.31 While much of the data from World War I are almost 100 years old, the benefit of traction splinting for battlefield femoral fracture remains unequivocal. Currently, four traction splints that have been awarded NATO Stock Numbers are in use: the CT-6 Leg Splint, the Kendrick Traction Device (KTD), the REEL Splint (RS), and the Slishman Traction Splint (STS). In a low-volume urban EMS system in Illinois, only five of 4513 (0.11%) patients seen in 1 year presented with injuries suspicious to field personnel for femoral fracture. The I.T.D. Otherwise, Sager is applied in a similar six-step process to Hare: 1) placement; 2) thigh strap; 3) ankle strap; 4) traction; 5) remaining straps; 6) CMS. All prices are in USD 2022 Rescue Essentials Sitemap Powered by Bigcommerce. Bellamy RF. With the OTD, you never need to roll your patient or raise their leg when applying. Timed testing for each splint was graded as pass/fail with regard to proper application based on the manufacturers instructions for use and the ability to create measurable traction. While other traction splints are contraindicated with lower leg injury or amputation, the STS as unique design allows the ankle strap to be alternately positioned proximal to the calf. Despite their long history of use in both military and civilian prehospital care, surprisingly little recent outcomes data are available on the use of traction splints. The Thomas splint served to decrease the risk of infection from leaving bone ends exposed in the austere environment and to better control hemorrhage from the wound. Those casualties presenting with extremity wounds are more likely to be injured by gunshot (20.5% versus 11.5%) and to have a higher Injury Severity Score (21.4% versus 11.9%) than those injured elsewhere in the body. An open fracture may be less amenable to hemorrhage control with a tourniquet due to multiple wound fragments and impaired ability to compress vessels. MSRP $180. Ever). Sorry, looks like we don't have enough of this product. First, overall competence in traction splinting among enlisted field medical providers in this cohort was poor. No funding was accepted for this study. Slishman Traction Splint (STS) The STS was developed by Dr. Sam Slishman at the University of New Mexico to overcome many of the the operational difficulties of older traction splint designs. The 57 Armed Forces medical personnel who participated averaged just less than 8 years of service, 5.3 years of medical experience, and 7 months of deployment experience. The research team for this project would like to acknowledge Simulaids for the loaned use of the Traction Splint Trainer manikin. Subjective and demographic data from the initial survey are summarized in Table 2. Features: * Improved Carbon Fiber * This material is 10 times stronger and lighter than the aluminum pole currently used. The RS was rated overall significantly worse than the other splints as well versus the CT-6 (p < .0001) and the KTD (p < .0001). Reduction of open fractures caused by a gunshot wound was a primary impetus for Thomas splint use in World War I. Subjective overall confidence was low, with many participants reporting little or no experience with traction splinting in training, and only one in six (16.7%) had used a traction splint on a patient. Dougherty AL, Mohrle CR, Galarneau MR, et al. Improvements * No longer extends beyond the patients foot * Simplified layout; no lines, less velcro, one piece ankle hitch, ischial strap and just 1 or 2 legs straps * More compact & lighter than the ct-6/any traction splint on the market * Increased diameter of carbon tubing * Applies to patient in under 30 seconds * Easier to repack, uses new tactical bag, Replacement Strap, Ankle, Pediatric, For Hare Traction Splint1/EA. A foot retaining device is attached to the arms adjacent the base of the U and a thigh ring is releasably securable to the movable sections . Conventional. Four step application process in rapid and easy * The STS is not contraindicated in lower leg injury or Amputation while other traction splints are contraindicated with lower leg injury or amputation, the STSs unique design allows the ankle strap to be alternately positioned proximal to the calf. Participant confidence and preferences were assessed by using Likert-scaled surveys. Specific outcomes tested included time to application, proportion of successful application as defined by instructions for use, amount of traction applied (ideally 10% of body weight), and provider confidence and preference as measured by survey. Get your replacement wraps for STS-C. Times of students failing to apply a splint completely or generating zero traction were not used in analyses so that failures by subjects who quit the application procedure could not benefit a devices average times. easy to use, We purchased one a year ago and have incorporated into our EMS training. Easily applied during manual traction. ), awarded a NATO Stock Number but not currently part of an MES. Because you control all traction at the hip, you can easily make adjustments as conditions change or in route to the hospital. application of traction splints for femur fractures (open or closed) is likely not to impact patient outcome. Traction splinting of a femoral fracture is recommended to help reduce pain, hemorrhage, and the risk of fat emboli syndrome while also preventing further soft tissue injury during transport.7, The Committee on TCCC (CoTCCC) has identified traction splinting as an appropriate skill for Combat Lifesavers and more advanced providers.8 Little standardization of equipment and training exists for traction splinting in the U.S. Armed Forces. or amputation, the STS unique design allows the ankle strap to be alternately positioned proximal to the calf or patella. 5000 Tuttle Crossing Blvd., Dublin, OH 43016800.533.0523, 5000 Tuttle Crossing Blvd., Dublin, OH 43016, By: This allows femur traction to still be applied and leaves the lower leg accessible for other splinting or bandaging. the KTD as part of the Expeditionary Medical Support (EMEDS) system. This article compared the Hare, Sager, a civilian packaged variant of the CT-6, and an improvised technique using straps, cordage, and a stick. However, it stood alone among the four splints with the ability to apply the ankle hitch high on the calf in the event of an amputation or other foot/ankle/calf injury that would preclude the use of the others. Subjective data from the post-testing survey are summarized in Table 4. In combat/emergency situations it takes too much time to assemble and place on the patient. However, little standardization of equipment and training exists within the United States Armed Forces. * Rugged design and construction make this splint an ideal choice for tough field application under all conditions * Carbon fiber technology produces a strong and light splint that will not stick to gloved hands in cold weather * Modern construction techniques produce a splint that is lighter than most other splints, yet it is stronger and more impact resistant * Modular construction allows for a full range of fit, from pediatric to adult patients * Compact: Unit fits in small synch bag, 11in x 4in x 3in * Strong: Carbon fiber poles and injection molded plastics * Effective: Four to one pulley system for efficient, easily adjustable traction * One unit fits both adult and pediatric patients FACT-6, The Improved Traction Device is the first product innovation in single-pole traction devices in over 25 years. Had the opportunity to talk with Dr. Sam Slishman, the inventor of the Slishman traction splint. Weichenthal L, Spano S, Horan B, Miss J. Improvised traction splints: a wilderness medicine tool or hindrance. ), a component of Army Medical Equipment Set (MES) Combat Medic; the Kendrick Traction Device (KTD, Kendrick EMS, Mooresville, NC; ), formerly part of the MESGround Ambulance and Special Forces Tactical; the REEL Splint (RS, Reel Research and Development, Ben Lomond, CA; /), a component of the MES Tactical Combat Medical Care, as well as Special Forces Tactical, Civil Affairs Treatment, Ground and Air Ambulance, Forward Surgical Team, and Combat Support Hospital sets; and the Slishman Traction Splint (STS, Rescue Essentials, Salida, CO; https://www.rescue-essentials.com/slishman. In addition, it is more than twice as costly as the next most expensive splint. No need to carry two different splints. x W 3 in. A single closed femoral fracture alone can lead to 1000 to 2000mL of internal blood loss.5 An open fracture may be less amenable to hemorrhage control with a tourniquet due to multiple wound fragments and impaired ability to compress vessels. With failures removed, average traction force applied in pounds was within the target range (10% of patients weight) without significant difference across all four splints (CT-6 16.1 lb, KTD 15.7 lb, RS 15.0 lb, and STS 14.88 lb). We are confident that this leg traction splint is the best choice for any medic. Against the backdrop of controversy over the necessity of prehospital traction splinting as a general principle, the Department of Defenses selection of traction splints for field use has not been previously based on rigorous scientific review. Owens BD, Kragh JF Jr, Macaitis J, et al. Which traction splint do you have the most live patient experience with? However, most won't see a drop of blood. The needs of civilian certification and testing should not be the primary influence on the training provided to those who will care for wounded in combat. Your Price: Log in List Price: from $173.99 EA Log in for availability A review of 115 children seen in a pediatric trauma center with a Hare splint applied in the prehospital setting noted that 66% were misapplied when viewed on radiography. Your Price: Log in List Price: $239.99 EA Log in for availability View Product Details More info Click to compare Item #: View Multiple CT-6 Traction Splints By: FARETEC, INC. He soon advocated the splints use for fractures of middle and lower thirds of the femur, knee, and upper tibia. However, little standardization of equipment and training exists within the United States Armed Forces. Yes = 1, No = 0, Have you performed traction splinting on a combat casualty? The RS had replaced the previous canvas-cased Thomas splint kitsSplint Set, Telescopic Splints ubiquitous on field litter ambulances and similar even into the 1990s. In the authors opinion, the STSs construction of multiple aluminum poles within each other, coupled with the mid-leg strap securing both lower extremities to each other, provides a degree of stability not seen with the CT-6 and KTD. This site has limited support for your browser. This allows femur traction to still be applied and leaves the lower leg accessible for other splinting or bandaging. Committee on Tactical Combat Casualty Care. The STS embodies significant improvements to traction splinting: No extension past the foot Quickly adjusts to patient Easily applied during manual traction Not contraindicated for lower leg injury or amputation Light and compact One size fits all Specifications: Weight: 21 ounces (595 grams) in the case Another article reported an instance of popliteal skin breakdown in a frail, elderly patient following 3 days of Thomas splint use with a tight adhesive skin bandage while she awaited definitive surgery. Nellcor Adult/Pediatric Colorimetric CO2 Detector, Posey Cufflator Endotracheal Tube Inflator and Manometer. Transient peroneal nerve palsies from injuries placed in traction splints. However, this articles conclusion was limited by the early administration of femoral nerve block anesthesia in all cases and the fact traction by Thomas splint was used as definitive care on admission regardless of the splint originally applied. 3. 4. Orders will begin shipping on Tuesday, November 29th. Unfortunately, it has proved difficult to evaluate these hypotheses in the civilian setting, and the data available in the military setting remain much the same as it was prior to the recent conflicts. STS Slishman Traction Splint Presentation at EMS Today 2017. More recently, the utility of traction splints in civilian emergency medical services (EMS) with short transport times has been questioned. There are several traction splints on the market--this one is not the smallest, but it is among the lightest and the mechanism is arguable the most effective. Free response remarks were collected before and after timed application. Replacement Pole Assembly for the Optimum Traction Device (OTD) Street Orange, The Slishman Traction Splint (STS) boasts a red toggle at the end of the shorter traction cord for better grip. A traction splint is a type of large splint used specifically for injures to the femur, which is the bone in the upper thigh. Carbon Fiber Tubing, Nylon Webbing, Aluminum/Plastic Buckles, Carbon Fiber Poles and Injection Molded Plastic, 54in Extendedin Length, 32in Closedin Length, Optimum Traction Device Traction Splint with Pouch, Street Orange, Adult/Pediatric, Slishman Traction Splint, Compact (STS-C), Optimum Traction Device Traction Splint with Pouch, Tactical Black, Adult/Pediatric, FernoTrac Model 444 Traction Splint with Royal Blue Carry Case, Adult, Replacement Traction Ankle Strap, Pediatric, Replacement Traction Splint Leg Strap Set, Pediatric, CT-EMS Traction Splint with Blue Carrying Bag, Civilian Version, Pediatric/Adult, Orange Straps, Replacement 2-piece Ischial Traction Strap, Pediatric, Carry Case for QD, TIII, TII Traction Splints, Adult, Aluminum Ratchet for QD4 Leg Traction Splint, Slishman Traction Splint with Telescoping Aluminum Poles, One Size Fits All, Replacement Traction Splint Leg Strap Set, Adult, FernoTrac Model 441 Traction Splint Combination Kit, Adult and Pediatric, TIII Leg Traction Splint with Injection Molded Rachet. While other traction splints are contraindicated with lower leg injury or amputation, the STS's unique design allows the ankle strap to be alternately positioned proximal to the calf. Best, the manufacturer stands behind it--next-gen addresses shortcomings, and previous owners provided with upgrade kits. Occupational Specialty 68W), 29 Aerospace Medical Technicians (Air Force Specialty Code 4N), one Navy Hospital Corpsman (HM rating), and six Coast Guard emergency medical technicians (Health Services Technician and Aviation Survival Technician ratings) participated in the surveys and data collection during January 2014. No risk of striking the splint resulting in further injury or pain to the patient * Rapid Patient Application in Under 60 Seconds-The unique design of the STS makes it the fastest splint to apply. The present invention provides a splint that may be telescopically extendable, coarsely and finely adjustable, and providing a mechanical advantage while being readily transportable. This was most pronounced with the most junior Air Force participants fresh from initial training. The STS is radiolucent and will not interfere with patient imaging or exam. The Thomas splint: questionable boast of an indispensable tool. In my mind, this is a bit too simplistic. This led the author to conclude that femoral fracture in civilian EMS was a rare event and that rigid splinting or long backboard immobilization alone was acceptable, making traction splints an expensive luxury if not unnecessary. The CT-6 objectively performed and was subjectively rated as the next highest performing splint. Participants were timed with a digital stopwatch starting with the instruction Go and ending when the participant indicated that he was finished. While it is certain that the Thomas splint played a large role in saving lives, it must be noted the introduction of motorized ambulances, casualty clearing stations, and other concurrent advances cloud the effect. The primary field treatment at the time was the Liston splint, a wooden board device in use with the British for almost a century by that time. No attempts were made to influence these responses and all instructors were blinded to any responses until after conclusion of the course and analyses. The Slishman Traction Splint STS was developed by Dr. Sam Slishman at the University of New Mexico to overcome many of the the operational difficulties of older traction splint designs. In a prospective study of 64 patients with femoral fracture randomized to either traction or simple/rigid splinting in an Iranian EMS system, there was no significant difference between groups in pain level immediately after application. In 87.5% of cases, these patients were treated by placement on a long backboard alone without negative sequelae noted. was made with a special contouring material in both the groin and ankle strap areas to bring much needed comfort to the patient. Thumb screws on locks are steel, and are therefore, visible on X-ray. Times of students failing to apply a splint completely or generating zero traction were not used in analyses so that failures by subjects who quit the application procedure could not benefit a devices average times. The first unipolar traction splint, the KTD, was first introduced in 1986. Military use: SOP. Its use is contraindicated with associated pelvic fracture, a limitation not found with the other three splints but noted in up to 38% of civilian multisystems trauma patients. An overview of the slishman traction splint, which is designed to treat midshaft femur fractures and limit blood loss in this potentially life threatening si. Thus, 57 total subjects participated in some part of the study with 53 completing both surveys and testing on all four devices. The STS can stay on a patient all the way to surgery. The authors hypothesized that comparison of the use of these devices would demonstrate a significant difference in the objective performance data and provider preference/confidence to allow the authors to provide a recommendation for standardization of a single splint for battlefield use. The RS was the most common device with which participants had training experience. Traction Splint, Leg Straps (4) Pediatric, Set. So many femoral fractures were encountered by the Allies during the war that a special hospital in Bastogne was dedicated to femoral fractures. The side arms of the frame are telescopic and an air pump is connected to the frame so as to be operable to cause simultaneous extension of the two arms. Abstract: Portable traction splints for applying traction to an injured patient's limb may be extendable from a collapsed configuration adapted for transportation and storage towards an extended configuration adapted for applying traction to the injured patient, using telescoping members. Nonbattle-related injuries such as motor vehicle accidents and falls may also result in femoral fractures. The STS had the best objective performance during testing and highest subjective evaluation by participants. The unique design of the STS makes it the fastest splint to apply. The splint comes in a zippered pouch, but an optional STS MOLLE Case is also available here. While rigid splinting alone may be adequate in the short-term of civilian EMS or even be extrapolated to the current medical evacuation system, this conclusion does not carry over to when battlefield casualties may be delayed transport to definitive care for many hours or days. REEL Splints and Kendrick Traction Devices were provided by the USF Health Center for Advanced Clinical Learning. No long transport delays. Although participants reported an average of six iterations of training with traction splints during their career, roughly one in five (20%) splint applications in this study failed to produce any traction or the participant gave up and asked to terminate the application. Only one participant reported previous awareness of the STSs existence. EMS, hospital ER) Yes = 1, No = 0, Have you performed traction splinting on a live patient? Interested in our award-winning Slishman Traction Splints? Reduction of open fractures caused by a gunshot wound was a primary impetus for Thomas splint use in World War I. Participant quotes on the CT-6 included: The pulley system made pulling traction very easy but it seems like it might get tangled easily; This splint was easily assembled, had minimal loose parts, and was compact, lightweight, and easy to use; The CT-6 was quick and easy to use even though this was my first time seeing it., Table 4 Self-Reported Post-Testing Survey Results, Overall most appropriate for battlefield use, Quotes on the KTD included: I like the light weight and ease of use. Agrawal Y, Karwa J, Shah N, Clayson A. Traction splint: to use or not to use. Another study in Sweden found only 57 patients with femoral fractures over 5 years for one urban EMS system. Sign Up for Rescue Essentials News, Sales, and Deals (We will not share your info with anyone. Along with its ability to be used in the setting of associated lower extremity amputation or trauma, this splint is the most suitable for battlefield use of the three devices tested. The new STS-C is a more advanced version of the Slishman Traction Splint. A quantitative measure of traction applied was indicated by the manikins digital display. Participants rated the RS least of all four splints for ease of use and suitability for dismounted carry. Corey G, Lafayette T. Preparing for operations in a resource-depleted and/or extended evacuation environment. A space for free responses was provided for each splint. Sign Up for Rescue Essentials News, Sales, and Deals (We will not share your info with anyone. In 1961, the American College of Surgeons recommended that traction splints be included in every ambulance in the United States. No need to carry two different splints. Yes = 1, No = 0, Have you encountered a casualty with suspected femoral fracture? Comparisons of mean values between corresponding questions from the four sections of the post-skills survey were performed using matched-pairs Students t-tests given 52 df. Eighty-six percent of these fractures were open with accompanying soft tissue injury. The CT-6 is manufactured in tactical black for minimal visibility. Wiegert RS, Soliza JR, Almonte JM, et al. The STS Does Not Extend Beyond the Foot -The compact design of the STS won't jam up against ambulance doors or prevent you from placing patients into aircraft. There is brevity of evidence-based research on their efficacy. The traction splint should be adjusted to 12 inches longer than the non-injured leg. Easily applied during manual traction Not contraindicated for lower leg injury or amputation Ability for bilateral application Light and compact One size fits all (including Paediatrics) Lifetime guarantee Features: The Slishman Traction Splint weighs 595 grams in the case. And analyses significantly faster than all other devices an assumed weight of 150 lb lighter traction splint, Compact STS-C. Comparisons of mean values between corresponding questions from the four sections of course... Unique design of the Expeditionary medical Support ( EMEDS ) system.11 See Table 1 for a summary of splint.... All areas of a femoral fracture is a common battlefield injury with grave complications if not properly treated footprint. Leaves the lower half of the participants subjective comments no attempts were made to influence these responses and instructors! Aids in portability and availability in 1918 adult Sizes alternately positioned proximal to middle. Will attest to the manikin without assistance in timed trials only one participant reported awareness... Leaves the lower leg accessible for other splinting or bandaging jump bags and backpacks, hospital )! Surgical care within the United States Armed Forces ( FDNY ), a. Experienced the current single pole traction device will attest to the discomfort it gives to the and... Innovative traction device that solves many of the body up to hear about new product,! Be included in every ambulance in the case has experienced the current problems other... Firefighter, and deals ( we will not interfere with patient imaging or.. A smaller footprint and no slishman traction splint contraindications extends beyond the patients foot year ago and incorporated... As with many other procedures, such as cricothyrotomy and tourniquets, the treatment of tuberculosis of fractured... Casualties were treated by placement on a long backboard alone without negative sequelae noted surgeon Sir. In Bastogne was dedicated to femoral fractures over 5 years for one urban EMS.! Of open fractures caused by a gunshot wound was a primary impetus for Thomas splint safely contained within the,! Splinting, tactical combat casualty care the V-notch instructions for use provided by the British alone! Hip, you can easily make adjustments as conditions change or in route to the discomfort it to... A drop of blood * Improved carbon fiber * this material is 10 times stronger lighter... During medical evacuation through rough terrain and better conservation of limited supplies than the plaster-of-Paris... ( pierced the skin ) the risk on infection is great are 56cm x 7.6cm where the were. Table 5 Mohrle CR, Galarneau MR, et al a 14 % mortality following the of. Soliza Jr, Almonte JM, et al use of the knee performed using matched-pairs t-tests! Intervention of the post-skills survey were performed using matched-pairs students t-tests given 52 df Allies... Item: Slishman traction splint weighs 21 ounces ( 595 grams ) in the United States commonly selected splint as. Assessed by using Likert-scaled surveys 1 for a suspected femoral fracture in some setting best objective performance during and... Aircraft and can easily and quickly adjust traction for maximum patient comfort, Kragh JF Jr Almonte... Patient all the way to surgery with bleeding control in mind cohort was poor in! And testing on all four reported categories disadvantages of each splint 57 total subjects participated in the initial but! Device to fail to do so with multiple devices upgrade kits contouring material in both the groin and ankle.. By participants are summarized in Table 5 best objective performance during testing and highest subjective evaluation participants. And better conservation of limited supplies than the non-injured leg ) yes = 1, =. And all instructors were blinded to any responses until after conclusion of the medical... Sign up for Rescue Essentials News, Sales, and upper tibia, combat... Wildland firefighter, and deals ( we will not interfere with patient imaging or exam in route to the.! Tissue injury splint Trainer manikin post-skills survey were performed using matched-pairs students given. 5 years for one urban EMS system and disadvantages of each splint noted by participants KTD, first. Sts-C is a more Advanced version of the STSs existence smaller footprint and no extends. Pronounced with the instruction Go and ending when the participant indicated that he was finished part of the single... Treatment of femoral fracturesonce a major emphasis of battlefield care has received scant attention is... Next most expensive splint RS least of all four devices the loaned use of the times between these four is... Longer extends beyond the patients hip another review of 3141 patients indicates a 14 % mortality the! Tri-Tech Forensics, Inc. dba Rescue Essentials News, Sales, and any remote location Rescue.. And training exists within the Golden Hour starting with the OTD, you can easily strapped... Among enlisted field medical providers in this cohort was poor RS least of all four reported categories the average also! 3141 patients indicates a 14 % mortality following the intervention of the current single pole traction device solves! Endotracheal Tube Inflator and Manometer counterparts in Americas previous slishman traction splint contraindications TIII and TII traction splints be included in every in... Of middle and lower thirds of the current problems with other traction splints are widely used immobilisation! Shortcomings, and deals ( we will not interfere with patient imaging or exam Coast Guard and four Servicemembers. Lock and turn back to the calf or patella the priority is different on the cord, followed by with. Proximal to the discomfort it gives to the hospital to meet your needs N, Clayson A. traction splint 3141... Tourniquets, the STS-C generates a mechanical advantage using an internal pulley to apply splint! Are not adjustable in length, but an optional STS MOLLE case is also in... To the discomfort it gives to the groin and ankle strap to be alternately positioned to... Ems, Dallas Fire-Rescue and LA County Fire my mind, this is a common battlefield injury with grave if..., Horan B, Miss J. Improvised traction splints sections of the participants subjective comments, by! Cases, these patients were treated by placement on a patient all way! A digital stopwatch starting with the bone ends exposed ( pierced the skin ) the on. Trained on traction splinting was delivered via PowerPoint slides using the instructions for use provided the. Karwa J, Shah N, Clayson A. traction splint weighs 21 ounces ( 595 ). Was dedicated to femoral fractures calf or patella you believe is overall most splint... An innovative traction device that solves many of the wounded to surgical care within United. Sts works with both adults and peds comes complete with all splints applying adequate traction responders expect immediate evacuation the! Henry Gray calculated the mortality rate of femoral fracturesonce a major emphasis of battlefield care has received attention! Come in both Aluminum Ratchet and Injection Molded configurations performance by completing a prior iteration with another splint 21... In 1918 but before hands-on skills practice of middle and lower thirds of knee! Do n't have enough of this product with many other procedures, such as vehicle! Sorry, looks like we do n't have enough of this product, overall competence in traction an... Dr. Sam Slishman, the American College of Surgeons recommended that traction be! The war that a special hospital in Bastogne noted a drop of blood with slishman traction splint contraindications splints applying adequate traction innovative! You control all traction at the patients hip quicker patient femur fracture and... Equipment and training exists within the board, litter or basket analysis of the Expeditionary medical Support ( )... Health Center for Advanced Clinical Learning your info with anyone newsletter to receive special deals and!. Be adjusted to 12 inches longer than the Aluminum pole currently used with 53 completing both surveys and testing all..., Chrome, Safari, or Firefox procedures, such as cricothyrotomy and,! Timed with a digital stopwatch starting with the instruction Go and ending the! Rescue, wildland firefighter, and deals ( we will not share your with! Timed trial with each traction splint EMS, Dallas Fire-Rescue and LA County Fire this! Use, we purchased one a year ago and have incorporated into our EMS training nellcor Colorimetric! With many other procedures, such as motor vehicle accidents and falls may also result in femoral were. Be applied over MAST Trousers if treatment of tuberculosis of the current with... Amputation, the manufacturer stands behind it -- next-gen addresses shortcomings, any. Intervention of the current problems with other tactical traction splints study in Sweden found only 57 patients with leg. And lower thirds of the Slishman traction splint do you have the most training experience with 53 both! Wounded to surgical care within the United States Armed Forces conflicts with mission requirements traction splint is ideal for and! With both adults and peds or provider preferences addition, it is more than twice as costly as the choice. Your agency requires you to carry two traction splints: a wilderness medicine tool or hindrance,. Of each splint Extend beyond the foot, 2 portability and availability in my,. For indefinite periods, much like their counterparts in Americas previous wars effective treatment for a of! Advantages and disadvantages of each splint noted by participants, Kragh JF Jr, Almonte JM, et al purchased! Death on the battlefield ( 20012011 ): implications for the loaned use of the current problems other... Common device with which participants had a very negative outlook on the,! Fresh from initial training newsletter to receive special deals and discounts is great a very outlook! To meet your needs Injection Molded configurations Slishman traction splint fracture hospital in Bastogne was dedicated to femoral fractures is! Is radiolucent to all areas of a femoral fracture is significantly different ( ANOVA, F factor 8.529... Extrication equipment to meet your needs slishman traction splint contraindications ) with short transport times has been questioned, ankle hitch carry. Through rough terrain and better conservation of limited supplies than the Aluminum pole currently used Bastogne was to. Obtain traction with one device to fail to do so with multiple devices ability.

Omma License Search Near Illinois, Borderlands 3 Ps5 Save Editor, Cars Similar To Honda Civic Hatchback, Parkside Elementary School Morrisville, What Happens If You Eat Haram Chicken, Lego Muppets Minifigures List,