Types and Management of Clients with Immobilization Devices.

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Splints/Immobilizers
Casts
Traction
External Fixation
Internal Fixation
Why?
Splints, casts, and braces support and protect broken
bones, dislocated joints, and injured soft tissues such
as tendons and ligaments. Immobilization restricts
motion to allow the injured area to heal. It can help
reduce pain , swelling, and muscle spasms . In some
cases, splints and casts are applied after surgical
procedures that repair bones, tendons, or ligaments.
This allows for protection and proper alignment early in
the healing process.
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Removable and allow for monitoring of skin
swelling or integrity.
Can be used to support fractured/injured
areas until casting can be done or used for
post-paralysis injuries to avoid joint
contracture
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Prefabricated and typically fasten with velcro
straps.
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Types:
◦ Short- and long-arm and leg casts
◦ Spica casts, which refer to a portion of the trunk
and one or 2 extremities. Typically used on children
with congenital hip dysplasia
◦ Body Casts, which encircle the trunk of the body.
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Casting Materials
◦ Plaster of Paris casts are heavy, not water-resistant,
and can take 24-48 hrs to dry.
◦ Synthetic fiberglass casts are light, water-resistant,
and dry very quickly (30 min)
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Casts, as circumferential immobilizers, are
applied once the swelling has subsided (to
avoid compartment syndrome).
If the swelling continues after cast application
and causes unrelieved pain, the cast can be
split on one side or both.
A window can be placed in an area of the cast
to allow for skin inspection (clients have a
wound under the cast)
Moleskin is used over any rough area of the
cast that may rub against the client’s skin.
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Uses a pulling force to promote and maintain
alignment to the injured area.
Goals of traction:
◦ Realignment of bone fragments
◦ Decreasing muscle spasms and pain
◦ Correcting or preventing further deformities.
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Involves fracture immobilization using
percutaneous pins and wires that are
attached to a rigid external frame.
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Visualization of a
fracture through an
incision in the skin, with
repair made with plates,
screws, pins, rods, and
prosthetics as needed.
After the bone heals,
the hardware may be
removed, depending on
the location and type of
hardware.
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A collar is generally used for neck
injuries.
A soft collar can relieve pain by
restricting movement of the head and
neck.
Collars also transfer some of the weight
of the head from the neck to the chest.
Stiff collars are generally used to support
the neck when there has been a fracture
in one of the neck bones.
Cervical collars are widely used by
emergency personnel at the scene of
injuries when there is a potential neck
or head injury .
The collar helps to ensure that the neck
and head do not move, which could
make the injury worse.
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Slings are often used to support the arm after
a fracture or other injury. They are generally
used along with a cast or splint, but are
sometimes used alone as a means of
immobilization. They can be used in an
emergency to immobilize the arm until a
doctor can see the child. A
triangular bandage is placed under the
injured arm and then tied around the neck.
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Freedom and independence in purposeful
movement.
Adapting to and having self-awareness of the
environment.
Functional musculoskeletal and nervous
systems are essential for mobility.
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The inability to move freely and
independently at will
The risk of complications increase with the
degree of immobility and the length of time
of immobilization.
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Temporary, following knee surgery
Permanent, paraplegia
Sudden onset, fractured from accident
Slow onset, multiple sclerosis
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Elastic Stockings or thromboembolic device
(TED) hose help maintain external pressure
on the muscles of the lower extremities and
promote blood return to the heart.
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And intermittent pneumatic compression
(IPC) have plastic or fabric sleeves that wrap
around the leg and secure with velcro. The
sleeves are then attached to an electric pump
that alternately inflates and deflates.
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