Traction splint Puns

So I was talking to a fellow paramedic about applying traction splints which I haven’t had the opportunity to do in my short 2 years as a medic but I had a question that hopefully one of you can answer.

When it come to applying the traction splint are you only applying the traction splint if there is no pedal pulse/distal CWCMS of the leg is affected in some way? Or are you always trying to realign the femur break to try and reduce internal bleeding that can be up to 1500mls regardless of the pedal pulse?

I'm having trouble finding information about how/when to bandage with an open femur fracture. I am in Ontario, Canada, where the protocol is to treat open femur fractures with a traction splint (just clearing that up as I know that isn't a universal protocol).

Would I bandage the wound before applying a traction splint? Or at all? Seems like it would be almost impossible to bandage after applying the splint, but I'd be worried about the effects the traction splint would have on the wound in regards to bandaging if I did that beforehand. Any help would be greatly appreciated!

Thanks

I recently had a flight where the patient would not fit in the aircraft because his leg was being held in a traction splint. It was a diagnosed femur fracture via obvious deformity and xray. The sending physician told us to just disengage the traction during flight and then re-engage it to the set 25lb after arrival at the recieving facility. Obviously this was against everything we had ever learned or trained on with a traction splint. We opted to not do that and take the patient by ground. Then, of course, the big wigs come in and our medical director jumps our asses because according to him "traction splints are useless and out of date" so therefore we should have just taken it off. As a medic, I was thinking about acting in the best interest of the patient and doing no harm. I am under the impression that traction splints relieve pain, improve perfusion, and help lessen the chance of fatty embolisms, lacerated arteries, muscle and tissue damage and nerve damage. But today I was told by a doctor that those things are "irrelevant." So what would you all have done? And does anyone have any evidence based research on risk/reward/use of traction?

TLDR: Doctor said to take off a traction splint on a diagnosed post MVC for transport, is this a good idea?

I have a mini drill coming up and the crew always tries to throw curve balls at me, I was hoping someone with more knowledge could give me some insight on what you’ve found useful, indications, contraindications.. I’m doing my own studying but the more knowledge the better! Thank you!

So traction splints can only be used on a closed mid shaft femur fracture with no other leg involvement, does that include abrasions or lacerations or just other fractures? Test is on Tuesday, thanks in advance for info.

Who uses them regularly? I've used them a couple times (and they were part of EMT class), but I had the most senior medic in our department tell me she'd never used one, even for obvious femur fractures. Is she simply weird, or is this a common point of contention/opinion?

Part of my duties includes monthly training, and this month’s topic was traction splinting. During my research, I found very little scientific support for the practice, and essentially no evidence of traction splinting being any better than slapping on a wood splint or even using a backboard as a splint

I know that the orange book taught us all about traction splinting for closed, unilateral, mid shaft fractures of the femur — but a simple wood splint may perform just as well and is faster to apply

What are your experiences with traction splinting and your agency’s protocols related to the practice?

There is some controversy concerning the application of traction splints to compound femur fractures in wilderness settings. WMA (Wilderness Medical Associates) has stopped teaching/advocating the practice, while WMI (Wilderness Medical Institute) has continued to support the use of traction splints, even improvised splints. What is your opinion/experience with this?

Edit: Links to opinions

https://m.facebook.com/note.php?comment_id=17904602&offset=0&total_comments=8&note_id=10150266420721331

http://www.wildmed.com/blog/tractions-splints-in-wilderness-medicine/

While I've never had to use one, I'm familiar with both the Hare and Sager. For some reason, I prefer the Hare. maybe it's because I learned that one first. What device does everyone else prefer and why?

In 12 years of EMS, had the opportunity to use a traction splint. The few times it was indicated, fire already had it applied.

What's something you've been trained to do, but haven't had the opportunity to put into practice?

So, I just passed my nremt and I’m reviewing for a job I’m about to start. What am I supposed to do if a patient does not have PMS after a break? Cry for the medic?

Hi all

first post i'm doing on this sub but have been lurking on here and tinnitus talk for a while, talking to members here and there. I believe I had a moderate/severe case of tonic tensor tympani syndrome and i feel like i am 95% out of it. hoping this is the right place to post and gives some hope to people

i have been djing as a passion and going to raves for 10 years now, and started producing 5 years ago. not having worn protection for most of it, my ears have taken a big beating throughout the last 10 years.

fast forward to march 2020, and i received my first pair of studio headphones to make music with. not being able to help myself, i started making music every evening until 2 AM at loud volume until after a week, ringing started in my right ear. the next day i went to a house party where i djed, and before starting the music, i couldn't bare being in a room with all my friends talking and shouting so i put some earplugs on before my set. i didn't think much there and then, but over the next month of april a lot of strange symptoms popped up (ear fullness, sensitivity to sound, fluttering of eardrum in response to high frequencies, bilateral T). i couldnt bear the sound people talking loudly, or speakers from a laptop. also i would tense up in loud places such as resturants etc and get fullness in my ears there and then as a result. this would then pop up randomly during days. producing music was giving me an uncomfortable feeling of fullness and i felt as if i couldn't really focus on frequencies.

i tried visiting several audiologists to no avail, and finally ended up on forums and read about acoustic trauma, hyperacusis and so on and i freaked out. was my time in music finished, just when i was starting to gain some traction as a dj/producer? was my lifes main passion about to end? so i did what most on here suggest: silence and protection. while this helped stabilise a lot of the stranger auditory symptoms (inability to focus to sound ,fullness in response to loud sounds etc), the sensitivity progressively got worse, along with my depression and anxiety towards the condition and sound in general, possibly caused by my increased isolation and a lot of what i read online. i had other health issues during this time, and all of this caused me to have a total breakdown when in may my face started tingling as well. i started having sharp pains in my jaw and year, and couldn't really open my mouth properly i think developing early stage TMD

i r

I don't want to step on anybody's toes here, but the amount of non-dad jokes here in this subreddit really annoys me. First of all, dad jokes CAN be NSFW, it clearly says so in the sub rules. Secondly, it doesn't automatically make it a dad joke if it's from a conversation between you and your child. Most importantly, the jokes that your CHILDREN tell YOU are not dad jokes. The point of a dad joke is that it's so cheesy only a dad who's trying to be funny would make such a joke. That's it. They are stupid plays on words, lame puns and so on. There has to be a clever pun or wordplay for it to be considered a dad joke.

Again, to all the fellow dads, I apologise if I'm sounding too harsh. But I just needed to get it off my chest.

Alot of great jokes get posted here! However just because you have a joke, doesn't mean it's a dad joke.

THIS IS NOT ABOUT NSFW, THIS IS ABOUT LONG JOKES, BLONDE JOKES, SEXUAL JOKES, KNOCK KNOCK JOKES, POLITICAL JOKES, ETC BEING POSTED IN A DAD JOKE SUB

Try telling these sexual jokes that get posted here, to your kid and see how your spouse likes it.. if that goes well, Try telling one of your friends kid about your sex life being like Coca cola, first it was normal, than light and now zero , and see if the parents are OK with you telling their kid the "dad joke"

I'm not even referencing the NSFW, I'm saying Dad jokes are corny, and sometimes painful, not sexual

So check out r/jokes for all types of jokes

r/unclejokes for dirty jokes

r/3amjokes for real weird and alot of OC

r/cleandadjokes If your really sick of seeing not dad jokes in r/dadjokes

Punchline !

Edit: this is not a post about NSFW , This is about jokes, knock knock jokes, blonde jokes, political jokes etc being posted in a dad joke sub

Edit 2: don't touch the thermostat

The doctor says it terminal.

Do your worst!

How the hell am I suppose to know when it’s raining in Sweden?

Mathematical puns makes me number

Ants don’t even have the concept fathers, let alone a good dad joke. Keep r/ants out of my r/dadjokes.

But no, seriously. I understand rule 7 is great to have intelligent discussion, but sometimes it feels like 1 in 10 posts here is someone getting upset about the jokes on this sub. Let the mods deal with it, they regulate the sub.

We told her she can lean on us for support. Although, we are going to have to change her driver's license, her height is going down by a foot. I don't want to go too far out on a limb here but it better not be a hack job.

They were cooked in Greece.

I'm surprised it hasn't decade.

He lost May

Now that I listen to albums, I hardly ever leave the house.

Two muffins are in an oven, one muffin looks at the other and says "is it just me, or is it hot in here?"

Then the other muffin says "AHH, TALKING MUFFIN!!!"

Don't you know a good pun is its own reword?

For context I'm a Refuse Driver (Garbage man) & today I was on food waste. After I'd tipped I was checking the wagon for any defects when I spotted a lone pea balanced on the lifts.

I said "hey look, an escaPEA"

No one near me but it didn't half make me laugh for a good hour or so!

Edit: I can't believe how much this has blown up. Thank you everyone I've had a blast reading through the replies 😂

It really does, I swear!

And now I’m cannelloni

Because she wanted to see the task manager.

And boy are my arms legs.

But that’s comparing apples to oranges

Put it on my bill

Heard they've been doing some shady business.

but then I remembered it was ground this morning.

Edit: Thank you guys for the awards, they're much nicer than the cardboard sleeve I've been using and reassures me that my jokes aren't stale

Edit 2: I have already been made aware that Men In Black 3 has told a version of this joke before. If the joke is not new to you, please enjoy any of the single origin puns in the comments

Can you use traction for OPEN femur fracs?