Prehospital midthigh trauma and traction splint use: Recommendations for treatment protocols

Abarbanell, Neal Robert

doi:10.1053/ajem.2001.21302

Cited by 29 publications

(29 citation statements)

References 6 publications

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“…This is quite consistent with the distribution of injuries based on the defined external causes. Also previous researches in Iran as well as American studies were in line with these findings (15, 16). The case-fatality reported in present study was lower compared to previous studies.…”

Section: Discussionsupporting

confidence: 82%

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Trauma-related Therapeutic Procedures at Shohada Trauma Center in Tabriz

Bazargani¹,

Azami-Aghdash²,

Ziapour³

et al. 2013

Trauma Mon

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BackgroundTo decrease the burden of injuries it is essential to have an overview of trauma patterns and its management at regional trauma centers.ObjectivesThe aim of this study was to investigate some patterns of trauma and trauma-related therapeutic interventions at our trauma center.Materials and MethodsIn a cross-sectional study, 19530 trauma cases admitted to the emergency department and hospital wards of Shohada University Hospital during 2007-2008 were assessed.ResultsOf the 19530 trauma cases, 14960(76.7%) were males. Mean (SD) of age was 31(19.9) years. The elderly aged 65 and above, comprised 10% (1953) of the participants; while 44 were infants. Falls and traffic injuries were the most common cause of injuries among trauma patients. Most of the mortalities were men comprising 74% of the 57 deaths. Reduction of fractures and dislocations were the most common types of operations among trauma patients.ConclusionsYoung men form the target group for possible interventions to decrease the burden of trauma following falls and traffic accidents.

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Section: Discussionsupporting

confidence: 82%

“…Falls due to slipping comprised the major cause of injury in our study while other Iranian studies showed different results (16, 20). This can be due to the fact that Shohada hospital is known for having famous orthopedic surgeons and orthopedic problems that are more common in falls were referred to this center.…”

Section: Discussioncontrasting

confidence: 55%

Trauma-related Therapeutic Procedures at Shohada Trauma Center in Tabriz

Bazargani¹,

Azami-Aghdash²,

Ziapour³

et al. 2013

Trauma Mon

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“…One LOE 4 prehospital study 187 and 6 LOE 5 hospital studies and reviews 188 -193 showed no evidence that straightening of an angulated suspected long bone fracture shortens healing time or reduces pain prior to permanent fixation. One LOE 4 194 study showed reduced pain with splinting without straightening.…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 13: First Aid

Markenson¹,

Ferguson²,

Chameides³

et al. 2010

Circulation

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The International First Aid Science Advisory Board identified 38 questions in first aid practice that had not been subjected to an evidence review process or that needed to be updated since the 2005 process. Two or more members of the International First Aid Science Advisory Board volunteered to independently review the scientific literature and complete an evidence-based review worksheet summarizing the literature (see Part 2 of this supplement for additional information). After the evidence was presented to the full board, a draft consensus summary of the scientific evidence and a draft consensus treatment recommendation were developed and represented at a subsequent meeting. Thus, each question, evidence-based review, draft summary of science, and draft treatment recommendation was presented and discussed on 2 separate occasions, and a Consensus on Science and Treatment Recommendation was reached by the Board. This document is a report of the group's consensus.As in 2005, the worksheets revealed the continuing paucity of scientific evidence to support specific first aid interventions. Very little research is being conducted in first aid, and most of the recommendations are extrapolations from research and experience in other medical venues, animal studies, and case series. It is hoped that this document will be a stimulus to future research in first aid. First Aid for Medical Emergencies SummaryThe medical questions addressed include poisoning, anaphylaxis, oxygen administration, and aspirin administration for a suspected coronary event.No changes were recommended for first aid management of acute poisoning.In reviewing epinephrine administration for anaphylaxis, evidence was found that laypeople and some medical and prehospital professionals are unable to recognize the signs and symptoms of anaphylaxis and therefore cannot, without training, make an independent decision to administer epinephrine with an auto-injector or to administer a second dose if the first is not effective. This issue takes on added importance in view of legislation in some jurisdictions that permits these actions.No evidence was found, except in decompression injuries, to support the routine administration of oxygen by first aid providers.The administration of aspirin to a victim experiencing chest discomfort is problematic. The literature is clear on the benefit of early administration of aspirin in an acute coronary event, except when there is a clear contraindication, such as aspirin allergy or a bleeding disorder. Less clear, however, is whether first aid providers can recognize the signs and symptoms of an acute Consensus on ScienceThere are no human studies on the effect of treating oral caustic exposure with dilution therapy. One in vitro LOE 5 chemistry study 2 demonstrated no benefit from the addition of large volumes of diluent to either a strong base or a strong acid. Five LOE 5 animal studies 3-7 demonstrated histological benefit to the esophagus when a diluent was administered following exposure to an alkali or acid. Treat...

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“…From the standpoint of paramedic and emergency services, only one reference can be found in the literature suggesting that long backboard immobilization and rigid splinting, as an alternative to traction splinting, may constitute an acceptable course of care with fractures to the femoral shaft 11 . In children, our experience is that most splints fitted on arrival either need to be changed or need to be refitted.…”

Section: Discussionmentioning

confidence: 99%

Traction splinting of femoral shaft fractures in a paediatric emergency department: Time is of the essence?

2003

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Objective: To describe the use of traction splinting in children with femoral shaft fracture and to determine if timing of traction splinting application effects outcome. Methods: A retrospective descriptive study conducted over a five and a half year period (1 January 1996 to 1 July 2001) on children presenting with femoral shaft fracture to a Paediatric trauma centre. Data were collected on all children with a radiological diagnosis of fracture to the femoral shaft. Evidence for hypovolaemic shock and neurovascular compromise was sought. The administration of parenteral analgesia and whether a validated pain scale was employed to monitor pain relief was documented. The use of a traction splint or other leg splint device before arrival in the ED and subsequent changes to splinting in hospital were noted. Times to perform radiographic examination and femoral nerve block were also recorded. Results: Ninety‐five (95) patients met the study inclusion criteria with 66.3% having some form of immobilization and 70% administered parenteral analgesia in the pre‐hospital setting. In only 7.3% of patients was a Thomas splint traction applied within 2 h of arrival. Adverse clinical outcome was not reported in any patient regardless of time to application of Thomas splint traction. The application of Thomas splint traction in the ED resulted in a significant delay in the performance of diagnostic radiographs and femoral nerve block. Conclusions: The timing of traction splinting is not associated with poor outcome in isolated paediatric femoral shaft fracture provided effective analgesia has been administered in a timely fashion.

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Prehospital midthigh trauma and traction splint use: Recommendations for treatment protocols

Cited by 29 publications

References 6 publications

Trauma-related Therapeutic Procedures at Shohada Trauma Center in Tabriz

Trauma-related Therapeutic Procedures at Shohada Trauma Center in Tabriz

Part 13: First Aid

Traction splinting of femoral shaft fractures in a paediatric emergency department: Time is of the essence?

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