Types and Management of Clients with Immobilization Devices

Types and Management of Clients with Immobilization Devices.

Immobilizing Interventions 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. �

Splints � 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

Immobilizers � Prefabricated straps. and typically fasten with velcro

Casts � 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. � 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)

Casts cont’d � 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.

Traction � 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.

External Fixation � Involves fracture immobilization using percutaneous pins and wires that are attached to a rigid external frame.

ORIF (open reduction and internal fixation) � 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.

Cervical Collar 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. �

Slings � 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.

Special Devices for Promoting Mobility and Circulation

Mobility � Freedom and independence in purposeful movement. � Adapting to and having self-awareness of the environment. � Functional musculoskeletal and nervous systems are essential for mobility.

Immobility � 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. ◦ ◦ Temporary, following knee surgery Permanent, paraplegia Sudden onset, fractured from accident Slow onset, multiple sclerosis

Promoting Venous Return � 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.

Sequential Compression Devices (SCD’s) � 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.

Continuous Passive Motion