In this SplintER Series, we review splinting fundamentals, introduce advanced concepts, and highlight ways to implement these into your next shift. In SplintER 102, we reviewed the materials used in splinting and a general approach to applying a splint. Today’s post puts the spotlight on some of the potential complications of splinting, discharge care plans, and pharmacological adjuncts to aid in recovery.
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The purpose of the SplintER series is to teach the fundamentals and introduce advanced concepts of splinting to the Emergency Medicine (EM) professional. Humans have been splinting their injuries since 1300 B.C.1 Although the fundamentals have not changed, splint selection and application require some thoughtful consideration. A 2017 prospective, observational study in the Journal of Pediatric Orthopaedics demonstrated that more than 90% of splints applied in the Emergency Department were inappropriate (30% applied by EM attendings), as evaluated by orthopaedic surgeons.2 While that number may not be representative in your institution, it certainly highlights the inadequacies that many of us feel when approaching a splint!