Why do we splint? Splinting is one of the fundamental procedures of the Emergency Department (ED). How well-versed are we with it? Why do we even splint? By the end of this post, you will know the reason why we splint, when to splint, and just as importantly — when NOT to splint in the ED.
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!
“The part can never be well unless the whole is well.” – Plato
The rigors of post-graduate training can strain even the most stoic of residents – the next task, the next project, the next shift. These reduce our resiliency to stressful situations. The likelihood is that your program has worked very hard to develop new and innovative initiatives to improve resident wellness and resiliency. And chances are, they have done this in-house. It takes tremendous efforts, however, to create and revise the efforts. In this digital age of social media, this siloed approach no longer is necessary because programs can easily get feedback and share their experiences with others.
|“Dear colleagues. The unbearable has happened…last Friday we discovered that one of our residents was tragically taken from us… It appears that the resident took their own life in response to acute grief…”
– Dr. Christopher Doty (Program Director, University of Kentucky EM Residency Program)
Calling ALL Emergency Medicine (EM) physicians – residents and attendings alike! It shouldn’t take Dr. Doty’s story or the loss by the resident’s family, friends, and colleagues suffered in order for us to recognize the importance of wellness. Our specialty is known to be high risk and it is surprising that we are so late to the game to try and change that. Well, together we can. We are a strong group of people. We see, hear, touch, and smell things that would make the average person nauseous. We are problem solvers and leaders.