Care of orthopedic traction person is to prevention of harm to person- Emphasis is place on the system of care delivery. To enhance recovery potential. These services are provided for the purpose of improving the health status, maintaining health status to fulfill the person’s needs and goals. There are various measures to take care of person who is having tractions.
Following articles we should keep ready for applying skin traction.
- Will get the skin traction kit, from pharmacy / medical store.
- Foam Tape.
- Elasto crepe Bandage.
- Foot Plate.
- Nylon Rope.
- Pulley (Metal Rod)
- Ensure that the affected part is clean.
- We have to take Assistant the application of the foam tape without fold or creases.
- If possible, leave the ankle joint free.
- Ensure that the part affected is in the correct anatomical position e.g. feet and patellae pointing upwards when person is in supine position.
- Examine the extremity to the traction.
- Observe continuously for any presence of oedema on ankle.
- We have to check peripheral pulses.
- We also check temperature and colour of feet to see, if both are normal.
- After applying on person, Check the traction mechanism.
- Weight should hang freely, off the floor and bed.
- Knots should be secure in all ropes.
- Ropes should move freely through pulley(s).
- H.Sq. traction pulley.
- Padded pelvic traction belt.
- Pelvic traction spreader bar.
- Water bag / sand weight bag / iron casted weight set (each weight is of 1 kg.).
- Keep the higher frame of the bed at the leg end of the person.
- Place pulley on the higher frame and adjust pulley angle approximately at 50o.
- Ensure that the person is made to lie flat in supine position.
- A small pillow under the head may be allowed.
- Apply the pelvic traction to the waist correctly.
- Attach the belts to the traction rope.
- Attach the weight at the other end of the bed as per doctor’s instructions (approximately 5 to 8 kg of weight is applied).
- Weight is decided as per person weight. It is one tenth of body weight.
- Instruct person not to loosen the belt unless allowed by the doctor for toilet facilities as well as for meals.
- We do not turn on bed with traction belt
- We do not sit with traction belt, person has to remove the belt.
Care of Person in a Wet Plaster Cast
- Explain to the person that he / she will feel warm as the plaster dries (drying time 24-28 hours).
- Place bed-board under the mattress, if person wears a Spica / body cast.
- Use only the palms of your hands on the cast when turning and positioning for the first 24 hours.
- Support the cast with pillows as necessary.
- Keep the casted extremity above the level of the heart.
- Maintain the angles that were built into the cast.
- Prevent cracking from undue pressure.
- Prevent the spots in the cast caused by pressure on the bed e.g. when person has a long leg cast, place pillows under knees to maintain angle of the cast and under lower leg to prevent pressure and flattening of heel area.
- Keep cast uncovered.
- If the cast is near the groin, protect this area with plastic.
- If edges of the cast are rough or crumbling, place gamjee pads over.
Assessing a Casted Extremity
- Encourage person to inform you if he feels any unusual sensations / changes in the casted extremity.
- Check the person’s finger or toes to make sure they are pink in colour.
- Feel the person’s finger or toes to make sure they are warm.
- Assess for capillary refill by applying pressure to one of person’s toenails or fingernails.
- Ask the person to move the fingers or toes that are affected by the cast. The person should be able to move them without difficulty.
- Ask the person to identify the exact location of any pain. Assess for adequate blood supply or nerve paralysis.
- Check for drainage from a wound under the cast. Note the colour and amount of drainage.
- Mark the circumference of the stain on the cast to assist for any increase in the amount of drainage.
- Discourage patient to scratch with pen, pins or any other sharp object.
- Report any unusual odour or increase in drainage to your doctor