MANAGING PATIENT

SAFETY DEVICES AND

CONFORT

1 By: Firaol R. (BSc,MSc)

 “I will prescribe regimens for the
good of my patients according to my ability and my
judgment and never do harm to anyone” …..
(Hippocrates Oath)

2 By: Firaol R. (BSc,MSc)

Introduction to patient safety

 Patient safety- is a discipline in the health care sector that

emphasize safety in health care through the prevention, reduction,

and reporting unnecessary harm caused by the process of health

care itself.

 It minimizes the incidence and impact of, and maximizes recovery

from adverse events

3 By: Firaol R. (BSc, MSc)
Introduction to patient safety…
 Much unnecessary harm is caused by healthcare errors and
system failures.

Example,
 Hospital acquired infections from poor hand-washing.
 Complications from administering the wrong medication

4 By: Firaol R. (BSc,MSc)

 Patient safety….
 Patient safety is absence of preventable harm to the patient
during health care

 It is generally agreed upon that the meaning of patient

safety is…“Please do no harm”

5 By: Firaol R. (BSc,MSc)

Introduction….
What is safety?
 S= Sensing the error
 A= Act to prevent the error
 F= Follow safety guide line
 E=Enquire in to accidents/Death/
 T=Take appropriate remedial measure
 Y= Your responsibility

6 By: Firaol R. (BSc,MSc)

Patient safety…

7 By: Firaol R. (BSc,MSc)

Patient safety…

8 By: Firaol R. (BSc,MSc)

Patient safety…

9 By: Firaol R. (BSc,MSc)

Patient safety…

10 By: Firaol R. (BSc,MSc)

Introduction…

 Comfort - is defined as “the contented enjoyment in

physical or mental well-being, a state of freedom from

pain, discomfort, tension & anxiety.

11 By: Firaol R. (BSc,MSc)

Introduction…
 The alert nurse quickly sense when the client is
uncomfortable.
 The skillful nurse knows simple ways of easing discomfort
& does not think of a sedation first

12 By: Firaol R. (BSc,MSc)

Safety devices promoting patients comfort
 Comfort devices- are the mechanical  Bed-cradle
devices planned to provide optimal  Bed side rails
comfort to an individual  Sand bag
 Pillows  Fracture board
 Cotton rings  Back rest
 Foot-board  Splint
 Air rings

13 By: Firaol R. (BSc,MSc)

 Applying Pillow
 Pillows are used to give comfortable position to the patient.
 These are mostly used to support various body part

Purposes:
 To maintain proper body alignment.
 To support body parts in good alignment.
 Help to reduce pressure.
 It is used to support head, neck, arms, legs & parts of the back.

14 By: Firaol R. (BSc,MSc)

Pillow….

15 By: Firaol R. (BSc,MSc)

Applying back rest
 It is a mechanical device which provide a suitable support &
rest for the back of patient in sitting position.

Purposes
 To support back
 To facilitate breathing (relieve dyspnea)
 Promote drainage from abdominal cavity
 It is given especially for heart & asthma patient even in
post- operative period
16 By: Firaol R. (BSc,MSc)
Back rest…

17 By: Firaol R. (BSc,MSc)

Sand bag
 They are sand filled plastic bags that can be shaped to
body contours
 These are canvas rubber or plastic bags filled with sand.
 These are used to immobilize a part.

18 By: Firaol R. (BSc,MSc)

Applying sand bag …
Purposes
 To relive discomfort
 Used to support body part
 Used to immobilize the body part

19 By: Firaol R. (BSc,MSc)

Sand bag…

20 By: Firaol R. (BSc,MSc)

 Air rings

 Air rings are made of rubber

 The air rings is inflated about half full, tested for leakage,

covered & then placed under the patient’s hips

 These are placed under bony prominences such as heels &

fastened in place if necessary.

21 By: Firaol R. (BSc,MSc)

Air rings…

Purposes:-
 To lift the hip from bed to prevent bed sores
 To prevent direct pressure on bony prominences
 To improve circulation

22 By: Firaol R. (BSc,MSc)

Applying Air ring

23 By: Firaol R. (BSc,MSc)

Applying bed cradle

 It is a frame used to hold the bed linen from touching the

patient.

 Cradle is a semicircular / rectangular frame which support

& take off the weight of top bedding.

24 By: Firaol R. (BSc,MSc)

Bed cradle…
Purposes:

 To prevent the top cloth if coming in contact with the

patient especially burn patient.

 To allow air to circulate around lower limbs

 Electronic bed cradles are used to supply the desired

warm in case of shock.

25 By: Firaol R. (BSc,MSc)
Bed cradle…

26 By: Firaol R. (BSc,MSc)

Applying fracture board
 Is a support that is placed under patients mattress to give
added rigidity to the mattress.
 Usually made of wood/canvas & is constructed to fit the
standard hospital bed

27 By: Firaol R. (BSc,MSc)

Applying foot-board
 Device that is placed towards the foot of patients bed to
serve as support for his feet
 Usually made up of wood/plastic/heavy canvas

Purpose

• To support patients feet

• To prevent foot drop.

28 By: Firaol R. (BSc,MSc)

Applying foot board…

29 By: Firaol R. (BSc,MSc)

Applying bed- side rail
 Side rails are the bars positioned along the sides of the
length of the bed

Purpose
 Ensure patient’s safety & are useful for increasing
mobility
 Provide assistance in rolling from side to side or sitting
up in bed

30 By: Firaol R. (BSc,MSc)

Applying bed- side rail …

31 By: Firaol R. (BSc,MSc)

Applying rubber and cotton ring
 These are circular rings made of rubber or cotton.

Purpose
 These are used to relieve pressure on certain parts of the
body like elbow and heels.

32 By: Firaol R. (BSc,MSc)

Applying rubber and cotton ring…

33 By: Firaol R. (BSc,MSc)

Applying splint
 Any device used to immobilize(prevent movement) a
fracture or dislocation is a splint.
 A splint can be soft or rigid, commercially manufactured
or improvised from virtually any object that can provide
stability.
 It is used to support, protect, or immobilize an injured or
inflamed part of the body

34 By: Firaol R. (BSc,MSc)

Purpose of splinting

 To provide immobilization to the injured area

 To protect the injured area
 To prevent further injury
 To help reduce pain
 Decreases risk of converting a minor injury to a major
injury

35 By: Firaol R. (BSc,MSc)

Indications for Splinting
 Fractures
 Sprains
 Acute arthritis / gout
 Lacerations over joints
 Puncture wounds

36 By: Firaol R. (BSc,MSc)

 Indications for Splinting…

 To reduce/prevent contracture

 To stabilize and rest joint in ligamentous injury

 To correct deformity

 To support and immobilize joints and limbs postoperatively

until healing has occurred

37 By: Firaol R. (BSc,MSc)

Contraindications of splinting
 Compartment syndrome – Occurs when excessive pressure build up on
inside an enclosed muscle space in the body
 Need for open reduction
 Skin at high risk for infection

5p’s of compartment syndrome

 Pain
 Pallor (Pale skin tone)
 Paresthesia (numbness feeling)
 Pulselessness
 Paralysis (Weakness with movement)
38 By: Firaol R. (BSc,MSc)
Splinting material

Plaster of Paris
 Made from gypsum - calcium sulfate dehydrate
 Exothermic reaction when wet - recrystallizes
 Average setting time – 3-9 min
 Average drying time – 24-72 hours

39 By: Firaol R. (BSc,MSc)

Plaster of Paris…
Advantage Dis advantage
 Easier to mold  More difficult to apply

 Less expensive  Gets Soggy/soaked when

getting wet

40 By: Firaol R. (BSc,MSc)

Splint materials…
Fiber glass
 Can be used in non-displaced fracture.
 Lighter weight, durable, require less maintenance.

Disadvantage
 More expensive
 More difficult to mold

41 By: Firaol R. (BSc,MSc)

Pre-splinting requirement
 Check for neurovascular continuity
 Use the 5 P’s (pain, pallor, pulse, paresthesia, paralysis)
 Treat wounds and slow/stop any bleeding
 Remove jewelry
 Immobilize the joint proximal and distal to the injury (if
possible)
 Before application of splint, gather all materials first!

42 By: Firaol R. (BSc,MSc)

PRE/POST SPLINT CHECKS

 F- Function

 A- Arterial pulses

 C- Capillary refill

 T - Temperature

 S- Skin

43 By: Firaol R. (BSc,MSc)

 General procedures of splinting

1. Stockinette is applied

2. Webril is applied

3. The wet plaster is

positioned

4. Elastic bandage is applied

5. The plaster is molded

44 By: Firaol R. (BSc,MSc)

General procedures of splinting…
 Apply the stockinette so that it extends 2 or 3 inches
beyond the plaster
 Apply 2 or 3 layers of Webril over the area to be splinted
 Wet the plaster and place it over the area to be splinted
 Fold the ends of stockinette over the plaster to smooth the
edges of the splint

45 By: Firaol R. (BSc,MSc)

 Selecting appropriate splinting
materials
Upper extremity splint

 Volar splint

 Thumb Spica splint

 Radial Gutter splint

 Ulnar Gutter splint

 Short Arm Sugar Tong splint and others…

46 By: Firaol R. (BSc,MSc)
Lower extremity splint

 Short Leg Posterior splint

 Long Leg Posterior splint and etc..

47 By: Firaol R. (BSc,MSc)

The Volar Splint
 Carpal Tunnel Splint Carpal tunnel syndrome.PNG /Cock-up
Splint /Wrist Splint

Application/Location
 Applied on volar aspect of the arm
 Approaches both the proximal and distal palmer creases and
completes approximately one inch distal the Antecubital fosse
 Usually applied with wrist dorsally extended from 0 - 30
degrees
48 By: Firaol R. (BSc,MSc)
Volar splint…
Utilization

 Wrist sprains/strains and fractures

 Post-surgical fracture repairs as well as carpal tunnel

releases.

 It can be used to treat metacarpal and phalangeal issues as

well.

49 By: Firaol R. (BSc,MSc)

Volar splint…
Volar splint.mp4

50 By: Firaol R. (BSc,MSc)

The Thumb Spica Splint

 Also known as Radial Gutter Spica Splint

Application/Location:

 Applied on radial aspect of the arm.

 Includes the thumb from its most distal tip and completes

approximately one inch distal the Antecubital fosse.

 Usually applied with wrist dorsally extended from 0 - 30

degrees.
51 By: Firaol R. (BSc,MSc)
Thumb Spica Splint…
Utilization:
 Used for thumb sprains /strains/
 Thumb fractures, post-surgical fracture repairs
 Tendonitis/Tenosynovitis and
 Scaphoid injuries/fractures.

52 By: Firaol R. (BSc,MSc)

Thumb Spica Splint…
thumb Spica splint.mp4

53 By: Firaol R. (BSc,MSc)

The ulnar gutter splint
 Also known as Boxer’s Fracture Splint
 Application/Location: Applied on ulnar aspect of the arm
 It includes the 5th and 4th digits from their most distal tip
and completes approximately one inch distal the Antecubital
fosse.

 Usually applied with wrist dorsally extended from 0 – 30

degree and 70 -90 degree flexion of 4th and 5th Metacarpal
54 By: Firaol R. (BSc,MSc)
Ulnar gutter splint…
Utilization:

 Used for 4th and 5th metacarpal fractures

 Post-surgical fracture repairs as well as tendon repair.

(Initial Boxer’s fracture treatment of choice).

55 By: Firaol R. (BSc,MSc)

Ulnar gutter splint…
Splint like a pro_ Ulnar gutter splint.mp4

56 By: Firaol R. (BSc,MSc)

 The Short Arm Sugar Tong Splint
 Application/Location: Applied on the dorsum and volar
aspects of the arm from proximal palmer creases
 It rounds the elbow posteriorly
 Usually applied with wrist dorsally extended from 0 - 30
degrees and 90 degrees of flexion at the elbow.
 The finish product resembles a “sugar tong” which is used to
pick up sugar cubes from a dish.

57 By: Firaol R. (BSc,MSc)

The Short Arm Sugar Tong Splint…
Utilization

 Used for various radial and ulnar fractures

 Post-surgical fracture repairs

 Tendon repair

 This splint usually requires an arm sling.

58 By: Firaol R. (BSc,MSc)

The Short Arm Sugar Tong Splint…

59 By: Firaol R. (BSc,MSc)

The Long Arm Double Sugar Tong
Splint
 Application/Location: A long Arm Sugar Tong is applied
first, then a second “sugar tong” will start approx.
 Start at 2 inch distal from the Axilla, continue around
the elbow and finish laterally on the head of the biceps.
 Usually applied with wrist dorsally extended from 0 - 30
degrees and 90 degrees of flexion at the elbow.
 The finish product resembles two intersecting “sugar
tongs”.
60 By: Firaol R. (BSc,MSc)
The Long Arm Double Sugar Tong
Splint…

Utilization:
 Used for various radial and ulnar fractures
 Post-surgical fracture repairs as well as tendon repair.
 This splint usually requires an arm sling.

61 By: Firaol R. (BSc,MSc)

The Long Arm Double Sugar Tong Splint…
Long arm double sugar tong splint.mp4

62 By: Firaol R. (BSc,MSc)

The Short Leg Posterior Splint
 “L” splint or Short Leg Splint
 Application/Location: Usually applied slightly distal to
the most prominent of the digits
 Terminate distally 2 - 3 inches of the Popliteal Fosse.
 Usually applied with foot in neutral position of the ankle
and the ankle is at 90 degrees.

63 By: Firaol R. (BSc,MSc)

The Short Leg Posterior Splint…
Utilization:

 Used for foot and/or ankle sprains/strains and fractures

 Post-surgical fracture repairs as well as tendon repair.

 With appropriate splint modification, can be used to treat

acute Achilles tendon injuries

64 By: Firaol R. (BSc,MSc)

The Short Leg Posterior Splint…
Short leg splint.mp4

65 By: Firaol R. (BSc,MSc)

The Long Leg Posterior Splint

 Also known as Long Leg Extension Splint

 Application/Location: Usually applied slightly distal to the
most prominent of the digits
 Terminating distally 2 - 3 inches of the Gluteal Sulcus (Fold
of the Buttock).
 Usually applied with foot in neutral position of the ankle and
the ankle is at 90 degrees and the knee at 0 –10 degrees of
flexion.
66 By: Firaol R. (BSc,MSc)
The Long Leg Posterior Splint…
Utilization:
 Used for midshaft and/or high tibia/fibular fractures
 Acute femur fractures and
 Knee injuries/fractures.

67 By: Firaol R. (BSc,MSc)

The Long Leg Posterior Splint…

68 By: Firaol R. (BSc,MSc)

THANK YOU!

69 By: Firaol R. (BSc,MSc)