San Diego Study, Bill Dodson Study

 The Reel Splint is a multiple function splinting device that can be utilized in various configurations. Over the last five months I have been using the Reel Splint in a testing phase. The initial perception of the Reel Splint is that of a Hare Traction splint with additional knobs and a hinge on it.

The Reel Splint comes in a package containing the main body of the splint and the optional attachable traction device. The Reel Splint utilizes a dual rail design with a strapping system that hammocks the extremity thereby removing the weight off the dependent extremity and sight of injury. The Reel Splint has articulating joints that allows the splint to immobilize the affected extremity in position found. The Reel Splint also has a additional traction device that connect to the end of the splint to apply traction to midline femur fracture.

After removing the Reel Splint from it’s packaging there were some initial hesitation in regards to what appeared to be a complicated splinting device. Taking a short amount of time to become familiar with the device I began to practice placing the splint on everyone around in the conference room. In the process of practicing with the splint we were able to place the splint on legs in every conceivable position we could come up with short of actually breaking or dislocating a limb. After practicing with the Reel Splint I still had some initial hesitation that it would not work as well in the field as it did in a controlled setting. I took the Reel Splint to work and spent about twenty minutes explaining it to my partner.  It took about two days until we had an opportunity to utilize the Reel Splint. The following are some of the patient situations that the Reel Splint was utilized.

Called to private residence to find an 85 year old female found in right lateral position with deformity and lateral displacement to the left hip area. With the assistance of the engine crew we placed the upper portion of the splint along the pelvic area with the medial hinge at the area of deformity. After securing the splint into place we were able to move the patient onto her back with minimal discomfort. We currently do not carry any type of splinting device that would have been able to secure the patients hip. We would have had to manipulate the patient without securing the hip increasing the level of pain and possibly injuring the patient further.

When my intern started I gave her a brief description of the Reel Splint and let her play with it for about 30 minutes. Later in the shift we were called to the Midway Post Office for a 45yo male that stepped off a loading dock had a 4 foot fall striking his right knee on a trailer hitch that was stinking out. The patient presented with a knee that was grossly deformed with noted crepitus and a pain level of 10/10. My intern applied the Reel Splint to the knee with my assistance. My intern secured the splint to the lateral side of the right leg in position found. Once the Reel Splint was secured into place the patient stated that his pain scale had dropped from a 10/10 to a 2/10. The patient was offered morphine for pain management and refused stating that after the splint was in place the pain had reduced significantly and that he was able to tolerate the discomfort.

I worked an overtime shift on Medic 66 with another paramedic and his intern. I gave the paramedic and his intern a very brief overview of the splint. During the course of the shift we encountered a 22yo female that was 3 weeks post right knee replacement surgery. The patient was walking down some stairs when she slipped on a wet area falling forward striking her knee on the ground. The patient had obvious displacement of the right knee. The intern was able to place the Reel Splint into place in position found without manipulating the patient’s knee. The patient had a relief from a 10/10 to a 6/10, after the administration of 4mg of morphine the patient had a reduction of pain from a 6/10 to less than a 1/10. At the emergency department the physician asked that the splint be left in place until after x-rays were taken to avoid moving of the affected joint. The patient later had the splint removed and was taken to surgery for the knee repair.

Approximately 2 months after receiving the adult Reel Splint I received a pediatric Reel Splint with traction device. The pediatric Reel Splint is approximately one third the size of the adult Reel Splint. The first opportunity to use the pediatric Reel splint was not on a pediatric patient or an injured leg. The first opportunity I had to use the pediatric Reel Splint was on a 37yo/f that had fallen off her bicycle with injuries resulting from her attempting to break her fall. The patient had two areas of deformity. The first area of deformity was at the wrist with what appeared to be a Collies type fracture and mid shaft radial/ulna deformity. Due to the splints ability to hammock the injury we were able to support the arm proximal and distal to the injury sites without placing pressure on the injury areas themselves. We would not have been able to accomplish this using Frak Pack or Sam Splints without applying pressure directly to the injured areas.

 We received a call for a 45yo male fall from bicycle. Upon arrival we found a patient with a severally angulated left elbow injury. The patient was in visible pain and rated his pain as a 10/10 and did not want anyone to touch him. When the patient attempted to move himself the injury was obviously unstable. With assistance from the firefighter/paramedic off of E35 we were able to place the Reel Splint in about 45 seconds. The Reel Splint was able to support the injured extremity taking the weight off the site of injury. The patient states that he was able to tolerate the discomfort, grabbed the rail of the splint supporting his own arm stood up and walked to the gurney. During transport it was observed that the patient was developing a significant amount of swelling. With the splints open design we were able to observe the swelling that was present and able to readily reassess distal PMS and swelling levels. Upon arrival to the Emergency department the attending physician stated that he believed that the patient was in the process of developing compartment syndrome. The physician asked that the splint be left in place. The splint stayed in place through the obtaining of x-rays and remained in place until it was removed by the Orthopedic Surgeon during surgery. Because the splint was left on the patient the duty supervisor was notified that the splint was left on the patient. Arraignments were made to be notified by hospital staff when the splint was available for retrieval. Dispatch was notified by the hospital staff and the Reel Splint was retrieved by supply personnel.

During the trial period I had several opportunities to utilize the Reel Splint. The Reel Splint performed better than expected in various situations. I unfortunately was not able to use the traction device portion of the Reel Splint. Due to the versatility of the Reel Splint I was able to splint several injuries that there was no other effective way to splint.

The training needed for the Reel Splint is relatively simple and could be completed in an IST or CE setting with little additional time involved. The Reel Splint is easy to clean with replaceable strap system.

The cost of the Reel Splint Traction System is relatively close to that of a standard Hare Traction splint and performs many more functions. When you additionally add in the fact that the Reel Splint can also replace the Frak Pack and Sam Splints the cost is relatively low. The Reel Splint provides a splinting system that allows a patient to be splinted in position found,  relieves pain, and prevents further injury from improper splinting.

 

William Dotson 

 

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