Professional Documents
Culture Documents
TRACTION
Objectives:
After 5 hrs of varied classroom discussion, the level III students will be able
to:
1. define the following terms:
1.1 countertraction
1.2 fixator
1.3 traction
1.4 trapeze
2. state the purpose of traction
3. enumerate the indications and contraindications of traction
4. cite the types and applications of the ff:
4.1 traction
4.2 fixator
5. explain the scientific principles involved in the care of patients with
traction
6. identify the possible complications of traction application
7. discuss the general care for the patients with traction
7.1 assessment of body parts
7.2 handling new traction
7.3 skin care
7.4 turning
7.5 toileting to bathing
DEFINITION OF TERMS:
1. . Counter traction
- pulling force equal and opposite the traction weights. Usually the patients
body weight and bed position adjustment.
2. Fixator
- metallic plate or screw placed on the bone to provide support. It fixes the
origin of prime movers so that the muscle acts in an exerted at the insertion
3. Traction
- is the application of a pulling force, used to stretch soft tissue and to
separate join surfaces on bone fragments . It involves applying as a force of
sufficient magnitude and duration while simultaneous resisting movement of
the body
4. Trapeze
- an overhead patient helping device to promote mobility in bed. A triangular
device hung from the ceiling or from a bar over the bed which can be
adjusted to the patients reach. Patient should be assisted upon changing
positions or sitting.
PURPOSE:
INDICATIONS:
stretching adhesions
treatment of painful arthritis, sore muscles and ligaments, dislocations,
degenerated or ruptured intervertebral disks and spinal cord
compression
degenerative joint disease
nerve root syndromes and herniated discs
relief from general, vague back pain
CONTRAINDICATIONS:
APPLICATION OF TRACTION:
1. SKIN TRACTION
- in skin traction, the pull is applied to the client's skin which transmitted the
pull to the musculoskeletal structures. A belt, head halter, foam rubber
wrapped with an elastic bandage, or a foam boot is applied to the client's
skin before the appendage is attached to traction.
d. Bryant's Traction
Apply bilaterally with hips with hips flexed 45 degrees and legs in
extension
Ensure skin integrity with nonadhesive straps and wraps that do not
impair neurovascular status
Ensure buttocks are elevated 1 to 2in. from mattress
Ensure parents understanding of the purpose and use of traction
Utilize jacket or vest restraint to prevent child from rotating in the bed
e. Cervical Head Halter Traction
for neck pain, neck strain and whiplash, traction can be applied to the
cervical spine by means of a head halter. The pull of cervical skin
traction should be felt as an upward pull on the back of the neck. A
slight change in the level of the head of the bed is often the key to
correct application of this type of traction. Because this is a form of
skin traction, it cannot be used for prolonged periods.
this type of traction is often used by client at home with the client
sitting in a chair.It can be used to alleviate painful muscle spasm of the
neck, to create alignment, or to prevent deformities.
2.SKELETAL TRACTION
-is a applied directly to the bone with wires or pins that are inserted
during surgery.
Discharge
Odor
Bleeding
Clean skin around puncture sites as ordered
3. RUNNING TRACTION
- is a pulled in one direction against the long axis of the body or
bone. With this type of traction, the body must be aligned with
the pulling force to be effective
TYPES OF FIXATOR
EXTERNAL FIXATOR
-is the device is used to manage complex fractures that associated with soft
tissue damage or with open wounds in the fractures area. A physician inserts
multiple pins that protrude through the clients of skin into the bone
fragments. The external fixation device is a metal frame that, on the outside
of the body, holds the pins in place and maintains immobilization. The
picture shown is an example of external fixator being used in the treatment
of a fractured radius bone.
INTERNAL FIXATOR
Internal fixation is done through open reduction, the surgeon places a pin,
wire, screw, plate, nail or rod into or onto the bone to keep it reduced
(properly aligned), immobilized, or both. This procedure is called open
reduction, internal fixation (ORIF) and is the treatment of choice for certain
fractures in which casting is generally impossible (hip fracture).
Internal fixation can be performed using various devices. It is most
frequently with fractures of the legs long bones, in which case the spike is
called intermedullary nail
3. Physics
- the nurse should observe on the friction between traction part and
the bed. Also the nurse should know the mechanical devices such as
ropes, pulleys, and weights supply is used properly for the part to be
traction to prevent further injury.
4. Psychology
- adequate explanation of the procedure to be used in applying and
maintaining the traction is essential. Provide privacy to the patient.
Give time to patient that he can accept the injury that he had. Provide
good environment to prevent depression of the patient.
5. Safety and Security
-the nurse should observe on the safety of the patient to prevent
aggravation on the injured part. This is also to prevent fall of the
patient that may cause further injury.
6. PRESSURE ULCERS
The nurse examines the patients skin frequently for evidence of
pressure or friction, paying special attention to bony prominences.
It is helpful to reposition the patient frequently and to use protective
devices (e.g elbow protectors) to relieve pressure.
The nurse consult with the physician and the woundostomycontinence nurse.
7.1.6 Slipping
- is there slipping of the traction tapes and does outer bandage
need rewrapping?
7.1.7 Pressure
- is there pressure on the lateral aspect of the leg over the head
of the fibula? Pressure in this area may result in a palsy of the peroneal
nerve.
7.1.8 Patients Comfort
- traction should never be a source of undue discomfort for the
patient. Listen carefully and heed complaints of discomfort.
7.1.9 Complication
- because of the prolonged bed rest and minimal activity,
hypostatic pneumonia is a constant threat, particularly to the elderly patient.
Encourage coughing and deep breathing.
7.2. HANDLING NEW TRACTION
- inspect traction apparatus frequently to ensure the ropes are running
straight and through the middle of the pulleys; the weights are hanging free;
that bed clothes, the bed or the frame or bars of the bed are not impinging
on any part of the traction apparatus
- check ropes frequently to be sure they are not frayed.
- Avoid releasing weights from or altering the line of pull of the traction.
- Avoid adding weight to the traction
- Check the position of the Thomas splint frequently; if the ring is away from
the groin, readjust the splint to its proper position without releasing the
traction.
- Avoid bumping into the bed or traction equipment
- Be sure that weights are securely fastened to their ropes
- Avoid manipulation of pins
7.3. SKIN CARE
- encourage the patient to turn slightly from side to side and to lift hip up on
the trapeze to relieve pressure on the skin on the sacrum and scapulae
- avoid padding the ring of the Thomas splint- since this will create dampness
next to the skin. Bathe the skin beneath the ring, dry it thoroughly, and
powder the skin lightly.
- inspect skin frequently to be sure that it is not being rubbed, macerated by
traction equipment; readjust splint or the extremity in the splint to free the