Republic of the Philippines

TARLACSTATEUNIVERSITY
COLLEGE OFSCIENCE
DEPARTMENT OF NURSING
Lucinda Campus, Brgy. Ungot, Tarlac City Philippines
Tel.no.: 4931865 Fax: (045) 982-0110 website:
www.tsu.edu.ph
Awarded Level 2 Status by the Accrediting Agency of Chartered Colleges and Universities in the Philippines Inc (AACCUP)

Performance Evaluation Checklist

APPLICATION OF BALANCED SKELETAL TRACTION

Name of Student:
Year, Section & Group:
School Year:
Term: First Semester Second Semester Summer
Inclusive Dates of Clinical Rotation:
Clinical Instructor:

Numerical Interpretation of grades:

2 - Outstanding
1 - Satisfactory
0 - Needs Improvement/Repeat Performance

Definition:
- Traction is the act of pulling and drawing which is associated with counter traction
Indications:
1. For support
2. To prevent and correct deformity
3. For immobilization
4. To reduce fracture
5. To reduce pain and muscle spasm
6. To maintain good alignment

SCORE
Preparation 2 1 0 REMARKS
1. Check the doctor’s order
 Patient’s name
 Extremity to be placed on BST
 Weights to be applied

2. Prepare patient psychologically

 Introduce yourself
 Inform patient on what is to be done
 The purpose of the treatment
3. Assemble equipment and supplies:
Orthopedic bed
 Firm mattress
 Fracture board
 Bed elevator/ shock block (optional)
 Balkan frame (cross bar, curve bar, vertical, horizontal,
diagonal bars)
 3 pulleys
 3 clamps
 Overhead trapeze
Traction equipment
 Thomas splint (with half ring)
 Pearson’s attachment
 Rest splint
 Steinmann’s pin holder
 Braun-Bohler splint
 Slings with clips or pins
 3 sash cords (thigh rope, traction rope, suspension rope)
 2 weight bags
 Traction weight (10% of patient’s body weight)
 Suspension weight (1/2 of traction weight)
 Foot pedal or foot board

PRINCIPLES:
1. Patient should be in dorsal recumbent position
2. There must be counter traction (patient’s weight serves as
 the counter traction)
3. There must be continuous traction
4. The line of pull should be in line with the deformity (the first pulley
is in line with the inguinal area, the second pulley is in line with
the knee, the third pulley is in line with the first and the second
pulley)
5. Avoid friction
 There should be no knots near the pulley
 Cords should be running along the grooves of the pulley
 Weights should be hanging freely
 Observe for the wear and tear of the bags and the cords.
Procedure
5. Assist the client to a dorsal recumbent position.
Measure the distance from the lateral side of the trochanter to
the knee by using one of the cords.
6. Position the Pearson’s attachment under the Thomas splint
according to above measurement. Screw them together.
7. Apply the rest splint
8. Apply the slings following the principles below:
 Start from the medial aspect of the Thomas splint and
fasten at the lateral aspect with clips or pins to prevent
injury.
 Apply slings snugly, not too tight (to not impede circulation)
nor too loose (which defeats the purpose of support).
 The smooth surface of the slings should come in contact
with the skin (to prevent irritation).
 Provide approximately an inch space between the slings
(for ventilation).
 If slings are too long, fanfold it.
 Number of slings will vary with the size of patient’s leg.
 Keep the ankle and popliteal area free from slings (these
are highly vascularized areas).
 The broader and longer slings are for the thigh area, while
the narrower and shorter ones are for the leg area.
9. Using slip knot, tie one end of the thigh of the rope at the
junction of the medical upright of the Tomas splint (for
privacy).
10. Decide on the three-manpower team:
Man 1
Insert the Thomas Splint and Pearson’s Attachment without
moving the leg inappropriately (position self at far end of the foot
of the bed on the affected side).
Man 2
Provide continuous manual traction and pushes Braun-
Bohler splint away from work area (position self in between the
1st and 3rd man).
Man 3
Support leg with palm on hand (position self at the side near
the affected leg).
11. Instruct the patient on the following:
 Hold on the overhead trapeze.
 Flex the unaffected leg and lift the buttocks.
 At the count of three, swing the body so that we
simultaneously transfer at the affected leg on the Thomas
Splint.
12. At the count of three, transfer the affected leg while
providing manual traction.
13. Attach the Traction Cord
 Using a slip knot, tie one end of the traction cord at
the Steinmann’s pin holder.
 Pass the cord along the groove of the third pulley, then
attach the traction weight bag (10% of the weight of the
client) to the other end of the traction cord using any kind
of knot.
 There should be one foot distance from the pulley to the
knot or the bottom part of the bag should be at the level
of the bed.
 Consume the rope.

14. Tie the other end of the thigh cord to the lateral aspect of
the Thomas splint using a slip knot.
 15. Attach the Suspension Cord
 Using again a slip knot, tie one end of the suspension
cord to the middle of the thigh cord.
 Pass the cord along the groove of the first pulley, then to
the suspension weight bag (½ of the weight of the
traction weight).
 Temporarily hang the weight bag over the pulley.
 Pass the same cord along the groove of the second
pulley, down to the outer side of the traction cord,
then under the rest splint.
 Tie it over the end of the Thomas splint using a clove-hitch
knot and another clove hitch knot at the end of the
Pearson’s attachment.
 Consume the rope.
16. Release the suspension weight and remove the rest splint

17. Apply foot pedal using ribbon knot.

 The shorter cords should be tied at the Thomas splint.
 The longer cords are tied to the Pearson’s attachment in between
the last and the second to the last sling.
18. Check for the efficiency of the traction by swinging backwards
and forward and sideways.
19. Remove the traction
 Hang the suspension weight.
 Apply the rest splint.
 Apply the suspension cord and weight bag.
 Apply manual traction and remove the traction weight.
 Tie the traction rope instead to the rest splint then the Thomas
splint and to the Pearson’s attachment using the clove-hitch knot.
20. Documentation
 The status of the traction
 Extremity placed on BST
 Weight applied

TOTAL SCORE:
TRANSMUTED GRADE

Shown to me by:

Signature over Printed Name

Student

Wilson S. Lanario RN, MSN

Signature over Printed Name
Clinical Instructor