Thomas Splint video

https://www.youtube.com/watch?v=c2oHnW1ePaI
How to apply a Thomas
splint
• Analgesia
– Femoral nerve block
– Entonox

• Ensure bed assembled for

traction on ward prior to patient
arrival

• Measure uninjured limb

– Length, inside leg to heel, add 15-
20cm
– Ring, Circumference of unaffected
thigh at groin level, add 5cm
• Prepare the splint

• Select corresponding ring

and splint

• Avoid closed ring splints

• Position and secure slings

along the splint

• Leave heel free, extra

padding under knee

• Double layer of Gamgee

• Before application - MUST
– NV assessment of limb, check
for skin cuts, abrasions/rashes
etc

• Apply manual traction to

limb

• Apply skin extension, tape

placed medial and lateral
aspects of limb
– Foam passing over malleoli
– Free from creases and foam
padding
– Leave room between foot and
end of extension to allow full
ROM ankle
• Bandage skin extension to
patients lower leg using crepe

• Avoid tight bandaging over

fibula head, malleoli and
Achilles tendon

• Secure ends with tape/safety

pin

• Leave knee exposed

• Place splint with manual

traction, gamgeee/padding
• Secure traction cords to end of
splint

• Outer cord over the lateral bar

• Inner cord under the medial

bar
– Controls rotation

• Tie

• Apply a windlass
After application - MUST
•Check and document NV
status

•Crepe can be applied

over to prevent
tampering

•Splint can be suspended