BST Retdem

NOTE: Hatiin nyo na yung mga sasabihin sa group nyo para hindi lang isang member yung
nagsasalita. Example: may isa sa indications, principles, parts of ortho bed etc.
Isang bagsakan nyo na sabihin sa CI HAHAHAHA
1. Preparatory Phase
• Intro and identify patient (name, age, DOB, Wristband)
• “Good morning Sir my name is (name ng members) and we will be your nurses for
today. We will be applying a balance skeletal traction on your injured leg. So
what is traction?”
• Traction – is an act of pulling and drawing which is associated with counter
traction.
• “Now for the indications…”
• Indications
▪ Reduce fracture
▪ Maintain good alignment
▪ Prevent and correct deformity
▪ For support
▪ For immobilization
▪ Reduce pain and muscle spasms
• “So the principle of BST are…”
• Principles
▪ Patient should be on dorsal recumbent
▪ There must be counter traction under patient’s bed (fracture board)
▪ Continuous traction (pulley system)
▪ Line of pull should be in line with deformity
▪ 1st pulley is in line with inguinal area
▪ 2nd pulley is in line with the knee
▪ 3rd pulley is in line with the 1st and 2nd pulley
▪ Avoid friction
▪ No knots near the pulley
▪ Cords should be running along the grooves of the pulley
▪ Weights should be hanged freely
▪ Observe for the wear and tear of the bags and cords
• “For the orthopedic bed we have the Balkan frame, which consists of…”
• Parts of Orthopedic Bed
• “Next, the materials needed for this procedure are as follows…”
NOTE: For materials, dapat specific daw like gaano kabigat yung suspension and traction
weight, yung malapad and narrow na slings saan mo ikakabit, and yung tali ng foot pedal
(maiksi at mahaba) saan mo ikakabit.
MATERIALS NEEDED
2. Check Doctor’s Order
• “Now we will check the doctor’s order along with the weight of the patient and
the site of traction.”
3. Actual Application
• Using the thigh rope, measure the length of the thigh by using the end of it from
the greater trochanter to the knee.
• Attach Thomas splint and Pearson’s attachment by placing the measured length
of the thigh rope, so that the screw of the Pearson’s is in line with the knee.
• Mount the Thomas splint and the Pearson’s attachment to the rest splint.
• Apply the slings.
▪ Yung dalawang slings na malapad, ikakabit yun sa Thomas Splint
▪ Yung tatlong slings na narrow, ikakabit yun sa Pearson’s attachment.
▪ Fanfold technique sa slings.
Dito magslip knot gamit thigh rope
Malapad na slings
Temporarily secure yung thigh
rope dito after mag slip knot
Narrow slings
• “The distance between slings should be 1-2 inches and popliteal area and
ankles should be free from slings because they are highly vascular areas.”
• Instruct patient to hold on to the overhead trapeze, flex their unaffected
leg, and at the count of three lift the buttocks.
• Get the thigh rope (yung pinakamaiksi na rope) and itali dun sa Thomas
splinter using slip knot. Then, temporarily secure yung rope sa screw ng
Pearson’s attachment.
• Transfer the affected leg to the apparatus using 3 manpower.
• Nurse 1 – will be applying manual traction by holding the Steinman’s pin
holder and removing the Braun Bohler at the same time. Maintain
applying traction until traction weight is applied.
• Nurse 2 – will support the affected leg, ensuring that the thigh is in line with
the 1st pulley and the knee is in line with the 2nd pulley.
• Nurse 3 – will insert the apparatus (pinagkabit na Thomas splint, pearson’s
attachment, rest splint, and slings).
• Get traction rope (yung medyo mahaba na rope) and itali (slip knot) sa
steinman’s pin holder habang nakahawak dun yung nurse 1. The isuksok
mo sa 3rd pulley and itali mo yung traction bag (yung mas magaan) sa
traction rope (slip knot).
• Back to the thigh rope na nakatali sa Thomas splint. Irelease mo yung
rope na temporarily na nakasecure sa pearson’s and itali mo na yon sa
kabilang end ng Thomas splint.
Dito itali yung
suspension rope (slip Thigh rope
knot)
Clove hitch knot
• Grab suspension rope (pinakamahabang rope) and itali mo sa gitna ng

thigh rope. Then, isuksok mo sa 1st pulley, isuksok mo yung suspension bag
(pinakamabigat) and hang mo saglit sa taas ng pulley, then isuksok mo
yung rope sa 2nd pulley and idaan mo sa ilalaim ng rest splint.
• Then, itali mo yung rope sad ulo ng Thomas splint and pearson’s
attachment using clover hitch knot.
• Alisin mo na yung suspension bag sa taas ng pulley, bale naka hang na
sya sa suspension rope.
• Place foot board using ribbon knot. After non, tanggalin mo na yung rest
splint.
NOTE: yung mas mahabang tali sa foot board yun yung itatali sa pearson’s and yung
maikli na tali is itatali sa Thomas. Para di kayo mahirapan magtali.
• “Sir we need to check the efficiency of the traction so we need you to

hold on to the trapeze, flex unaffected leg, and lift your buttock at the
count of three.”
• Swing mo yung leg traction forward, backward, and side-to-side.
• Give health teaching/nursing considerations/nursing care
▪ Monitoring neurovascular status
✓ Compare extremity on traction to the unaffected extremity
q hour for the 1st 24 hours then q 4hrs after.
✓ 6 P’s pain, pallor, poikilothermia, pulselessness, paresthesia,
and paralysis
✓ Color, temp, capillary refill, and edema.
▪ Insect pin site
✓ q 8hrs for signs of inflammation and infection.
✓ S/sx of rection: redness, warmth, and serosanguinous
drainage.
✓ S/sx of infection: purulent drainage, pin loosening, tenting of
the skin at pint site, odor, and fever.
▪ Promoting exercises
✓ Unaffected side: active exercises: pulling on trapeze, flexing
and extending feet, ROM, and weight resistance exercise.
✓ Affected side: isometric exercise (quadriceps and gluteal
setting exercises)
▪ Maintaining effective skeletal traction
✓ Check traction apparatus
✓ Ropes are in wheel grooves of the pulleys
✓ Ropes are not frayed
✓ Weights hang freely
✓ Knots in the rope are tied securely
✓ Evaluate position: because slipping down in bed results in
ineffective traction.
▪ Maintaining positioning
✓ Maintain alignment of the patient’s body in traction as
prescribed to promote an effective line of pull.
✓ Foot is supported by foot board to avoid foot drop.
✓ Pain from muscle spasms
o Weights may be too heavy and may need
realignment
o Fail to decrease pain – opioids analgesics, muscle
relaxant
▪ Preventing skin breakdown
✓ Instruct patient to use trapeze when getting up in bed.
✓ Transparent film, hydrocolloid dressings, or skin sealants
applied in bony areas.
✓ Assess in ischial tuberosity, popliteal space, Achilles tendon,
and heel for irritation and inflammation at least q 8hrs.
✓ Keep bed dry and free of crumbs and wrinkles.
4. Removing BST
• Hang suspension bag sa taas ng pulley ulit.
• Attach rest splint.
• Tanggalin yung tali ng suspension rope na nakatali sad ulo ng Thomas
and pearson’s. Tanggalin na din sa pulleys yung rope and suspension
bag.
• May isang maghahawak ng steinman’s pin holder and apply traction
doon, then tanggalin yung tali sa traction bag and itali yon sa rest splint,
Thomas, and pearson’s using clove hitch knot.
MATERIALS SA LAB

BST Retdem

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BST Retdem

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NOTE: Hatiin nyo na yung mga sasabihin sa group nyo para hindi lang isang member yung

Isang bagsakan nyo na sabihin sa CI HAHAHAHA

Clove hitch knot

• Grab suspension rope (pinakamahabang rope) and itali mo sa gitna ng

• “Sir we need to check the efficiency of the traction so we need you to

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