injuries poisoning
How To Apply a Sugar Tong Arm Splint
Step by Step Description of Procedure
Wear nonsterile gloves. Apply stockinette, covering the area from distal to the MCP joints to the mid-humerus. Make a hole in the stockinette to allow protrusion of the thumb. Wrap the padding from the MCP joint to the mid-humerus; overlap each turn by half the width of the padding and periodically tear the wrapping across its width to decrease the risk of tissue compression. Smooth the padding as necessary. Tear away any areas of excess padding to prevent areas of increased pressure on the skin. Lay out a length of splint material matching the distance from just proximal to the MCP joints extending around the elbow and back to the MCP joints. Unroll additional splint material, folding it back and forth along the first length until there are 8 to 10 layers (when using single-layer rolls). Alternatively, if using ready-made splint material, cut a single piece to the above length. Immerse the splinting material in lukewarm water. Squeeze excess water from the splinting material (do not wring out plaster). Apply the splint material from the volar surface of the MCP joints along the volar surface of the forearm around the elbow and then along the dorsal surface of the forearm back to the dorsal surface of the MCP joints. In the hand, fold the extra stockinette and cotton padding over the edges of the splinting material. Wrap the elastic wrap over the splinting material distally to proximally and overlap each revolution by half the width of the elastic wrap. Smooth out the splinting material using your palms rather than your fingertips to conform to the contour of the arm to fill in the interstices in the material. Maintain the wrist at 10 to 20°extension and the elbow at 90°flexion until the splinting material hardens. Check distal neurovascular status (eg, capillary refill, distal sensation, finger flexion and extension). 