Emergency Room MSK module on backslab application

Here are some videos that we have created as aid memoire for the junior doctors to learn how to apply plaster backslab:

Videos created in our department demonstrating the application of backslab

There is no one correct way....and there is no one size fits all. The most important thing to remember are the principles behind why and how we apply a backslab:

Why we apply?
1) It acts as a splint to immobilise the limb, allowing for good opposition of the ends of the broken bones
2) By acting as a splint, it prevents movement and hence reduces the pain from a broken limb

Types of material for splinting
Since splinting refers to immobilising the limbs, there are many methods of splinting which can range from using tree branches in the wild, to the SAM (Structural Aluminium Malleable) splint or splints made up of either Plaster of Paris or fibreglass.

Important principles

1. Backslab (non circumferential) splint is to be placed in an acute setting to allow for limb swelling to take place without placing the limb at risk of compartment syndrome
2. It is important to check and document the neurovascular status of the limb prior to and after placing a backslab
3. When placing a splint, it is important to keep the limb in an anatomically appropriate position to allow for healing without causing joint stiffening or deformity
4. It is important to have cotton gauze acting as a barrier between the plaster and the skin to prevent skin burns from happening
5. The pressure points are often forgotten and may require additional padding. Similarly, the plaster needs to be smoothen to ensure it doesn't exert excessive pressure on the skin and damage it

In a haste to help the patient, let's not cause the patient more harm!!!!