Extremity Splinting: SAM Splint

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Extremity SplintingSAM Splint

• Travis Welch, NREMT, PA

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References

• SAM Splint website www.samsplint.com
• SAM Splints for Special Ops Medicine Samuel
  Scheinberg, M.D., Journal of Special Operations
  Medicine
• SAM Splint Instruction Manual, Sam Scheinberg, MD
• Slides Travis Welch, NREMT, PA

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Introduction

• The SAM splint, a flexible metal splint with foam
  padding, can be effectively utilized to splint a
  variety of extremity fractures.
• The normally floppy splint simply requires a
  bend to be placed in it to make it rigid enough
  to be used as a splint
• This evening we will discuss some common uses for
  the splint, and offer some interesting ideas for
  its employment.

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The Basic Bend

• Curve the SAM Splint lengthwise to create a
  longitudinal bend which gives the splint
  strength.

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Add strength

• Curve the outside edges the opposite direction to
  make it even stronger.

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Even stronger

• Double the SAM Splint or create a "T-bend" for
  extra strength.

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Upper Extremities

• OPTION 1 The "Sugar-Tong"
• The "sugar-tong" configuration provides support
  for the distal radius and ulna, and to some
  extent prevents rotation.
• First fold into two equal limbs. Then beginning
  at the end of one limb, use your thumbs to
  produce a gentle cross-sectional curve or
  half-circle. Squeezing can quickly deepen the
  curve. Do not extend the curve all the way down
  the limb, as this will limit your ability to fold
  the "sugar-tong" around the elbow.

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• After completing the bends in the first limb,
  create a similar curve in the opposite limb. Fold
  the splint around the elbow and secure to the
  extremity with your wrap of choice.
• Excess splint should be folded back to allow good
  visualization of the fingers

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• OPTION 2 The "Double Layer"
• Also known as a volar splint
• Folding a 36 inch splint in half upon itself
  creates the "double layer" configuration. This
  two-layered splint is then curved into a
  cross-sectional half curve and molded to your own
  extremity. Small adjustments are then made after
  applying the splint to the patient.

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• OPTION 3 The "T" Bend
• This configuration is exceptionally strong. The
  splint is first folded onto itself along its
  longitudinal axis. The edges of that fold are
  then bent into a contrary direction to create a
  "T" shaped beam. The "T" beam is then placed as a
  support against the opposite limb of the splint
  which is curved to fit the extremity.

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LOWER EXTREMITES

• OPTION 3 The Ankle Stirrup
• The same "sugar-tong" technique used on the upper
  extremity is used on the lower to create an ankle
  stirrup. Remember to apply padding just above
  and around the bony prominences (malleoli).

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• OPTION 4 The Figure "8"
• The splint in folded into a figure "8" around the
  foot, boot or shoe. This can be quite useful when
  ambulation is required. Again, remember to pad
  the malleoli.

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• Tibia/Fibula Fractures
• Sugar Tong Splint
• Ankle Fractures
• Neck immobilization
• Wrist fractures
• Bending the Splint

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Other suggestions/tips/tricks?
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What are some scenarios where this will be useful
for us in our response setting?
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Lets practice!