23 May 2011

Adventures in Splinting Part 1

Splinting is a science and an art.  I think that's why I enjoy it so much.  My left brain enjoys the opportunity to problem solve and logically reason, while my right brain gets to create and play.  Everyone gets to be involved.  It's like balancing your checkbook with crayons!

Right now I am treating a very sweet lady who seems to have lived a very hard life.  About two weeks ago she had a large mass removed from her axilla (there I go with the fancy words again . . . truth be told, I'm just afraid if I type 'arm pit' on my blog, no one will take me seriously), which has left her with a gaping whole where skin and subcutaneous tissue should be covering her muscles.  Because of the size of the mass, our surgical team had to shorten some muscle tissue, which has left her with around 100degrees of shoulder flexion and abduction.  We have worked hard to maintain that.

Based on her progress, I had been told that she would be scheduled for a skin graft towards the end of this week.  So, today, on my to-do list for the afternoon was to go down to the workshop (where they keep the wood) and build her an airplane splint.

You can imagine my surprise when I arrived at the OR Bloc to do dressing changes only to find her on the list for today's surgeries!

I told the guys I work with that I'd be right back, and I took off running.  First stop: my office to pick up two SAM splints.  Next, off to the shop.

I tried explaining why I needed the guys to measure the distance between my upper arm and my waist and again from about mid-forearm.  They were hesitant.  When I asked for two dowels the length of both of those measures, they looked at me like I was CRAZY.  I tried again to explain.  I drew pictures.  They laughed at my artwork.

Finally I told them to trust me and just do each step I tell them.

Once the wood was cut, I asked for electrical tape.  They didn't have any.  I ran back to my office, and returned with a roll, along with a roll of red duct tape . . . hey, don't judge, sometimes here we just have to improvise!

Take this!  Hold here!  No! Not THERE!  Here!  Wait!  Pull here!  Again!  Okay . . . I think . . . that . . . just . . . might . . . maybe we should pray . . . maybe . . . it . . . will . . . work!!

I left the shop with what looked to me like an improvised airplane splint and to everyone else like more evidence that I should be committed.

Upon seeing the splint, our Chief of Surgery was very happy with it . . . I told him he was only allowed to be once it actually worked.

After her graft, we applied the splint.  So far, she's still only been supine (laying on her back), we'll see what happens once she sits up and gravity does it's dirty work.

The long trough-like piece at the top is for her arm.
The curved part on the bottom goes around her waist.
H. Le Vieux holds the splint.
He tells me he's my assistant, I try convincing him it's the
other way around.
Ready to go and waiting in the OR.


Barbi said...

 Deb - You are amazing!  On behalf of the patients, I am thankful you are here!  

Shight01 said...

Where were those skills when you were with me? Just kidding. Great job! Keep it up!

Deb. said...

I was keeping them hidden . . . didn't want to make you look bad! :)