AN EXPEDIENT IMMOBILIZATION DEVICE: THE PNEUMATIC SPLINT.

Abstract

Younger children and infants, particularly when frightened, are able to move about sufficiently that even the shortest radiographic exposure with conventional equipment results in blurred images. This problem becomes greater during fluoroscopy when the tiny patient, now more frightened by the darkness, has to maintain various positions for relatively longer periods of time. There is also the necessity of immobilizing the small child in emergency minor surgery, during the performance of cut-downs, and in angiography. For immobilization the patient must be restrained either manually (partially irradiating 2 or perhaps 3 aides), or by means of mechanical devices or perhaps by both methods. The problems inherent in all such procedures are manifold: efficiency, radiographic density, washability, speed of application, etc. Pneumatic splints have been used in the treatment of edema secondary to lymphatic obstruction (1), for immobilization of fractured extremities (2), and to improve the “take” of grafts (3). The author has employed such a splint modified for radiographic purposes.2 Description The “radiographic” pneumatic splint (Fig. 1) consists of a hollow tube made of transparent, practically nonopaque polyvinyl plastic. The measurements vary with the respective age group (e.g., infants up to six months of age: 20 × 30 cm.). One-half of the mantle is double-walled to allow insufflation; the other side is a single layer permitting close approximation of the patient's body to the radiographic table. The child is pulled through the tubular splint until the legs and pelvis are completely within the sheath. If the movement of hands and arms presents difficulty, they can be tied individually and the ties pulled through the splint prior to insufflation (Fig. 2). Insufflation of the splint is accomplished by a sphygmomanometer bulb. A simple valve built into the splint is closed by pushing in the stem of the valve, and the bulb may be removed. The pressure exerted upon the patient is checked by inserting a finger, which should be freely movable between the splint and the patient. Yet, this low pressure is sufficient for immobilization.3 Being transparent, the splint allows total observation of the ensheathed part. The splint may be left on for thirty minutes. Since reapplication is so easily accomplished, however, it may be deflated between the different phases of examination. As the pressure is exerted more or less evenly over a large area by the splint, congestion of veins does not occur. The pressure within the splint is less than 10 mm. Hg and causes little discomfort. This device may be applied easily and quickly, even by untrained personnel; it is washable; and the smooth surface is not subject to impregnation with radiopaque material. The splint can be sterilized by gas or cold disinfectants.