Traction Training

Tucker Angier, senior and co-president of ski patrol wrote this account of our on-hill traction splint training.

“This week as part of our continual effort to improve quality of care and efficiency on the hill, we participated in a traction splinting training. Traction splinting is the process of pulling on someone’s ankle, in the event of a femur fracture, in order to set the bone, relieve pressure put on the two broken ends, and alleviate pain. Most patrollers have not seen a femur fracture, a potentially life-threatening injury, so on Wednesday we ran through two traction trainings. These trainings also provided us with some good framework for almost any injury we encounter at the Bowl.

 

On Wednesday morning, Caroline and I were stationed at the top hut and Sean called in, stating that he had some information regarding a potentially injured skier on the Lang. Angie, who was in the bottom hut at the time of the call, responded on snowmobile. Since Caroline and I were en route from Worth, Angie also grabbed the toboggan,as well as oxygen, and went to work on the patient. She called in an injured, 30-year-old male patient on the right side of the Lang who was complaining of a leg injury. This was also a training exercise, so Angie explicitly stated that. When Caroline and I arrived on scene Angie was attending to Sean (the injured patroller), assessing his cervical spine, which was fine. She stated that he had a broken femur, and that she needed the head bag. I set my skis in an “X” above the patient while Caroline maintained stabilization of the injured leg and Angie took the snowmobile to the top of the Sheehan to collect the headbag. During Angie’s absence, I got the oxygen out of the bag and verbalized its administration.

 

When Angie returned with the head bag we checked Sean for his circulation, sensation and movement in the injured leg and compared that to his other extremities. We all then attempted to move his body into the correct anatomical position, with Angie taking over for Caroline to stabilize the injury. After putting Sean into the correct anatomical position, he still maintained a position of comfort, which made the application of the traction splint difficult. Once we got the traction splint on, beginning with the ischial strap and taking mechanical tension,  we deemed it necessary to put Sean on the backboard, not only to stabilize his hips, but also as a means of extrication. I then called in Sean’s injury to the office, so they could relay the information to MVAA (the ambulance). At this time, we realized that Sean’s oxygen had slipped far away from him, so we moved it closer to his body. Finally, after getting Sean into the backboard and secure into the toboggan, he ended the training to debrief.

 

In the afternoon we ran the same scenario, with Caroline acting as the patient and Sean being the first patroller on scene. Jeff also joined in as a responding patroller.

 

This time Caroline called in a possibly injured skier on the left side of the Lang. Sean quickly responded from the top of Sheehan and called in a 20-year-old, female patient who had a possible femur fracture. He also called for oxygen and the head bag. Angie was second on scene, and brought the head bag and oxygen down, while Jeff and I loaded Sheehan to provide support. When everyone arrived on scene, Sean explained that he had ruled out any cervical spine issues and that Caroline had broken her femur. Since there were four of us responding to Caroline’s injury, the hill became quickly saturated with patrollers and Sean directed us to do certain tasks. Jeff was delegated to maintain stabilization of the injured leg, Angie was in charge of oxygen and I called in the injury to the office to get MVAA on the line as well as set up skis in an “X”.

 

After getting her leg into the correct anatomical position, we got Caroline onto the backboard, checked her circulation, sensation and movement and then applied the traction splint. However, the ischial strap, an anchoring strap that goes around your groin, snapped and we had to improvise with a cravat. The cravat in place, the rest of the traction splint could be utilized and Caroline was then strapped into the backboard. At this time the training ended and we packed up the gear to head down and debrief in the bottom hut.

 

All of us thought it was a good idea to run a second training that afternoon to look through the scenario a second time. While in both trainings we all demonstrated effective packaging of the patient and correct application of a traction splint, the second run through proved to be smoother. We all noted that is was helpful to have an extra person, as well as a clear leader guiding us through the process. This leader doesn’t necessarily need to be the primary responder, but having one voice communicating what needs to be done and what has already been done is an effective way to expedite the extrication efficiently.

 

Since the femur fracture is a potentially life-threatening injury that necessitates a speedy extrication and advancement to higher care, this training will be done throughout next week to ensure that all of the patrollers at the Snow Bowl have experience with traction splinting on hill.”

 

 

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