Page 59 - Journal of Special Operations Medicine - Summer 2014

Table 2 Initial Survey Table 3 Timed Testing Results
Average Mean Time
Question or Mode Traction Without Number of
Splint Mean Time Failures Failures
Years of service 7.97
Device (seconds) (seconds) (N = 53)
Years as a field medical provider 5.38
CT-6 314.6 301.3 10 (18.9%)
Total months you have served deployed to 7.08 KTD 265.9 258.7 11 (20.1%)
the AOR
RS 361.3 351.9 12 (22.6%)
Have you treated a casualty on the battlefield? 0.21
Yes = 1, No = 0 STS 242.1 225.3 15 (28.3%)
If yes, how many? 2.11
Have you encountered a casualty with 0.09
suspected femoral fracture? Yes = 1, No = 0 The participants had high numbers of failures on all de-
Have you performed traction splinting on a 0.05 vices, with the fewest (10) failures on the CT-6, followed
combat casualty? Yes = 1, No = 0 by 11 failures on the KTD, 12 failures on the RS, and
If yes, which traction splint did you use? RS 15 failures on the STS. The STS had significantly more
Have you encountered a patient with suspected failures than the KTD (p = .044) and CT-6 (p = .024)
femoral fracture in another setting? (e.g. EMS, 0.19 but not the RS.
hospital ER) Yes = 1, No = 0
Have you performed traction splinting on a 0.16 With failures removed, average traction force applied in
live patient? Yes = 1, No = 0 pounds was within the target range (10% of patient’s
If yes, which traction splint did you use? KTD weight) without significant difference across all four
splints (CT-6 16.1 lb, KTD 15.7 lb, RS 15.0 lb, and STS
How many times have you conducted training 5.98 14.88 lb).
on traction splinting?
Which traction splint do you have the most RS On the post-testing survey, the STS was the highest
training experience with?
rated splint across all four reported categories. The STS
Which traction splint do you have the most KTD (4.34/5) was rated as the splint participants felt most
live patient experience with?
confident to apply compared with the CT-6 (4.23/5,
Which traction splint do you believe most p = .459, not significant) versus the KTD (3.89/5, p =
effectively treats a suspected femoral fracture CT-6 .011) and versus the RS (3.45/5, p = .00037). The STS
if properly applied?
(3.98/5) was also rated the highest as the device that
Which traction splint are you the most CT-6 best treated a suspected femoral fracture compared with
confident in your ability to properly apply?
the CT-6 (3.70/5, p = .00229) versus the RS (3.70/5,
Which traction splint do you believe is best CT-6 p = .00363) and the KTD (3.34/5, p < .0001). The STS
designed for dismounted carry? (4.25/5) was also rated as best designed for dismounted
Which traction splint do you believe is overall CT-6 carry compared with the CT6 (4.21/5, p = .85522, not
most appropriate for battlefield use? significant) versus the KTD (3.60/5, p = .00249) and the
RS (1.79/5, p < .0001). The RS was rated as having the
worst design for dismounted carry with significance ver-
the RS (361.3 seconds). With failing times removed, the sus the CT-6 (p < .0001) and the KTD (p < .0001). Last,
average student still applied the STS the fastest (225.3 the STS (4.17/5) was rated as the overall most appro-
seconds), followed by the KTD (258.7 seconds), then priate traction splint for battlefield use compared with
the CT-6 (301.3 seconds) and finally the RS (351.9 sec- the CT-6 (3.92/5, p = .28455, not significant) versus the
onds). Statistical analysis of the times between these KTD (3.15/5, p < .0001) and the RS (1.94/5, p < .0001).
four groups is significantly different (ANOVA, F fac- The RS was rated overall significantly worse than the
tor of 8.529 and p < .01). Individual t-tests reveal these other splints as well versus the CT-6 (p < .0001) and the
differences with comparisons between each device STS KTD (p < .0001). Subjective data from the post-testing
versus KTD (p = .19), STS versus CT-6 (p = .0028), STS survey are summarized in Table 4.
versus RS (p < .0001), CT-6 versus RS (p = .032), and
KTD versus RS (p < .0001). These data show that the Participant quotes on the CT-6 included: “The pulley
STS was significantly faster than all other devices except system made pulling traction very easy but it seems like
the KTD where the results were trending toward signifi- it might get tangled easily”; “This splint was easily as-
cance. Application times of all the splints were statisti- sembled, had minimal loose parts, and was compact,
cally superior to the RS. Objective data are displayed in lightweight, and easy to use”; “The CT-6 was quick and
Table 3. easy to use even though this was my first time seeing it.”

Evaluation of Traction Splints for Battlefield Use 49