Page 64 - Journal of Special Operations Medicine - Summer 2014

testing, best subjective rating in all four categories as- femoral traction splints in suitability for battlefield use.
sessed in the post-testing survey, and its unique ability to Further study of all aspects of battlefield femoral trac-
be used with a lower extremity amputation, the authors tion splinting is warranted with greater attention paid to
recommend the STS as the single-best traction splint for this skill in initial and sustainment training.
military use.
Acknowledgments
Unfortunately, the generalized poor performance and
overall low confidence with traction splinting slightly The research team for this project would like to ac-
decrease the value of the participants’ subjective com- knowledge Simulaids for the loaned use of the Traction
ments. However, the population included in this study Splint Trainer manikin. FareTec and Rescue Essentials,
generally represented the typical enlisted field medical respectively, donated several CT-6 and Slishman Trac-
provider for the Armed Forces, and thus their opinion tion Splints that were used in the study. REEL Splints
is of the most practical value. It must also be noted the and Kendrick Traction Devices were provided by the
STS had 15 failures, which is statistically significant USF Health Center for Advanced Clinical Learning.
compared to 10 for CT-6 and 11 for KTD. However, the The authors would like to thank CMSgt Joseph Pow-
STS and its application technique are markedly different ell, SMSgt Chruleeporn Carter, and Mr. James Norbech
from those any of the other three devices. Thus, partici- with the MacDill Regional USAF Hospital (6th Medical
pants could not improve their performance by complet- Group) as well as MAJ Thomas Larkin and SFC Rich-
ing a prior iteration with another splint, as is possible ard Caton with the 256th Area Support Medical Com-
for the other devices. Only one participant reported pany (Florida Army National Guard) for their support
previous awareness of the STS’s existence. A single without which this project would not have been pos-
brief demonstration followed by a single tested iteration sible. Capt Lynette Studer generously provided editorial
without opportunity for practice is hardly enough time guidance. CDR William Quillen, USN (Ret) and Col
to demonstrate proficiency with a new technology. This John Curran, USAFR (Ret) are a continuing inspiration
fact alone would tend to skew both objective perfor- to us and all our colleagues at USF College of Medicine.
mance and self-reported preference in favor of the more No funding was accepted for this study.
familiar devices. Despite this, the STS’s participant self-
ratings after a single application were superior across all Disclaimer
four domains assessed, with the fastest time implying
greatest ease of use. Lack of familiarity is coupled to the The views expressed in this article are those of the au-
overall high rate of splint failures among participants, thors and do not necessarily reflect the official position
showing generalized poor traction splinting skills even or policy of the U.S. Army, Department of Defense, or
with devices for which they reported long-standing ex- U.S. Government.
perience. Total failures for each splint included multiple
iterations where participants requested termination of Disclosures
the event prior to attempting full application of the de- The authors have nothing to disclose.
vice due to a high level of frustration with their skills.
Most STS failures were accompanied by failures on at
least one other device. Thus, the authors believe this References
higher failure rate on single timed trial is due to initial 1. Committee on Tactical Combat Casualty Care. Tactical
familiarization with the device and could be overcome Combat Casualty Care Guidelines. 28 October 2013. https://
with a focused training package that would be required www.jsomonline.org/TCCC/TCCC%20Guidelines%20
with implementation of a new device to the field. 131028.pdf.
2. American College of Surgeons. Advanced trauma life sup-
port for doctors. 8th ed. Chicago, IL: American College of
Conclusion Surgeons; 2008.
Femoral traction splinting is an essential battlefield skill 3. Nessen SC, Lounsbury DE, Hetz SP. War surgery in Af-
that has decreased in recent popularity within the civil- ghanistan and Iraq: a series of cases, 2003–2007. Wash-
ian EMS community. Traction splints and the tourniquet ington, DC: Walter Reed Army Medical Center Borden
Institute; 2008.
have the distinction of being the only prehospital mea- 4. Owens BD, Kragh JF Jr, Macaitis J, et al. Characteriza-
sures proven to save lives on the battlefield in casualties tion of extremity wounds in Operation Iraqi Freedom and
with extremity injury. The STS had the best objective Operation Enduring Freedom. J Ortho Trauma. 2007;21:
performance during testing and highest subjective evalu- 254–257.
ation by participants. Along with its ability to be used in 5. American College of Surgeons and National Association of
the setting of associated lower extremity amputation or EMT’s. Prehospital trauma life support: Military edition.
trauma, it stood above the other commercially available 7th ed. Burlington, VT: Jones & Bartlett; 2011.

54 Journal of Special Operations Medicine Volume 14, Edition 2/Summer 2014