REEL evolution of the splint
With the lighter and smaller vehicles we are starting to see in EMS, the size of our equipment will start to be a really big deal
Traction splints are used for reducing and immobilizing long bone fractures of the femur. In the early 1900s, femur fractures were often fatal. The Thomas Traction Splint, also commonly called the Thomas Half-Ring, was the first traction splint.
It was invented by Dr. Hugh Owen Thomas, a Welsh surgeon. When Sir Robert Jones applied this splint during World War I, it reduced mortality of compound fractures of the femur from 80 percent to less than 8 percent over a two-year period from 1916. Traction splints have been an essential piece of EMS equipment ever since.
I actually saw one on an ambulance once. I was trained to use it in my EMT class in the 1970s. The Thomas Half-Ring has what is still today the distinctive and familiar dual limbed shape; two long rods down each leg laterally with a distal cross member connecting and some kind of padded half-ring shape at the top. I guess it was a great cheap way to meet regulations, but I questioned how many really knew how to use it properly.
One reason is that you basically have to make all the moving parts yourself, commonly from cravats, and then windlass the rig with a handy stick or oxygen wrench. As a general rule, and with no disrespect to anyone, EMTs and paramedics usually don't do easy assembly required.
They are compelled to rip all packages open. They buy the floor models of children's toys to avoid having to put them together. But I digress — the real reason why is that we have had better options for many years now.
In the 60s, a guy I met early in my career named Glen Hare built his version of a better traction splint called the Hare Traction Splint. It had all the components integrated, which was for the time revolutionary.
It also could be length adjusted, for a much more practical packed length and shorter patient package for moving. It had an integrated winch, strap, and padded ankle hitch.
The Hare Traction Splint quickly became the most popular traction splint and it was what I used in my early years in EMS. The company he founded, Dyna-Med, still proudly makes the splint. A similar high quality adjustable length splint which also features two lateral telescoping frame members is the FernoTrac Traction Splint.
Then, along came several great single limbed traction splints, like the Sager and Kendrick and Faretec CT-6. We won't go into those here, because I want to get into more detail about another dual limbed traction option: The REEL Splint. This is really much more than a traction splint; it can immobilize the knee or any lower long bone fracture, PLUS it is a great traction splint.
Even better, it easily adapts to deformity and patient positioning of the knee rather than force dangerous movement. The "uncontrolled" manipulation or reduction of an injured knee or angulated lower extremity is dangerous, and can induce greater pain and injury. Think of the REEL Splint as an origami leg splint and you won't be far off.
The two big articulation knobs at the knee are easy to use and lock once in the desired position. It quickly adjusts for length and the anatomically pivoting ischial pad automatically adjusts for a better fit to the left or right leg.
These features make the REEL an extremely easy leg splint to use. You can apply it to the leg, usually keeping the leg in the same exact position you found it. You just don't use the traction system if you don't need it, and quickly add it when you do.
The manufacturer has also taken their time to perfect all the various deployment options EMS needs. From tactical to wilderness rescue, they have adapted the REEL technology to each application. As it folds up, it is by far the most compact evolution of the many dual limbed Thomas Half-Ring-style devices.
All the components are top grade, the workmanship is superb, and I love the fast and easy padded ankle hitch. The same person that holds traction can apply mechanical traction. One REEL Splint can replace all your leg splints and probably do a better and safer job.
Another thing I like is the fact that they have sold quite a few on military contracts. Whenever you challenge a product to the demands of the military medical market, you wind up with a better quality product.
Lately we are starting to see lighter, safer and more fuel-efficient ambulances. With these smaller platforms, the size of our equipment will start to be a really big deal. The compact form of the REEL system lends itself to these newer vehicles.
As the REEL Splint does more, it makes the most out of scant storage. One reason why it can is that it prevents rotational movement. A dual limbed device can do that very effectively and have been doing so for a very long time.
Complex design and quality components make this a modestly pricey splint. But if you do get your stuff back from the hospital reliably, than long term it will easily pay for itself. It sure is built to last, and replacement parts are readily available.
- Patient Handling