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Back Slab PDF

The document outlines the procedure for back slab application, including indications such as temporary immobilization of fractures and soft tissue injuries, as well as contraindications like open fractures and suspected compartment syndrome. It details the required equipment, common types of back slabs, procedural steps, potential complications, and common questions with answers related to the technique. Proper technique is emphasized to prevent complications such as compartment syndrome and pressure sores.

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Mayurdhvajsinh Parmar
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120 views3 pages

Back Slab PDF

The document outlines the procedure for back slab application, including indications such as temporary immobilization of fractures and soft tissue injuries, as well as contraindications like open fractures and suspected compartment syndrome. It details the required equipment, common types of back slabs, procedural steps, potential complications, and common questions with answers related to the technique. Proper technique is emphasized to prevent complications such as compartment syndrome and pressure sores.

Uploaded by

Mayurdhvajsinh Parmar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Back Slab Application – MRCEM OSCE Procedural

Skill Station
Indications
● Temporary immobilization of fractures (e.g. distal radius, ankle, elbow)

● Soft tissue injuries (e.g. severe sprain, ligament injury)

● Post-reduction support for dislocations

● Swelling phase post-injury or post-op (prevents compartment syndrome risk vs full


cast)

Contraindications
● Open fractures requiring surgical debridement

● Suspected compartment syndrome (avoid constrictive devices)

● Active infection at the site

Equipment Required
● Gloves, apron

● Wool padding (orthopedic roll)

● Crepe bandage

● Plaster of Paris (POP) rolls or fiberglass slab

● Scissors, bowl of warm water

● Stockinette (optional)

● Limb support (e.g. pillows)

Common Types of Back Slabs


● Below elbow slab: distal radius/ulna fracture

● Above elbow slab: supracondylar or elbow fracture

● Below knee slab: ankle fractures, calcaneus

● Above knee slab: tibia/fibula shaft fractures


● U-slab and coaptation slab: humeral fractures

● Posterior long leg slab: unstable knee injuries or immobilization

Steps of the Procedure


1⃣ Preparation: Explain procedure and gain consent. Check neurovascular status (cap refill,
sensation, movement, pulses). Support the limb in neutral functional position.

2⃣ Padding: Apply evenly around the limb, focusing on bony prominences (e.g. malleoli, heel,
olecranon). Use extra over pressure areas.

3⃣ Plaster Preparation: Cut the required length of POP (usually 8–12 layers). Immerse in
warm water, squeeze gently.

4⃣ Application: Place the wet plaster slab over the posterior aspect of the limb, molding gently
to maintain contour without tightness.

5⃣ Securing: Apply a crepe bandage gently over the slab from distal to proximal without
compression. Recheck limb position and alignment.

6⃣ Finishing: Support limb until plaster sets (~10–15 mins). Reassess neurovascular status.
Elevate the limb to reduce swelling.

7⃣ Documentation: Record the type of injury, type of back slab applied, time, and
neurovascular findings before and after application.

Complications
● Compartment syndrome (from tight application or swelling)

● Pressure sores or skin breakdown

● Neurovascular compromise

● Joint stiffness

● Cast burn (from exothermic reaction of POP if improperly handled)

Common Viva Questions & Answers


Q: Why choose a back slab instead of a full cast initially?

A: To accommodate swelling and reduce the risk of compartment syndrome.

Q: What are red flag signs after back slab application?

A: Increasing pain, numbness, tingling, pallor, or inability to move digits → may indicate
compartment syndrome.

Q: How to check neurovascular status?

A: Sensation, capillary refill, movement, pulses distal to injury site.


Q: What is the benefit of using wool padding?

A: Prevents pressure sores and accommodates limb swelling.

Q: What’s the correct limb position for an ankle injury back slab?

A: Ankle in neutral (90°) dorsiflexion; foot not hanging.

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