Prepared By: lecturer

1. Prepared By: lecturer/ Magda Bayoumi

2. Traction is the application of a pulling force to a part of the body

3. Purpose: to minimize muscle spasms; to reduce, align, and immobilize fractures; to reduce deformity; and to increase space between opposing surfaces

5. PRINCIPLES OF EFFECTIVE TRACTION countertraction must be used to achieve effective traction. Countertraction is the force acting the opposite direction. Usually, the patient's body weight and bed position adjustments supply the needed countertraction.

7. Types: Straight or running traction Balanced suspension traction

9. Traction may be applied to the skin (skin traction) or directly to the bony skeleton (skeletal traction).

10. Skin Traction: Skin traction is used to control muscle spasms and to immobilize an area before surgery. Skin traction is accomplished by using a weight to pull on traction tape or on a foam boot attached to the ­skin. The amount of weight applied must not exceed tolerance of the skin.

11. No more than 2 to 3.5 kg (4.5 to 8 lb) of tra­ction can be used on an extremity. Pelvic traction is usually 4.5 to 9 kg (10 to 20 lb), depending on the weight of the patient. Types of skin traction: used for adults include Buck's extension traction (applied to the lower leg), the cervical head halter (occa­sionally used to treat neck pain), and the pelvic belt (sometimes used to treat back pain).

12. Complication of skin traction: Skin breakdown, Nerve pressure Circulatory impairment

13. Nursing Intervention: Ensuring Effective Traction: Monitoring and Managing potential Complication

14. Skeletal Traction: to treat fractures of the femur, the tibia, and the cervical spine. The traction is applied directly to the bone by use of a metal pin or wire

15. Nursing Interventions: Maintaining Effective Traction. Maintaining Positioning. Preventing Skin breakdown. Monitoring Nurological Status. Providing Pin Site Care.

16. Nursing Process: The patient in Traction Assessment: evaluate the body part to be placed in traction and neurovascular status (ie, color, temperature, capillary refill, edema, pulses, ability to move, and sensation) and compare it to the unaffected extremity.

17. Diagnosis: Deficient knowledge related to the treatment regimen Anxiety related to health status and the traction device Acute pain related to musculoskeletal disorder Self-care deficit: feeding, bathing/hygiene, dressing/groom­ing, and/or toileting related to traction Impaired physical mobility related to musculoskeletal dis­order and traction

18. Potential complication: Pressure ulcer Pneumonia Constipation Anorexia Urinary stasis and infection Venous stasis with DVT

19. Planning and Goals: The major goals for the patient in traction may include understanding of the treatment regimen, reduced anxiety, maximum comfort, maximum level of self-care, maximum mobility within the therapeutic limits of traction, and absence of complications

20. Nursing Intervention: promoting understanding of treatment regimen: Reducing Anxiety. Achieve a maximum level of comfort. Achieving Maximum self care. Attaining maximum Mobility with traction. Monitoring and managing potential complication.

21. Evaluation: Demonstrates knowledge of traction regimen Exhibits reduced anxiety States increased level of comfort Performs self-care activities Demonstrates increased mobility Experiences no complications