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Non Custom Splinting Options
2 Plays2 minutes ago
On this episode of the podcast, Miranda and Josh discuss non-custom splinting options and when to utilize them. They break down practical applications and clinical considerations to help therapists make informed choices in patient care.
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Transcript
Introductions and Splinting Observations
00:00:06
josh MacDonald
Hi, I'm Josh McDonald.
00:00:07
Miranda Materi
And I'm Miranda Macerey and we are Hand Therapy Academy.
00:00:11
josh MacDonald
Let's chat a little bit. We've had the opportunity to be in some other people's clinics and kind of see other people posting online about what their splinting setup or their therapy setup looks like. And sometimes we see people out there doing the best work with kind of a Spartan setup. And it got us thinking like, what's the base requirement that you need in order to do what
Base Requirements for Splinting
00:00:31
josh MacDonald
we do? But then also like, what should you expect from your employer as like ah Listen, I could do it with that, but this is really what would provide a better patient experience. So, Marina, what do you feel like, maybe let's talk about splinting specifically, is kind of a base minimum that you feel like a therapist needs in order to get the job done?
00:00:48
Miranda Materi
Yeah, I think um one thing is a good pair of scissors and that's important for two reasons. I think getting a good edge on the splint, especially since we're charging a lot of money for these splints, but also to protect the therapist. If you don't have good scissors, you're more likely to get CMC arthritis, maybe some deep curve veins, things like that. So I would absolutely start with a good pair of scissors and I don't think they cost that much.
Tools and Technology for Splinting
00:01:09
Miranda Materi
Another thing would be ah decent way to make the splint in a hot water bath. So I have seen clinics use the hydroculator. um And we've even done this when our splint pan is down or being cleaned.
00:01:24
Miranda Materi
And you certainly can use it, but you can also get ah a nice hot water bath or a skillet for not that expensive.
00:01:30
josh MacDonald
Thank you.
00:01:31
Miranda Materi
So I think um as a therapist, I would want ah more of a splinting pan of some sort. And we know that these are very hard to find right now, right? Like you can't just go to Performance Health or North Coast and buy a s splinting pan And I think you have more experience with this because you've talked to a couple of the reps.
00:01:50
Miranda Materi
So I'll let you kind of talk to it but i don't know if it's because of COVID or why, why can't we find good splinting pants?
00:01:56
josh MacDonald
Yeah. Unfortunately, think the big producers or or the big carriers of all this stuff has realized that we're a niche as hand therapists. And so they're just not selling enough of those products to warrant keeping them in stock.
00:02:08
josh MacDonald
And so the company, I'm forgetting the enough top my head, that made all of the splint pans that we have all had for decades that were all sitting on our counters, they just don't make them anymore.
Innovations and Alternatives in Splinting
00:02:17
josh MacDonald
And so there's this alternative now that was this it's It's like we took and shoved as much technology into this thing. It's supposed to be self-cleaning and there's like special timers on it. And then so I talked to a rep for one of these companies last year at ASHT, I think.
00:02:33
josh MacDonald
And he said, oh, we've got second generation out because first generation like fuzz was getting caught and it was clogging it. And because the the debris that comes off of splints, we have to put back in there. um Ultimately, those things are very expensive to thousands of dollars for those because there's so much technology.
00:02:49
josh MacDonald
um It's just hard to justify for either small clinic like ours or a hospital when they're looking at the money that comes out of your your department to warrant thousands of dollars on this thing that then needs a ton of maintenance.
00:03:00
josh MacDonald
What we've fallen back on, I i have a hard time justifying. Charging hundreds of dollars for a splint that came out of an electric skillet from Target. So what we've done is we found on Amazon, we can get these um these warming trays.
00:03:09
Miranda Materi
Thank you.
00:03:15
josh MacDonald
Like if you go to ah conference or something and they have like food set out and there's all these stainless steel warming trays with water in them. And then they put the trays of food on top of that that's set on top.
00:03:27
josh MacDonald
All I need is one that has a lid and I don't even need the food holders. I just put water in the bottom and find um and mark on the dial where the right temperature is. Set it to that when I come in in the morning or on a timer.
00:03:41
josh MacDonald
And that keeps water warm for me. I just have to make sure it stays full and doesn't like dry out and ruin the device. But those are, gosh, I want to say 150 bucks for a decent size one of
Materials and Organization for Therapy
00:03:51
josh MacDonald
those. And that's what we have in one of our clinics because I wasn't dropping thousands of dollars on a splint pan.
00:03:56
Miranda Materi
Well, and you can't really even find a splint pan. I mean, you can find those high technology ones, but not like we used to use. So I'm with you on that. And I think some of the older pans that were manufactured by North coast were actually like those warmers. So, um,
00:04:10
Miranda Materi
I think that's more where the idea came from. I will say that when you do order them from Amazon, not all of them are equal. So if you get one that doesn't heat up high enough, don't give up. There's definitely brands that heat up to the right temperature.
00:04:20
josh MacDonald
Yeah.
00:04:23
Miranda Materi
Um, so cause I have ordered one. I'm like, well, this didn't get hot enough. Well, there are ones that get hotter. so
00:04:29
josh MacDonald
Yeah. And usually on the listing, you can see like what temperature it can get to. um So I look for a couple things. I look for the the size of it, making sure something that's big enough or not too big for my space.
00:04:40
josh MacDonald
The temperature can go to, does it have a lid? Because I don't want this, just, you know, evaporating off in a way. um And then unfortunately, because our links changed, I went to go buy the same one again and that link was gone. So i had to go hunting again, but that's a reasonable option. Just make sure your temperatures are checked regularly.
00:04:55
Miranda Materi
Yeah. And then you can go if you um like are desperate or you're in a big metro area, some of the like chef stores, like what we have a huge restaurant supply store by my house and they sell them as well.
00:05:06
Miranda Materi
So those, those are other options of finding them.
00:05:06
josh MacDonald
Nice. Okay.
00:05:09
Miranda Materi
So I think that's a definite necessity. Scissors, something protect the skin when you're making the flint.
00:05:13
josh MacDonald
I think, go ahead. Yeah.
00:05:17
Miranda Materi
So some type of stockinette.
00:05:19
josh MacDonald
Yeah. I think quality adhesive Velcro and strapping Velcro. I think that's something that is as important as quality splinting material. That is sometimes 50% of the patient's skin interaction um and having poor quality old stuff that's gotten crusty and is dried out, sticky that won't stay on. And so you're fighting with that and have to keep coming back.
00:05:43
josh MacDonald
Having quality product um will will help justify both the cost and the patient's experience and and it'll be a positive experience instead of a negative one.
00:05:53
Miranda Materi
Yeah, I definitely agree. If you have the Velcro that's not sticking or you don't know, because some Velcro you can heat up with a heater and some you can't, right? So it's knowing which Velcro do you have and how do you apply it and making sure you're applying it correctly.
00:06:08
josh MacDonald
Yeah, yeah.
00:06:08
Miranda Materi
Sometimes people think, oh, this is just regular Velcro, I'll stick it on. Well, actually, no, you have to heat it up.
00:06:13
josh MacDonald
Yeah. Yeah. And it won't stay well unless you heat it up. And on some materials on the splinting material, I may have to prep the material itself to get the adhesive past that layer of coating on the outside that makes it shiny. So knowing how to make sure your adhesive stays on, it's important.
00:06:30
Miranda Materi
And if you need that information, I would reach out to your rep of who you buy your supplies from, and they have that information. Is this what I heat up? Is this what I don't? um Especially and even with your thermoplastic materials, what is the prep for it?
00:06:43
Miranda Materi
And that's free.
00:06:43
josh MacDonald
Yeah.
00:06:43
Miranda Materi
So...
00:06:44
josh MacDonald
Yeah. um I would also say a station with organization. And this is maybe a little bit more on the therapist. Some of us are a little bit less type A and you've got a drawer that you open and explodes out strapping material and you just yank out scraps and pieces that you need.
00:07:00
josh MacDonald
I'm all for being frugal and saving decent usable scraps. But There's something about the patient sitting there. And if this splinting concept is an afterthought, it really compromises the legitimacy of what the service we're providing and our skillset. If they see this as like, oh, this isn't like an established thing you do regularly.
00:07:22
josh MacDonald
This is kind of, oh hold on a minute. I got find a scrap of this and
Role of Employers in Therapy Services
00:07:25
josh MacDonald
find a scrap of that. And let me open up this drawer and things explode everywhere. Like having it be ah an established thing is really a ah ah big, in my mind, is a big aspect.
00:07:35
Miranda Materi
Yeah, I think so. So some type of splinting cart. um And I've seen people get creative and use different things. So I don't think you have to spend a ton of money, but I think having something that you put your splinting pan on and something that's organized. I think Josh, you were sharing with me, you saw a video of someone having their splinting pan on the floor.
00:07:50
josh MacDonald
Yeah. Yeah. It was, it wasn't even a splinting pan. It was that electric skillet. And listen, if that's all you have access to and you're doing the best you can, I understand we don't have great situations, but I felt for this therapist because not only was he using an electric skillet to make a relatively large splint, but it was on the floor. And I thought, oh, this, this isn't, this is not okay for this. Like the, the employer needs to do better in this situation.
00:08:14
Miranda Materi
Yeah, and definitely.
00:08:15
josh MacDonald
Yeah. Yeah.
00:08:16
Miranda Materi
They need to pop that up on something.
00:08:18
josh MacDonald
Yeah. Well, and I think sometimes too, it's us being willing to go to our employer and saying like, we can build significant amounts of money for this. And one splint will pay for a reasonable option for me for a splinting pant. We'll pay for a cart.
00:08:35
josh MacDonald
So let's take one splints revenue and buy me a $60 pair of Ginger scissors and a hundred dollar warming tray that I can use and a $60 Amazon cart. And now I've got a splinting station that makes us look legitimate that doctors won't hear negative feedback from the patients when they go back.
00:08:53
Miranda Materi
Yeah, because when the patient gets that bill and I was like, why was my insurance charging charge $400 for the splint? And you're doing an unskillet on the floor.
Creative Solutions and Hardware Considerations
00:09:00
Miranda Materi
i i do think that says something. i mean, I'm all about being creative, but I think you're right.
00:09:04
josh MacDonald
Yeah. And again, that's not on the therapist. They're doing the best they can with what they've got. And I'm sure they would step into some of the awesome splinting setups in the country and be like, oh my gosh, this is like like luxury. It's not their fault. Their employer needs to do better for them.
00:09:18
Miranda Materi
Or some type of cabinetry too. I've seen people have different shelving systems, you know, where they can open it up and all their splinting stuff. So I think just you can be creative and find solutions that still look professional without spending a lot of money.
00:09:29
josh MacDonald
Yeah. Yeah. Do you consider some of the hardware, um, the thumb screws and the Phoenix outriggers and the, the dynamic extension, do you consider that a necessity that every therapist should have on hand?
00:09:43
Miranda Materi
Um, I think it depends on the skill level of your therapist. I've seen some really amazing custom outriggers made. Um, so, and I think it depends on like, if it's a MCP arthroplasty. So I, I think it, it just depends. I think you have to know your, your therapist, but I think if you're new and you might need some of those outriggers and hinges and things like that.
00:10:07
josh MacDonald
Yeah, yeah.
00:10:08
Miranda Materi
What about you?
00:10:08
josh MacDonald
It's possible. It's possible to make those things in a pinch when I was in the wrong office and had the wrong supplies. I made an outrigger out of thermoplastic and it was perfect for the patient. It worked just fine. So it's not necessarily a have to have item, but it's it's helpful. and And again, to have it in some kind of organizations, you know, rifling through and and mix matching stuff, but do the best with what you've got. If you can if you can find some of those things, it'll make your job so much easier if you have some of those ri outrigger items in hand.
00:10:39
Miranda Materi
And you know, they had to be pretty precise. So I think you have to have a high skill level if you don't have those tools, but if you have them, they can help you make your device or your orthosis really do precise with the angles and the line of pull.
00:10:52
josh MacDonald
Yeah, yeah, for sure.
Engagement and Contact Information
00:10:55
josh MacDonald
So if you have other thoughts on what's maybe a necessity, or if you have questions about any of the stuff we mentioned, where to get the good scissors from or anything like that, certainly reach out to us.
00:11:03
josh MacDonald
Info at handtherapy.com is our email, or you can reach us on social media, Hand Therapy Academy.