Caring for a Patient in Halo Traction
Goal: The patient maintains cervical alignment.
1. Review the medical record and the nursing plan of care to determine the type of device being used and prescribed care.
2. Identify the patient. Explain the procedure to the patient.
3. Perform hand hygiene.
4. Close the room door or curtains. Place the bed at a comfortable working height or have the patient sit up if appropriate.
5. Monitor vital signs and perform a neurologic assessment, including level of consciousness, motor function, and sensation, per facility policy. This is usually at least every 2 hours for 24 hours, or possibly every hour for 48 hours.
6. Examine the halo vest unit every 8 hours for stability, secure connections, and positioning. Make sure the patient’s head is centered in the halo without neck flexion or extension. Check each bolt for loosening.
7. Check the fit of the vest. With the patient in a supine position, you should be able to insert one or two fingers under the jacket at the shoulder and chest.
8. Put on unsterile gloves, if appropriate. Wash the patient’s chest and back daily. Place the patient on his or her back or sitting up if appropriate. Loosen the bottom Velcro straps.
9. Wring out a bath towel soaked in warm water. Pull the towel back and forth in a drying motion beneath the front. Do not use soap or lotion under the vest.
10. Thoroughly dry the skin in the same manner with a dry towel. Inspect the skin for tender, reddened areas or pressure spots. Lightly dust the skin with a prescribed medicated powder or cornstarch.
11. Turn the patient on his or her side, less than 45 degrees if lying supine, and repeat the process on the back. Close the Velcro straps. Assist the patient with changing the shirt.
12. Perform a respiratory assessment. Check for respiratory impairment, such as absence of breath sounds, the presence of adventitious sounds, reduced inspiratory effort, or shortness of breath.
13. Assess the pin sites for redness, tenting of the skin, prolonged or purulent drainage, swelling, and bowing, bending, or loosening of the pins. Monitor body temperature.
14. Perform pin-site care.(See Skills 9-18 and 9-19.)
15. Depending on physician order and facility policy, apply the antimicrobial ointment to pin sites and apply a dressing.
16. Remove gloves and dispose of them appropriately. Place the bed in the lowest position.
17. Perform hand hygiene.