DA Form 7595-1-15 "Apply a Traction Splint"

What Is DA Form 7595-1-15?

This is a military form that was released by the U.S. Department of the Army (DA) on March 1, 2014. The form, often mistakenly referred to as the DD Form 7595-1-15, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DA.

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Download DA Form 7595-1-15 "Apply a Traction Splint"

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APPLY A TRACTION SPLINT
For use of this form see TC 8-800; the proponent agency is TRADOC.
I
TABLE:
STP 8-68W13-SM-TG, Task: 081-833-0141, Apply a Traction Splint
REFERENCE:
PRIVACY ACT STATEMENT
10 U.S.C. S 3013 Secretary of the Army; AR 350-1, Army Training Leadership and Development.
AUTHORITY:
S
To ensure that accomplishment of training is properly credited to the correct individual for NREMT certification
PRINCIPAL PURPOSE:
IAW AR 40-68, AR 220-1 and AR 350-1.
Used by Unit personnel to monitor training. The DOD "Blanket Routine uses" set forth at the beginning of the
ROUTINE USES:
Army's compilation of system of records notices may apply to this system.
Voluntary. Failure to provide your name may result in a loss of credit for accomplishing the training or error in
DISCLOSURE:
processing applicable favorable personnel actions. For Official Use Only.
1. Soldier (Last Name, First Name, MI)
2. Date (YYYYMMDD)
SCENARIO:
While providing medical coverage for a drop zone in an airborne operation you hear the call for a medic to attend an injured Soldier. As you perform your
initial and rapid trauma assessment, the patient is conscious and complaining of severe pain in their mid-thigh, left leg. You detect moderate swelling and
elicit crepitus of the left thigh. You determine the patient's sole injury is a closed fracture to the left femur. You must apply a traction splint to the patient's
left leg; you have been provided the necessary medical equipment.
GRADING SHEET
TASK
COMPLETED
1ST
2ND
3RD
3. Performance Measures
P
F
P
F
P
F
a. Took body substance isolation precautions.
b. Exposed the injury by cutting away the patient's clothing.
c. Assessed the patient's pulse, motor, sensory (PMS).
d. Directed an assistant to manually support and stabilize the injured leg.
e. Placed the traction splint beside the patient's uninjured leg and adjusted the splint to the proper length.
f. Fastened the ankle hitch about the patient's ankle and foot.
g. While supporting the leg at the site of the suspected injury (one hand above the site and one hand below the
site), directed the assistant to manually apply gentle in-line traction to the ankle hitch and foot.
h. Slid the splint into position under the injured leg.
i. Padded the groin area and fastened the ischial strap.
j. Applied mechanical traction.
k. Secured the Velcro straps.
l. Reevaluated the ischial strap and ankle hitch.
m. Reassessed the PMS.
n. Documented treatment on DD Form 1380 [Tactical Combat Casualty Care (TCCC) Card].
4. Demonstrated Proficiency
Yes
No
5. Start Time
6. Stop Time
7. Initial Evaluator
8. Start Time
9. Stop Time
10. Retest Evaluator
This form was prepared by U.S. Government employees for use in the 68W MOS. Although it contains, in part, copyrighted material from National
Registry of Emergency Medical Technicians, Inc.
(NREMT)
, skill sheets ©2011, this form has neither been prepared nor approved by NREMT. Use is
restricted to guidelines contained in the Preface to TC 8-800.
Page 1 of 2
Supersedes DA Form 7595-17-R, May 2009
DA FORM 7595-1-15, MAR 2014
APD LC v1.00
APPLY A TRACTION SPLINT
For use of this form see TC 8-800; the proponent agency is TRADOC.
I
TABLE:
STP 8-68W13-SM-TG, Task: 081-833-0141, Apply a Traction Splint
REFERENCE:
PRIVACY ACT STATEMENT
10 U.S.C. S 3013 Secretary of the Army; AR 350-1, Army Training Leadership and Development.
AUTHORITY:
S
To ensure that accomplishment of training is properly credited to the correct individual for NREMT certification
PRINCIPAL PURPOSE:
IAW AR 40-68, AR 220-1 and AR 350-1.
Used by Unit personnel to monitor training. The DOD "Blanket Routine uses" set forth at the beginning of the
ROUTINE USES:
Army's compilation of system of records notices may apply to this system.
Voluntary. Failure to provide your name may result in a loss of credit for accomplishing the training or error in
DISCLOSURE:
processing applicable favorable personnel actions. For Official Use Only.
1. Soldier (Last Name, First Name, MI)
2. Date (YYYYMMDD)
SCENARIO:
While providing medical coverage for a drop zone in an airborne operation you hear the call for a medic to attend an injured Soldier. As you perform your
initial and rapid trauma assessment, the patient is conscious and complaining of severe pain in their mid-thigh, left leg. You detect moderate swelling and
elicit crepitus of the left thigh. You determine the patient's sole injury is a closed fracture to the left femur. You must apply a traction splint to the patient's
left leg; you have been provided the necessary medical equipment.
GRADING SHEET
TASK
COMPLETED
1ST
2ND
3RD
3. Performance Measures
P
F
P
F
P
F
a. Took body substance isolation precautions.
b. Exposed the injury by cutting away the patient's clothing.
c. Assessed the patient's pulse, motor, sensory (PMS).
d. Directed an assistant to manually support and stabilize the injured leg.
e. Placed the traction splint beside the patient's uninjured leg and adjusted the splint to the proper length.
f. Fastened the ankle hitch about the patient's ankle and foot.
g. While supporting the leg at the site of the suspected injury (one hand above the site and one hand below the
site), directed the assistant to manually apply gentle in-line traction to the ankle hitch and foot.
h. Slid the splint into position under the injured leg.
i. Padded the groin area and fastened the ischial strap.
j. Applied mechanical traction.
k. Secured the Velcro straps.
l. Reevaluated the ischial strap and ankle hitch.
m. Reassessed the PMS.
n. Documented treatment on DD Form 1380 [Tactical Combat Casualty Care (TCCC) Card].
4. Demonstrated Proficiency
Yes
No
5. Start Time
6. Stop Time
7. Initial Evaluator
8. Start Time
9. Stop Time
10. Retest Evaluator
This form was prepared by U.S. Government employees for use in the 68W MOS. Although it contains, in part, copyrighted material from National
Registry of Emergency Medical Technicians, Inc.
(NREMT)
, skill sheets ©2011, this form has neither been prepared nor approved by NREMT. Use is
restricted to guidelines contained in the Preface to TC 8-800.
Page 1 of 2
Supersedes DA Form 7595-17-R, May 2009
DA FORM 7595-1-15, MAR 2014
APD LC v1.00
APPLY A TRACTION SPLINT
GRADING SHEET (cont'd)
12. Stop Time
13. Final Evaluator
11. Start Time
14. Evaluator's Comments
Page 2 of 2
DA FORM 7595-1-15, MAR 2014
APD LC v1.00
Page of 2