 Here's a brief overview. Ensure that the basic ABCs of airway breathing and circulation are intact prior to any splint in activity. Expose any injured areas. Remove skin color and symmetry. Assess and document, pulse, motor, and sensory function. Apply constant yet gentle, long axis, that is inline manual traction on severely deformed long bone fractures. Return extremity to its normal anatomical position with an assistance supporting the extremity under the suspected fracture site. If the patient complains of increased pain, or if there is resistance during manipulation, then stop, and immobilize the extremity as best as possible in the position found. Maintain manual support of the injured area while coordinating additional assistance during the evacuous splint immobilization process. Your healthcare partner, or a qualified assistant, should apply appropriate dressings to all wounds in and around the suspected fracture site. Open the evacue splint carry case, and select a splint that will immobilize the joints above and below the fracture site. Shoulder and hip injuries will require additional immobilization methods to accomplish this goal. Remove the red leashed cap from the maxi valve, and push in on the red end of the valve to equalize the air pressure in the splint. Remove the splint out on the ground, and manually distribute the beads evenly throughout the splint. The evacue splint should be soft enough to easily and comfortably conform to the injured area, yet firm enough to keep the beads in place if positioned vertically. This adjustment method can easily be made by simply removing or allowing air to enter the splint. In support of the injured area, and elevate, if indicated, the injured extremity just enough to apply the splint. Slide or place the splint under the injured area. Positioning the splint so that at least one strap is above the suspected fracture site, and at least one strap is below the suspected fracture site. Cradle the injured extremity with the splint, and gently manipulate beads and devoides to provide the best conforming mold possible. The splint should conform easily, if not simply adjust by allowing air to enter the splint. The splint edges should not overlap. Tip. Leave an open space approximately one inch whenever possible along the length of the splint. This provides proper mobilization, yet also allows for visual inspection along the full length of the injured extremity. With the splint is too wide, fold the strapless edge back on itself, and smooth out the edge to form a narrower splint. Hold the splint in place, hands on stable, by grasping both top leading edges above and below the fracture site. Once the splint is properly applied, release your support of the extremity, letting the splint cradle the suspected fracture site. Still though, assisted by your partner's hands on stable support, which maintains the injured limb in a desired and comfortable position. Remove the red leash cap from the maxi valve and push in on the red end of the valve to equalize the air pressure in the splint. While holding the flange tubing on the splint, connect the maxi valve female coupling on the pump hose to the maxi valve on the evacue splint. You should hear a click when the connection has been made. If you are using a portable suction device, connect the maxi valve portable suction adapter or PSA to the end of your portable suction tubing. While holding the flexible flange tubing just below the maxi valve, attach the vacuum pump hose with adapter to the maxi valve. Evacuate the air from the splint until the splint forms a rigid cast around the injured area. You will feel resistance on the pump handle when the splint has been sufficiently evacuated. Remove the pump hose from the maxi valve by depressing the metal tab on the female coupling. Place the red leash cap back on the maxi valve. Just leave pull on the red end of the hook and loop straps to extend the strap. Place the splint straps with slight tension around the splint. Secure the straps in place. Note the evacue splint is available with hook and loop or side release buckle straps. The hook and loop straps are shown here. The suspected fracture site is now splint stable. Adjustments can now be made if necessary to add stability or to make slight positional changes for patient comfort. These adjustments can be accomplished by simply removing or allowing air to enter the splint. Unfacinate the attached straps prior to allowing air back into the evacue splint. Do not cut the evacue splint or straps. Please make sure all hospital personnel are informed about these removal procedures. Remove the red leash cap from the maxi valve and while holding the maxi valve, depress the red plastic center section allowing air to enter the splint. The evacue splint can now be easily removed. We all know that a flat backboard is simply not comfortable. For many patients, especially the elderly and those with chronic back problems, a backboard can seem like a torture rack. The evacue splint makes an excellent padding device for a backboard. The large size evacue splint pads the area from head to the hips on most adult patients. Here's how it works. Place the large size evacue splint on the backboard with the wide end at the head and the tapered end toward the foot. Remove a slight amount of air so the splint is like modeling clay with all the beads evened out. Now the splint can be easily held in place on the board during the log-roll maneuver. The patient can also be placed onto the evacue splint backboard combination with a little or no modification of your vehicle extrication procedures. After positioning the patient on the board and before applying vacuum for the final fit, have a partner mold the top corners of the evacue splint up around the patient's shoulders and head to form a snug head immobilizer. Create all the patient's head with your hands at the base of the head by the shoulders while you evacuate the air from the splint. The evacue splint should be under the patient's head and should not extend over the top of the patient's head. You can secure the patient with tape if desired. Here's another street-wise tip. When you have evacuated about half the air from the splint, you can change the position of your hands and use your thumbs to create ear channels in the now clay-like splint to make it easier for the patient to hear. Finish evacuating the splint with your hands holding both sides of the evacue splint. The polystyrene beads fill in at the voids at the lumbar, thoracic, and cervical spine areas. Then lock in place when vacuum is applied, providing custom fit comfort, support and motion restriction that a board and head blocks cannot provide. Unlike other padding techniques, you get a perfectly contoured fit for each individual patient, plus a head immobilizer in one simple low-cost device. This method is also much easier and faster than traditional padding techniques and head immobilization methods. If your pediatric vacuum splint or other pediatric immobilizer is not available, try using the evacue splint as a pediatric immobilizer in conjunction with the standard backboard. Lay the evacue splint on your backboard just as we did for the head immobilizer application. Remember that depending on the patient's age, your patient may need more padding under the torso than under their head. Spread out the beads to meet the needs of your pediatric patient. Place the patient on the evacue splint according to your local medical protocols. Use your hands to mold the evacue splint around the patient's head and shoulders, just as we did with the adult head immobilizer application. Take the splint and then secure the patient to the backboard. The evacue splint also acts as a thermal insulator, which is a real benefit when working with pediatric patients.