Respiratory Splinting: Definition & Techniques

Instructor: Charity Hacker

I am a nursing instructor with over 20 years of nursing experience and a Masters Degree in Nursing Education.

Breathing is essential to life. Breathing effectively is essential to the prevention of respiratory illness. In this lesson, we will explore what respiratory splinting is and how to do it properly.

What Does Splinting Have to Do with Respiration?

Before we start, we need a quick review of the respiratory process. The proper name for respiration is pulmonary ventilation. One respiratory cycle consists of breathing in, inspiration, and breathing out, expiration. Certain thoracic, or chest, structures are necessary for this process, specifically the rib cage and the diaphragm. The diaphragm is the large muscle at the bottom of the chest cavity. Diaphragm contraction causes the rib cage to expand, changing the air pressure in the lungs and causing air to be drawn in. This complex process is called inspiration. When the diaphragm relaxes the air is drawn back out, causing expiration.

Effective respiration is necessary for maintaining the human body. Each of our major organs and our tiniest cells depends on proper respiration for life. So, what does any of this have to do with respiratory splinting? Because sometimes we have injuries, either traumatic or man-made, to our chest and it hurts to breathe. So, what do we do about it? We splint! Is this a good thing or a bad thing? Let's see.

What Is Splinting?

If you stop a part of the body from moving because it causes pain or it may cause injury, that is called splinting. Splinting can be very complicated and it can be very simple, by a surgeon or by a patient. It can have both positive and effective effects, performed properly for the right reason, or perhaps, still properly but for the wrong reason. Let's look closer.

Techniques of Splinting

Improper Splinting

Sometimes splinting is a sign that something is wrong. For example, after one has sustained an injury to the chest, they may demonstrate splinting as a sign of injury. It may also be a sign of a disease or respiratory infection, such as lung cancer, spontaneous pneumothorax or pneumonia. Generally, if moving something causes you pain, you will splint it to prevent the movement that causes the pain from occurring.

When it comes to respiratory splinting, this type is often not helpful. For example, you might have just the smallest weakest cough to prevent pain or breathe very shallow for the same reason. These are improper forms of splinting. Preventing proper respiration is not helpful because it inhibits the respiratory process. Your lungs are not able to eliminate foreign substances, such as secretions, and the rib cage cannot fully expanding.

Proper Splinting

It is absolutely essential to maintain an adequate respiratory cycle both following injury and in respiratory illness. If you do not do this, you will undoubtedly develop pneumonia from lack of air movement. But, how do you maintain adequate airflow when it hurts so much to breathe? Splinting… Yes, splinting!

So, let's get this straight splinting is a bad thing… but it is also a good thing? Yes, it is a good thing too. There are two primary ways that bedside splinting can be done when respiratory complications are involved: pillow and manual splinting. These should be done at least four times every hour while you are weak to keep the lung fully expanded and at their best performance.

The first and most popular form of proper splinting is pillow splinting. This is when the patient uses an item such as a pillow, rolled blanket, or thick towel to brace the injured area. You would place the item over the injured area and then place both hands on top of the item. Next, you would take a very deep breath, at the top of this breath you should try to cough deeply while pressing firmly with both hands. This is the proper form of respiratory splinting.

Another type of splinting that is effective and acceptable is manual splinting. Manual splinting should also be performed frequently while the patient is awake to obtain the most effectiveness. Manual splinting is performed by placing one hand above the injury, or incision, and the other hand below the incision. Similar to pillow splinting, firm pressure should be applied with both hands at the top of a deep breath and with coughing.

Example of manual splinting
Picture of a patient deep breathing and performing manual splinting

Medical and Surgical Splinting

There are also types of respiratory splinting that are not performed by the patient or at the bedside by a health care worker. These include devices or procedure performed by surgeons or ordered by doctors. Many of these procedures are outdated and not evidence-supported, and are therefore no longer in use.

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