The Slishman Story: From Concept to Critical Care
Managing femoral fractures effectively in pre-hospital care is imperative in stabilising the injury to reduce pain, minimise further damage and improving blood flow/circulation. When you're facing a long transport time across Australia's vast distances, having equipment that can quickly and reliably reduce pain can make a world of difference in stabilising your patient. That's why the Slishman Traction Splint has become our most distributed product year on year, widely adopted by paramedics and first responders nationwide.
So, what makes this device the preferred choice for emergency first responders across Australia? Let's unpack the engineering and design elements that transformed such a simple concept into a lifesaving innovation.
Where it came from
The concept of traction splinting dates back to 1875 when Hugh Owen Thomas developed the first splint of its kind - known as the Thomas Splint. This device revolutionised the treatment of femoral fractures, dramatically reducing mortality rates during World War I. Yet despite over a century of medical advancement, the basic design remained largely unchanged, with practitioners facing the same fundamental challenges: too bulky, too complex, and limited versatility.
Innovation often springs from the most unexpected places. For Dr. Sam Slishman, an emergency medicine physician at the University of New Mexico, the inspiration for revolutionising trauma care came from an unlikely source: a ski pole. Observing the limitations of traditional traction splints in the field, Dr. Slishman envisioned a radical redesign that would challenge decades of conventional thinking in emergency medical care.
Traditional traction splints had long been plagued by operational challenges. They were bulky, extended beyond the patient's foot (creating hazards during transport), and were often contraindicated in cases of lower leg injuries or amputations – precisely when they were needed most. Drawing from his emergency medicine experience, Dr. Slishman conceptualised a design that would turn the traditional approach on its head: instead of pulling from the foot, his device would push from the hip.
The breakthrough came in the form of a telescoping system inspired by ski poles, incorporating a pulley mechanism that could be positioned at the patient's hip rather than the foot. This seemingly simple shift in design philosophy solved multiple problems at once. The device could be applied in under 60 seconds, didn't extend beyond the patient's foot, and could even be used in cases of lower leg trauma or amputation – a significant advancement particularly relevant for military combat scenarios.
In 2012, medical supplies company Rescue Essentials acquired the license for Dr. Slishman's innovative design through STC.UNM, and the Slishman Traction Splint (STS) was born.
Why It Matters
While many might assume a broken leg is a painful but straightforward injury, a femoral fracture presents serious risks that demand immediate attention, such as blood loss.
The femur is the strongest bone in the body, and when it breaks, the powerful muscles surrounding it contract violently, causing not just intense pain but potential nerve and blood vessel damage. Without proper stabilisation, the sharp edges of the broken bone can cause further tissue injury. What makes these fractures particularly dangerous is their proximity to major blood vessels – a femoral fracture can lead to significant internal bleeding, with patients losing up to 1.5 litres of blood into the surrounding tissue.
In remote areas, where treatment delays are measured in hours rather than minutes, this combination of blood loss, severe pain, and risk of shock makes early intervention critical. This is why effective management of femoral fractures isn't just about patient comfort – it's about preventing life-threatening complications.
Design Innovation
What sets the STS apart isn't just its effectiveness – it's how it fundamentally reimagines traction application. Traditional traction splints operate by pulling from the ankle, often using complex mechanical systems that extend well beyond the patient's foot. While functional, this conventional approach creates numerous operational challenges, particularly during patient transport and in confined spaces.
The STS revolutionised this concept by positioning the traction mechanism at the patient's hip. Instead of pulling distally from the foot, it creates traction through the extension of telescoping aluminium poles with locking clamps, generating a pushing force on the ankle strap. This design incorporates an adjustable groin strap that allows for precise traction control and quick adjustments even during transport – a crucial feature when patient comfort needs to be maintained over long journeys.
Here is a video from over 20 years ago, shared with us from Dr. Sam Slishman himself, showing his early generation STS in action:
The innovative STS design solves multiple challenges simultaneously:
- The four-step application process can be completed in under 60 seconds, with no pole assembly required – a stark contrast to traditional devices that often involve complex setup procedures.
- The one-size-fits-all design works effectively for both adults and children, eliminating the need for services to carry multiple sizes of splinting equipment, a significant advantage for space-constrained emergency vehicles and remote medical teams.
- Unlike traditional splints that become contraindicated with lower leg injuries or amputations, the STS's ankle strap can be repositioned proximal to the calf or even the patella. This means the splint can still provide effective femoral traction while leaving the lower leg accessible for additional treatment, bandaging, or wound care – a critical feature particularly relevant in cases of complex blast trauma or multiple injuries.
- The compact design doesn't extend beyond the foot, preventing the splint from jamming against ambulance doors or aircraft frames during transport and eliminating the risk of the splint striking obstacles that could cause additional pain or injury to the patient
- Allows continuous patient care through its radiolucent design, meaning it won't interfere with X-rays or patient imaging. This feature means the splint can stay in place from initial treatment through to surgery, streamlining the continuum of care and reducing unnecessary patient handling.
- Ensures superior stability through its unique construction of interlocking aluminium poles and a mid-leg strap system that secures both lower extremities together, providing better immobilization compared to traditional designs.
- Features an ultralight design weighing just 600 grams with compact dimensions (58.4cm W × 7.6cm H × 7.6cm D), essential for paramedics who need to maximise their limited equipment space.
How To Use It.
The evolution of emergency medical equipment often follows a simple but powerful pattern: identify a critical problem, reimagine the solution, and execute it with precision. The Slishman Traction Splint represents exactly this - a revolutionary response to a century old concept with long-standing challenges in trauma care.
At TacMed Australia, we understand the challenges of managing femoral fractures in rural and remote locations where time and distance are critical factors. If your organisation operates in these austere environments, we're here to support your emergency response capabilities. Contact info@tacmedaustralia.com.au for all corporate inquiries.
If you are an individual looking to improve your emergency preparedness, you can find more information on this device on our website, and our team is available on social media to answer any questions about its applications and usage.
Stay safe,
Team TacMed.
Note: Always follow current ANZCOR guidelines and seek immediate emergency medical care in any trauma situation. This information supplements but does not replace proper first aid training.
References:
Bledsoe B, Barnes D. Traction splint. An EMS relic? JEMS. 2004 Aug;29(8):64-9. PMID: 15326449.
