DAVAO DOCTORS COLLEGE, INC.

General Malvar Street, Davao City

College of Nursing
PERFORMANCE EVALUATION CHECKLIST
APPLYING RIGID SPLINT
NRG 304
NAME: GROUP: RATING: 40

5 4 3 2

1. PREPARE NECESSARY EQUIPMENT (RIGID BOARD, TRIANGULAR BANDAGES (ATLEAST 2) OR ANY LONG CLOTH
THAT CAN SERVE THE PURPOSE.
2. CHECK IF THE SCENE IS SAFE
2.1. Check for unusual noises
2.2. Check for unusual sight
2.3. Check for unusual odor
2.4. Check for unusual appearances
3. GET CONSENT
4. SUPPORT BOTH BELOW AND ABOVE THE SITE OF INJURY
5. CHECK FOR CIRCULATION
5.1. Check for feeling
5.2. Check for warmth
5.3. Check for color

6. PLACED AN APPROPRIATELY SIZED RIGID SPLINT (EX. PADDED BOARD) UNDER THE INJURED BODY PART
7. SECURE BANDAGES
7.1 Tie several folded triangular bandages (or any availble cloth) above and below the injured
body part.
8. RECHECK CIRCULATION
8.1. Check for feeling
8.2. Check for warmth
8.3. Check for color
9. PROCEED TO NEAREST MEDICAL FACILITY/HOSPITAL
TOTAL 0 0 0 0

STUDENTS COMMENT(S): ______________________

SIGNATURE

=
CLINICAL INSTRUCTOR'S COMMENT(S): ______________________
SIGNATURE

kms/cmf revised 2023

1
0

0
80

40