Page 104 - Orthopedic Casts and Splints2

APPLY A LONG LEG CAST
081-834-0017
Conditions: Given an orthopaedic patient requiring a Long Leg Cast (LLC ), sitting on a orthopaedic
examination bed, family member, nursing personnel, physician, physician's verbal or written order,
patient's medical record, or Standard Form 513(consultation form), pen , work cart/station, (4) rolls of 6
inch plaster , (3) rolls of 4 inch plaster, box of 5 x 30 inch plaster reinforcement sheets, (5) rolls of 4 or
5 inch fiberglass, (2) rolls of 3 inch webril, (3) rolls of 4 inch webril, (3) rolls of 6 inch webril, roll of
stockinette( 2, 3, or 4 inch), stockinette container, fiberglass casting gloves, examination gloves, scissors,
cast saw, cast spreader, (2) safety goggles, (2) packages of disposable foam ear plugs, roll of 2 inch
adhesive tape, (3) hospital pads (chux), (2) bed sheets, pillow, (2) disposable paper shorts, disposable
hospital gown, goniometer, ruler, tape measure, bucket of tepid water w/ plastic bag, thermometer,
support bar, cast care booklet or equivalent, box of alcohol pads, damp wash cloth or towel, sink w/
faucet, tube of surgical lubricant , orthopaedic bump, T (turnstile)stand, thigh holder, cast shoe and trash
receptacle.

Standards: Is reached when the injured leg, ankle and knee are immobilized by the cast from the web
spacing of the toes to 4 inches distal to the groin( on the medial side ), and flared 1 inch proximal to the
greater trochanter on the lateral side. The ankle is dorsiflexed at a 90 degree angle, absent of inversion
or eversion with toes having full range of motion. The knee is flexed between 0-15 degrees. Capillary
refill test is administrated to the toes and passed successfully .

Performance Steps
1. Receive the order from the physician (review if in writing).

2. Identify yourself to patient.
NOTE: Tell the patient your name and job title.

3. Explain the procedure to the patient.
NOTE: The Long Leg Cast ( LLC ) is applied from the web spacing of the toes to 4 inches distal to the
groin( on the medial side) and flared 1 inch proximal to the greater trochanter( on the lateral side) with
the knee flexed between 0- 15 degrees.

CAUTION: During cast application a chemical response(exothermic reaction) will occur between the
water(H2O) and the plaster ( gypsum). This is a safe and common occurrence. The cast will initially
become warm and cool down within 2-5 minutes. However, if it doesn't cool down or there is an increase
of heat intensity during the cast application, the cast may need to be removed.

4. Inspect injured leg/ankle with patient supine on the examination bed.
a. Place examination gloves on hands.
CAUTION: Always practice Body Substance Isolation (BSI) prior to applying traction, splints or casts to
patients.
b. Remove patient's shoes, socks and pants .
NOTE: Provide patient with paper shorts or hospital scrubs. If unavailable, cut the pant leg at the seam.

NOTE: Always provide patient with privacy when they are disrobing ( e.g. bed curtain, bed sheet )
c. Inspect patient's injured leg for any skin conditions ( e. g. cuts, abrasions, lacerations and skin
rashes ).
NOTE: Inform physician if conditions are present and follow physician's order.
d. Examine both legs for jewelry and remove if found.
NOTE: All jewelry must be removed. Give jewelry to family member or secure with patient's belongings in
NCOIC office.

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