Page 111 - Orthopedic Casts and Splints2

Performance Steps
e. Instruct patient to use crutches and not to place any pressure on the cast for 24-48 hrs.

39. Annotate the procedure applied to patient in medical record or SF 513.
NOTE: Record the procedure applied and cast care instruction provided to the patient in patient's medical
record or Standard Form 513 and sign your name.
40. Escort patient to front desk to make a follow up appointment.

Performance Measures GO NO GO

1. Received the order from the physician (reviewed if in writing). —— ——
2. Identified yourself to patient. —— ——
3. Explained the procedure to the patient. —— ——

4. Inspected injured leg/ankle with patient (supine) on the examination bed. —— ——
5. Checked patient's capillary refill. —— ——

6. Gathered equipment —— ——
7. Assembled materials —— ——

8. Prepared stockinette. —— ——
9. Prepared plaster reinforcement splint for the posterior aspect of the cast. —— ——

10. Prepared plaster reinforcement splint for use at the femoral condyles. —— ——
11. Applied stockinette to patient's injured leg —— ——
12. Positioned the patient's injured ankle at a 90 degree angle to the tibia. —— ——

13. Measured patient's injured ankle w/ goniometer. —— ——
14. Applied cast padding (webril) to patient's injured leg. —— ——

15. Prepared casting materials. —— ——
16. Placed fiberglass casting gloves on hands. —— ——

17. Opened fiberglass casting package and go to step 18 —— ——
18. Applied 1st plaster/fiberglass roll. —— ——

19. Laminated the casting materials. —— ——
20. Applied reinforcement splint to posterior aspect of cast. —— ——
21. Applied 2nd plaster/fiberglass roll ( repeat steps 18-19) —— ——

22. Molded the cast material to the lower leg. —— ——
23. Checked range of motion ( ROM ) of phalanges. —— ——

24. Checked alignment of injured ankle with goniometer. —— ——
25. Positioned the patient's leg to extend cast. —— ——
26. Applied webril to injured leg. —— ——

27. Applied 3rd plaster roll to injured leg. —— ——

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