Page 124 - Orthopedic Casts and Splints2

Performance Steps
NOTE: Provide patient with paper shorts . If unavailable, cut the pants at the seam.

NOTE: Secure patient's clothing in NCOIC's office, until casting is completed.
e. Place hospital pad or bed sheet on patient's lap.
NOTE: All patient's should be given a covering( e.g. chux, bed sheet) to reduce damaging their
clothing during the casting process and protect their privacy.
f. Check 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.
g. 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.

5. Check patient's capillary refill.
a. Squeeze patient's toes and nail beds will turn white .
b. Release patient's toes and nail beds will return pink .
CAUTION: If capillary refill is delayed for more than 2 seconds inform physician and follow physician's
instruction.

6. Gather equipment to include cast saw, cast spreader, hearing protection, goggles, thigh
holder,support bar,orthopaedic bump, goniometer, scissors, thermometer and bucket of tepid
water w/ plastic bag. Place on work cart or station.
CAUTION: The temperature of the water must be tepid ( 70-80 degrees) to reduce further injury
(possible burns) to the patient. The technician should draw water that is room temperature and initially
use a thermometer to gauge water temperature.

CAUTION: The technician must change the water after each application as the residue in the cast
bucket will act as an accelerator causing the casting material to increase in heat emission.

7. Assemble materials to include stockinette, webril, plaster or fiberglass rolls, fiberglass casting
gloves, examination gloves, hospital pad (chux), bed sheet, box of plaster reinforcement sheets,
surgical lubricant, box of alcohol pads, benzoin swabs and damp wash towel. Open and remove
(5) plaster rolls from their packages and place on work cart/station.
NOTE: Physician's order, technician's preference, availability of supplies, and/or patient's extremity
size will determine which casting material (fiberglass/plaster) will be used.
8. Prepare medial/ lateral plaster reinforcement splints.
NOTE: When using plaster reinforcement splints on a lower extremity cast the reinforcement splint is 5
thickness.
a. Open box of 5 x 30 inch plaster reinforcement sheets. Remove and unwrap package. Locate
edges of two stacks and remove from package. Place on work cart/station .
NOTE: 5 x 30 inch plaster splints are usually stacked in increments of five from the manufacturer. If
not pre stacked, count out five layers of plaster sheets.
b. Measure on the medial and lateral aspect of the leg , 4inches distal to the groin crossing
over the knee to the calf muscle.
NOTE: If 5 x 30 plaster sheets are not long enough, plaster rolls can be used. It is the technician
preference.
c. Place stacks of ( 5) plaster sheets next to the measured lengths , cut off excess amount and
place on work cart/station.
NOTE: Discard all excess material in the trash receptacle.

9. Apply skin adherent to injured leg.
NOTE: Tincture of benzoin/mastisol is used to prevent the cast from slipping.
a. Ask patient if they have ever had a skin rash after the use of benzoin or after eating shell
fish.

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