Page 13 - Orthopedic Casts and Splints2

Performance Steps

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Long Arm Hanging Cast

NOTE: The LAHC is applied from the distal palmar crease(DPC)/ metacarpophalangeal joints
(MCPJ's) to 2 inch distal to the axilla/ base of the deltoid muscle, with the elbow flexed at a 90 degree
angle. A plaster or fiberglass loop will be splinted or braced 1 inch proximal to the base of the thumb.
Traction cord will be threaded through the loop at the base of the thumb and attached to a padded
collar around the posterior(back) aspect of your neck .(Refer to Figure 3-x).

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 patient's arms.
a. Put on examination gloves.
CAUTION: Always practice Body Substance Isolation ( BSI ) prior to applying traction, splints or casts
to patients.
b. Inspect both arm for any skin conditions(e.g. cuts, abrasions, lacerations and skin rashes).
NOTE: Inform physician if conditions are present and follow physician's instruction.
c. Examine both arms and wrists for jewelry and remove if found.
NOTE: All jewelry on fingers and wrists must be removed. Give jewelry to family member or secure with
patient's belongings in NCOIC office.
5. Check patient's capillary refill.
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