Page 157 - Orthopedic Casts and Splints2

Performance Steps
a. Place bed sheets on floor and have patient stand on sheets.
NOTE: Bed sheets are used to keep the floor clean during the casting process.
b. Have patient remove gown.
CAUTION: Always use the same gender chaperone when patient's are disrobing.
c. Hold open sides of the stockinette.
d. Place the stockinette on patient.
NOTE: The patient can either step in the stockinette and pull it on, or have patient place arms above
head and pull stockinette down.
e. Pinch the stockinette at the base of the shoulder and cut the stockinette at a 45 degree angle.
f. Have patient place arms through the pre cut hole and adjust stockinette.
g. Cut the stockinette for eyes, nose and mouth openings.
NOTE: Stockinette should be 1-2 inches superior to the head and 3 inches distal to the iliac crests.

12. Measure patient's spine with goniometer.
NOTE: All body casts are applied absent of flexion or extension unless directed by physician's order.
a. Have patient stand erect.
NOTE: Family members, nursing staff, orthopaedic technician or support bar may be used to assist in
positioning the patient.
b. Place the stationary arm of the goniometer vertical , bisecting the oblique muscles.
c. Place the moving arm of the goniometer vertical, bisecting the lateral side of the femur.
d. Place the protractor of the goniometer on the iliac crest,
e. Set spine until the goniometer measures 0 or 180 degrees.
NOTE: Physician will determine the flexion/extension needed.
13. Place folded towel over the area of the diaphragm and have technician or patient hold in place until
secured by the webril.
CAUTION: A small folded towel is placed over the diaphragm and top of the stomach for a later cutaway
of the area which will provide for breathing and digestion.

14. Apply cast padding( webril) to patient's head and upper torso.
a. Hold webril with one hand.
b. Unroll the webril 1/2 - 1inch with second hand and grasp edge with index and middle finger.
c. Wrap the webril around the forehead and chin.
d. Cut away webril at eyes, nose and mouth.
e. Wrap the webril from the upper axillary level to below the greater trochanter.
f. Apply 4 strips of webril over each shoulder from mid scapula to mid pectoralis muscle.
g. Overlap the webril by 1/2-1/4 the previous wrap.
NOTE: The top of the webril should bisect the middle of the previous layer covering up the shallow line
and present evenly applied padding.
15. Apply felt padding to the anterior superior iliac spine, forehead, chin and ears.
NOTE: The felt pads can be applied horizontal or vertical on the iliac crests, spine and are used to reduce
chaffing of the skin.

16. Prepare casting materials.
a. If using fiberglass casting materials go to step 17, 18 and 19
b. If using plaster casting materials go to step 19.

17. Place fiberglass casting gloves on hands.
Caution: The use of fiberglass casting gloves are mandatory to prevent the technician from receiving
chemical burns when applying a fiberglass cast.

NOTE: Tube of surgical lubricant can be used to keep the gloves from adhering to fiberglass casting
material.
18. Open fiberglass casting package and go to step 19.

154