Page 159 - Orthopedic Casts and Splints2

Performance Steps
g. Place two to three reinforcement splints to the posterior(sacral area), medial and lateral(
oblique muscle region).
h. Laminate splints to casting material.

22. Apply 3rd and 4th plaster/fiberglass rolls (repeat steps 19-20)
23. Mold the cast.
a. Place heels of each hand on iliac crests, apply firm pressure .
b. Remove hands from cast when contours of the iliac crests have been shaped and cast is
cured.
c. Apply firm and gradual pressure beginning above the axilla and progress down the torso.
CAUTION: Excessive pressure may result in further patient injury. Talk to the patient during this
procedure( e.g. How do they feel?, Is the pressure too much?)
d. Remove hands from cast when contours of the torso have been shaped to the body and cast is
cured.
24. Trim cast to fit patient.
CAUTION: Patients in the cast room are always offered and encourage to use hearing/eye protection.
Technicians must wear hearing/eye protection when removing a cast.

NOTE: Patient's are under no obligation to wear hearing and eye protection, but are told of the
consequences of not using hearing and eye protection.
a. Draw and cut the lower trimming line:
NOTE: The markings can be done by a pen, grease pencil etc.

Note : The cast saw along with scissors can be used to cut outlines.
(1) Draw a curved line from the symphysis pubis arch upward, downward above the flexion
crease of the hip joint to the greater trochanter.
(2) The line is continued across the lower buttock region in a curved fashion to the
sacrococcygeal junction and is connected to the opposite trimming line.
(3) Draw a 4 inch circular outline at the diaphragm.
(4) With the cast saw cut outlines, remove towel and place excess cast material in trash
receptacle.
(5) Fold webril and stockinette edges over the trimmed cast ends and secure with adhesive
tape.
b. Draw and cut the upper trimming line:
(1) Draw the outline of the shoulder joint on the posterior and anterior of cast.
(2) Draw an curved line from just below the occipital bone located on the posterior aspect of
the head, behind the ears, parallel to the chin and connected to the opposite trimming line.
(3) With the cast saw cut outlines, remove excess cast material .
(4) Fold webril and stockinette edges over the trimmed cast ends and secure with adhesive
tape.

25. Check range of motion ( ROM ) of shoulders and hips.
a. Have patient sit in chair from a standing position.
b. Have patient rotate shoulders.
c. Have patient inhale and exhale to determine airway compliance.
d. Have patient rotate hips.
NOTE. If patient is unable to accomplish a-d trim the cast as needed.
26. Check cast dimensions.
a. The distal aspect of the cast rests on the iliac crests.
b. The frontal region of the forehead is immobilized.
c. The casting material is well molded to chin.
d. The lateral aspect of each scapula is visible.
e. Each shoulder joint is visible.

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