Page 165 - Orthopedic Casts and Splints2

Performance Steps
d. Place orthopaedic felt next to the measured lengths , cut off excess amount and place on
work cart/station.
NOTE: Discard excess material in the trash receptacle.

11. Apply stockinette to patient's upper torso.
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.
NOTE: Stockinette should be 3 inches proximal to the nipple line 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 so that it bisects the oblique muscles.
c. Place the moving arm of the goniometer so that it bisects 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.

13. Apply felt padding to the iliac crests, spine and any other areas of special attention.
NOTE: The felt pads can be applied horizontal or vertical on the iliac crests and are used to reduce
chaffing of the skin. The patient or nursing personnel can hold pads/towel in place prior to webril
application.
14. Place folded towel over the area of the diaphragm.
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.

15. Apply cast padding( webril) to patient's upper torso.
a. Hold webril with one hand.
b. With 2nd hand unroll the webril 1/2 - 1inch and grasp edge with index and middle finger.
c. Place the edge of the webril 1inch proximal to the stockinette edge at the sternal notch and
begin wrapping distal around the torso.
CAUTION: Keep the cast padding on the extremity throughout the application to avoid causing
circulation compromise of the patient's chest.
d. Continue down the torso ending 1inch distal to the stockinette.
e. With each turn overlap the webril by 1/2-1/4 the previous wrap. The top of the webril should
bisect the middle of the previous layer covering up the shallow line and present evenly
applied padding.
16. Prepare casting materials.
a. If using fiberglass casting materials go to steps 17, 18 and 19
b. If using plaster casting materials go to step 19.

17. Place fiberglass casting gloves on hands.

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