Page 168 - Orthopedic Casts and Splints2

Performance Steps
b. The lower edge of the scapula is visible.
c. The distal aspect of the cast rests on the iliac crests.
d. There is 2-4 inch distance from the axilla to the edge of the cast.

27. Measure patient's spine with goniometer.
a. Place the stationary arm of the goniometer vertically , bisecting the oblique muscles.
b. Place the moving arm of the goniometer vertically, bisecting the lateral side of the femur.
c. Place the protractor of the goniometer on the iliac crest.
d. The spine is measured in neutral position or according to physician's order.
28. Apply 5th and 6th plaster/fiberglass rolls ( repeat steps 19-20))
NOTE: The last roll in all casting applications is commonly referred to as the beautification roll or the
money roll. Take pride in your work.
29. Check patient's capillary refill.
a. Squeeze patient's fingers and nail beds will turn white
b. Release patient's fingers and nail beds will return pink .
CAUTION: If capillary refill is delayed for more than 2 seconds inform physician and follow physician's
instruction.

30. Clean plaster resin off patient's skin using a damp wash cloth, towel or alcohol pad.
Note: Use alcohol pad or fresh water from the faucet and not from the casting bucket .
31. Give patient verbal and written instructions on cast care.
a. Instruct the patient to call the cast clinic should they have any concerns or questions
regarding their cast .
b. Provide patient with a copy of the clinic hours and telephone number. After duty hours
instruct patient to report to emergency room.
c. Provide patient with cast care booklet or equivalent.
d. Instruct patient not to stick anything down the cast, do not remove the cast and do not alter
the cast( e.g. writing on it, coloring.)
32. Annotate the procedure applied to the patient in medical record or SF 513.
NOTE: Record the procedure applied and cast care instruction provided to patient and sign your name.

33. Escort patient or direct patient to front desk to make a follow up appointment.

Performance Measures GO NO GO
1. Received the order from the physician (reviewed if in writing). —— ——

2. Identified yourself to patient. —— ——
3. Explained the procedure to the patient. —— ——
4. Inspected patient's injured torso. —— ——

5. Checked patient's capillary refill. —— ——
6. Gathered equipment. —— ——

7. Assembled materials. —— ——
8. Prepared stockinette. —— ——

9. Prepared 3 plaster reinforcement splints for the posterior, medial and lateral —— ——
aspects of the cast.
10. Prepared felt pads. —— ——

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