Page 175 - Orthopedic Casts and Splints2

Performance Steps
CAUTION: To reduce cast indentations, which can cause pressure sores to the patient's skin under the
cast, keep finger tips off the cast during the application and molding process.

CAUTION: The patient must be asked throughout the casting process if they feel pressure sores or
hot spots developing under the cast. hot spots are areas within the cast that continue to stay warm and
may even progress to hot. If sores or hot spots are developing the cast must be removed
immediately
b. Rub the cast material in the direction it was applied.
NOTE: Laminating the cast material fills in the pores which assist it providing strength to the cast.
c. Conform the casting material to the body contours.
d. Continue rubbing the cast until the tone /texture changes from a glossy/creamy color to a dull
white color.
NOTE: The dull white color represents the cast beginning to cure.
21. Apply reinforcement splints to the cast .
NOTE: The reinforcement splints are used to strengthen and support the cast.
NOTE: The splints are applied vertically, horizontally or in a manner prescribed by physician's order.
a. Place each splint individually in tepid water, wait for bubbles to subside and remove from
water.
b. Squeeze each splint together to remove excess water.
c. Place reinforcement splints posteriorly(along the coccyx region), at the iliac crests, and
posteriorly to the injured shoulder.
d. Laminate splints to the cast.

22. Positioned injured arm on patient's chest.
NOTE: Physician's order will determine at what angle the elbow is positioned.

23. Apply 3rd and 4th plaster/fiberglass rolls( repeat steps 19-20)
NOTE: Incorporate injured arm/shoulder with the 3rd/4th roll of casting material.
24. Mold the cast.
a. Place heels of hand on iliac crests, apply firm pressure .
b. Remove heels of the hands from cast when contours of the iliac crests have been shaped
and cast is cured.
c. Apply firm and gradual pressure beginning below 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 heels of the hands from cast when contours of the torso have been shaped to the
body and cast is cured.
25. 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 they should be aware
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 then 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.

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