Page 180 - Orthopedic Casts and Splints2

Performance Steps

3
Shoulder Spica Cast

NOTE: The shoulder spica cast extends from the iliac crests to 2 inches distal to the axilla of the
unaffected side and extends distal to the acromioclavicular joint( AC joint ). The injury arm is abducted
at a 90 degree angle to the upper torso with the wrist having full range of motion. The neck ,uninjured
shoulder and both hands have full range of motion. The patient can sit comfortably, breath freely and
digestion is unrestricted. The Capillary refill test is administrated to the fingers and passed
successfully.( Refer to Figure 3-x).

CAUTION: During cast application a chemical response(exothermic reaction) will occur between the
water(H2O) and the plaster ( gypsum). This is a safe and common occurrence. The cast will initially
become warm and cool down within 2-5 minutes. However, if it doesn't cool down or there is an
increase of heat intensity during the cast application, the cast may need to be removed.

4. Inspect patient's injured torso.
CAUTION: Always practice Body Substance Isolation ( BSI ) prior to applying traction, splints or casts
to patients.
a. Place examination gloves on hands.
b. Place patient behind privacy curtain.
c. Give patient disposable paper shorts and gown.
CAUTION: The same gender chaperone should always be present to assist female patients in
removal of clothing.
d. Instruct patient to remove all clothing and put on shorts and gown.

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