Page 183 - Orthopedic Casts and Splints2

Performance Steps
Caution: The use of fiberglass casting gloves are mandatory to prevent the technician from receiving
chemical burns when applying a fiberglass cast.

NOTE: Tube of surgical lubricant can be used to keep gloves from adhering to fiberglass casting
material.

15. Open fiberglass casting package and go to step 16.
NOTE: Open one fiberglass package at a time, because fiberglass will start to cure and harden with
air contact
16. Apply 1st and 2nd plaster/fiberglass roll.
NOTE: If using plaster, examination gloves are recommended to protect the technician's hands as the
resin in the plaster rolls may cause the skin on the hands to dry up.
a. Hold plaster or fiberglass roll vertically.
b. With opposite hand unroll the plaster or fiberglass 1/2-1 inch and grasp edge with thumb,
index and middle fingers.
c. Place the plaster or fiberglass roll in bucket of tepid water and remove when bubbles
cease to rise.
CAUTION: Removing the casting material when bubbles are present ensures dry spots will be visible
during application. Dry spots affects the integrity of the cast.
d. Squeeze the roll together(do not wring the roll).
NOTE: To evenly distribute the water and prevent telescoping of the roll during application gently
squeeze the roll inward.
e. Place the plaster or fiberglass on the ulnar styloid and begin wrapping around the wrist two
rotations to secure the edge.
NOTE: The cast is most susceptible to losing strength in the palm region. Therefore, a twisting or cut
method is authorized.

The Twisting method: As the roll is pushed through the palm pinch the sides of the plaster roll
together (not recommended for fiberglass) twist and evenly space the casting material on the webril.
Smooth out with volar side of fingers. The twisting method provides strength to the cast .

The CUT method: As the roll is pushed through the palm make a horizontal cut to the proximal edge
of the plaster/fiberglass roll and smooth out with volar aspect of fingers or palm.The cutting method
provides cast cosmetics. Each technician may have their own preference to these methods.
f. Continue through the palmar crease, back up the forearm, figure of eight around the elbow,
ending 1/2 inch to the edge of the webril
g. Overlap the plaster/fiberglass by 1/2/ or 1/4 the previous wrap. The top of the
plaster/fiberglass should bisect the middle of the previous layer covering up the shadow line
and present an evenly applied cast.
NOTE: Depending on the size of the patient's forearm and biceps region more than two rolls may be
needed for the initial roll. Begin extra roll where the previous roll left off.
h. Place the casting material at the iliac crests and begin wrapping around the torso.
i. Continue up the torso, figure eight around the shoulder ending 1/2 inch to the webril edge.
j. Overlap the cast material by 1/2-1/4 the previous wrap. The top of the cast material should
bisect the middle of the previous layer and present evenly applied cast material.
NOTE: More than one roll may need to be applied initially.

NOTE: The weight of the shoulder spica should rest on the iliac crests.

NOTE: The edge of the cast must be superior to the acromioclavicular joint( AC joint ).
17. Laminate the casting material.
a. Place palm of each hand on the cast.

180