Page 192 - Orthopedic Casts and Splints2

Performance Steps
c. Measure across the pubic area and around each hip.
d. Place stack of ( 5) plaster sheets next to the measured lengths , cut off excess amount and
place on work cart/station.
NOTE: Discard all excessive material in the trash receptacle.
10. Prepare felt pads.
a. Measure length of sacral region across the hips.
b. Measure length of iliac crests anteriorly
c. Measure length of mid axillary across the chest..
d. Place orthopaedic felt next to the measured lengths , cut off excess and place on work
cart/station.

11. Apply stockinette to child.
a. Remove sheet or blanket from child.
CAUTION: Always use chaperone( same sex nursing personnel or parent).
b. Hold open 1st stockinette,
c. Roll the stockinette up the child's leg.
d. Hold open sides of 2nd stockinette.
NOTE: Assistance from the nursing personnel can be used.
e. Place stockinette over upper torso and adjust stockinette to torso.
f. Cut the medial aspect of the stockinette.
g. Eliminate any wrinkles and tape the cut stockinette ends together.
NOTE: The stockinette should be 3 inches proximal of the nipple line and resting at mid thigh with 1st
stockinette 2 inches distal of the toes and resting at the groin region.
12. Place child on hip spica table.
NOTE: Physician will assist with body placement.
a. The child is placed supine on the hip spica table.
b. The child's groin is placed up against the peroneal post.
c. The spinous processes bar is placed between the child's skin and the applied stockinette for
easy removal of child from hip spica table.
d. The child's scapula is flush with the edge of the hip spica table.
e. Nursing assistant (s) are holding the child's legs.
NOTE: The physician's order will determine if hips are adducted or abducted and injured knee flexion.
13. Apply felt padding to the iliac crests, spine and any other areas of special attention.
NOTE: The orthopaedic felt is applied to all bony prominences to reduce friction and cast
complications . Physician's order will determine whether the pads are applied first or the webril .
a. Place felt posterior across the sacral region.The felt should rests on both iliac crests.
b. Place felt anterior across the axillary region. The felt is positioned 2 inches distal to the nipple
line.
c. Place felt padding vertical on spine.The felt should encompass the length of the spine.
14. Place folded hand towel over area of the diaphragm.

15. Apply cast padding( webril) to patient's upper torso and injured leg.
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 of 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 child's chest.
d. Continue down the torso overlapping figure of eight between the torso ( inguinal region )
and upper leg ending at the metatarsals.

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