Page 193 - Orthopedic Casts and Splints2
P. 193

Performance Steps
                 NOTE: The following sequence is used for applying the cast padding as well as the cast material :
                 begin at the pubic symphysis, greater trochanter, gluteal fold, peroneal crease, inguinal ligament,
                 anterior superior iliac spine, lower sacrum, opposite anterior superior iliac spine, inguinal ligament,
                 peroneal crease, gluteal fold, greater trochanter, pubic symphysis.
                        e. Place the edge of the webril at the proximal edge of the stockinette on the uninjured leg and
                          continue down the torso overlapping figure of eight between the torso( inguinal region) and
                          upper leg, wrapping around the thigh and continue to the base of the thigh.
                        f. With each turn overlap the webril by 1/2-1/4 the previous wrap. The top of the webril should
                          bisect the middle of the previous layer covering up the shallow line and present evenly
                          applied padding.
                  16. Prepare casting materials.
                  17. If using fiberglass casting materials go to step 19 then 20.

                  18. If using plaster casting materials go to step 21.
                  19. Place fiberglass casting gloves on hands.
                 Caution: The use of fiberglass casting gloves is mandatory to prevent the technician from receiving
                 chemical burns when applying a fiberglass cast.
                  20. Open fiberglass casting package and go to step 21.
                 NOTE: Open one fiberglass package at a time, as fiberglass begins to cure and harden after contact
                 with air.

                  21. Apply 1st and 2nd plaster/fiberglass roll to injured leg.
                 NOTE: 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 with hand.
                        b. With opposite hand unroll the plaster or fiberglass 1/2-1 inch and grasp edge with thumb,
                          index and middle fingers.
                 NOTE: Alternative method may be used.
                        c. Place the plaster or fiberglass roll in the bucket of tepid water and remove when bubbles
                          cease to rise.
                 CAUTION: Removal of casting material prior to the cessation of bubbles will indicate the presence of
                 dry spots in the casting material. Dry spots in the casting material will reduce the integrity of the cast if
                 applied.
                        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 edge of the casting material 1inch distal to the stockinette edge and begin
                          wrapping around the torso.
                        f. Continue down the torso overlapping figure of eight between the torso ( inguinal region )
                          and upper leg ending at the metatarsals.
                 NOTE: The following sequence of application is used most often: beginning at the pubic symphysis,
                 greater trochanter, gluteal fold, peroneal crease, inguinal ligament, anterior superior iliac spine, lower
                 sacrum, opposite anterior superior iliac spine, inguinal ligament, peroneal crease, gluteal fold, greater
                 trochanter, pubic symphysis.
                        g. Place the edge of the cast material at the proximal edge of the stockinette on the uninjured
                          leg and continue down the torso overlapping figure of eight between the torso( inguinal
                          region) and upper leg, wrapping around the thigh and continue to the base of the thigh.
                        h. 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 padding.
                  22. Laminate the casting material.
                        a. Place palm of each hand on the cast.


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