Page 205 - Orthopedic Casts and Splints2

APPLY A LONG ARM SPLINT
081-834-0031
Conditions: Given an orthopaedic patient requiring a Long Arm Posterior Splint (LAPS), in supine or
sitting position on a orthopaedic examination bed , nursing personnel, physician, physician's verbal or
written orders, family member, patient's medical record, or Standard Form 513 (consultation form), work
cart/station,sink, (3) roll of 6 inch webril(cast padding), (4) rolls of 4 inch plaster, (4) rolls of 6 inch plaster,
box of 4 x 15 plaster reinforcement sheets, box of 5 x 30 plaster reinforcement sheets , examination
gloves ,scissors, (3) hospital pads ( chux ), (2) bed sheets, goniometer, ruler, tape measure, bucket of
water w/ plastic bag, sink, tube of surgical lubricant , orthopaedic bump, (3) elastic bandages, box of
alcohol pads/ damp towel, pillow, roll of 2 inch adhesive tape, cast care booklet or equivalent, pen, sling,
thermometer and trash receptacle.

Standards: Is reached when a posterior splint is secured to the patient's injured arm from the distal
palmar crease/metacarpophalangeal joints to 2 inches distal to the axilla by (3) elastic bandages. The
wrist is measured between 0-15 degrees of dorsal extension(absent of ulnar or radial deviation). The
elbow is measured at 90 degrees of flexion,(absent of pronation and supination ), with the fingers and
thumb having full range of motion . Capillary refill test is administered to the fingers and passed.

Performance Steps
1. Receive the order from the physician( review if in writing)

2. Identify yourself to the patient.
NOTE: Tell the patient your name and job title.
3. Explain the procedure to the patient.
NOTE: The Long Arm Posterior Splint (LAPS) is applied from the distal palmar crease (DPC) to 2 inches
distal to the axilla or base of the deltoid muscle, with elbow flexed at a 90 degree angle. The wrist will
be place in a neutral position (0-15 degrees dorsal extension), absent of radial, ulnar deviation, pronation,
supination with the fingers and thumb having full range of motion(ROM).

CAUTION: During splinting application a chemical response(exothermic reaction) will occur between the
water (H2O) and the plaster (gypsum). This is a safe and common occurrence. The splint 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 splint may need to be removed.

4. Inspect patient's arms.
a. Place examination gloves on hands.
CAUTION: Always practice Body Substance Isolation (BSI) prior to applying traction, splints or casts to
patients.
b. Place patient sitting or supine on examination bed.
c. Inspect both arms for any skin conditions(e.g. cuts, abrasions, laceration and skin rashes).
NOTE: Inform physician if conditions are present and follow physician's instruction.
d. Examine both arms and wrists for jewelry and remove if found.
NOTE: All jewelry on both hands and wrist must be removed. Give jewelry to family member or secure
with patient's belongings in NCOIC office.
5. Check capillary refill of patient's hands/fingers.
a. Squeeze patient's fingers and nail beds will turn white .
b. Release patient's fingers and nail beds will return pink .
CAUTION: If capillary refill is delayed for more than 2 seconds inform physician and follow physician's
instruction.

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