Page 214 - Orthopedic Casts and Splints2

Performance Steps

24. Escort patient to front desk to make a follow up appointment.
Performance Measures GO NO GO

1. Received the order from the physician( reviewed if in writing) —— ——
2. Identified yourself to the patient. —— ——

3. Explained the procedure to the patient. —— ——
4. Inspected patient's arms. —— ——

5. Checked capillary refill of patient's hands/fingers. —— ——
6. Gathered equipment —— ——

7. Assembled materials —— ——
8. Prepared cast padding ( webril) for ulnar splint. —— ——
9. Prepared plaster splint for the ulnar aspect of the hand. —— ——

10. Measured patient's injured wrist w/ goniometer. —— ——
11. Measured patient's uninjured 4th and 5th phalanges w/ goniometer. —— ——

12. Applied ulnar gutter splint to injured arm. —— ——
13. Secure ulnar gutter splint . —— ——
14. Molded splint to forearm/wrist. —— ——

15. Molded splint to the 4th and 5th metacarpals. —— ——
16. Checked range of motion ( ROM ) of uninjured phalanges and elbow. —— ——

17. Checked alignment of injured wrist and injured phalanges with goniometer. —— ——
18. Checked splint dimensions. —— ——

19. Checked patient's capillary refill. —— ——
20. Cleaned plaster off patient's skin using a damp wash cloth, towel or alcohol pad. —— ——

21. Fitted patient with a sling. —— ——
22. Gave patient verbal and written instructions on cast care. —— ——
23. Annotated the procedure applied to patient in medical record or SF 513. —— ——

24. Escorted patient to front desk to make a follow up appointment. —— ——

Evaluation Guidance: Score the orthopaedic technician a GO on the task, if all steps are passed (P).
Score the orthopaedic technician a NO-GO( NG ) if any step is failed (F). All performance measures must
be passed to receive a go.

References
Required Related
0812110-0765
0-8342-0763-X
38709590

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