Page 230 - Orthopedic Casts and Splints2

Performance Steps
f. Place palm of hand on the posterior aspect of the knee and apply pressure. Hold until contour
takes shape.
15. Check range of motion ( ROM ) of phalanges and hip
a. Have patient extend and flex toes.
b. Have patient raise and lower leg.

16. Check alignment of injured ankle and knee with goniometer( go to steps 10-11).
NOTE: If the malleolus is not at 90 degrees of dorsal flexion, everted or inverted and knee is not between
0-15 degrees of flexion, remove splint and go to step 8.
17. Check splint dimensions.
a. The toes are visible.
b. The splint edges rest at the tips of the toes and 4 inches distal to the groin region or resting on
the gluteal crease.

18. Check patient's capillary refill.
a. Squeeze patient's toes and nail beds will turn white .
b. Release patient's toes and nail beds will return pink.
CAUTION: If capillary refill is delayed for more than 2 seconds inform physician and follow physician's
instruction.
19. Clean plaster off patient's skin using a damp wash cloth, towel or alcohol pad.
Note: Use alcohol pad or fresh water from the faucet and not from the casting bucket .

20. Administer a crutch ambulation treatment ( see task number 081-836-0041) .
21. Give patient verbal and written instructions on cast care.
a. Instruct patient to call the cast clinic should they have any concerns or questions regarding
their cast. Provide patient with a copy of the clinic hours and telephone number. After duty
hours instruct patient to report to the Emergency Room.
b. Present patient with cast care booklet or ( written instruction )
c. Instruct patient to keep leg elevated and flex and extend toes to increase circulation in the foot.
d. Instruct patient not to stick any objects down the cast, do not remove the cast, and do not alter
the cast ( e. g. writing or coloring the cast).
e. Instruct patient to use crutches when walking.
22. Annotate the procedure applied to patient in medical record or SF 513.
NOTE: Record the procedure applied and cast care instruction provided to the patient in patient's medical
record or Standard Form 513 and sign your name.

23. 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 patient. —— ——

3. Explained the procedure to the patient. —— ——
4. Inspected patient's injured leg/ankle . —— ——

5. Checked patient's capillary refill. —— ——
6. Gather equipment. —— ——

7. Assembled materials. —— ——
8. Prepared cast padding ( webril). —— ——

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