Page 237 - Orthopedic Casts and Splints2

Performance Steps
NOTE: If wrist is not within 0-15 degrees of dorsal extension, ulnar or radial deviation are present,
remove splint and return to step 21.
29. Check splint dimensions.
a. The distal edge of the splint is resting on the DPC .
b. The medial edge of the splint is resting on thenar muscle border .
c. The proximal edge of the splint is resting one inch distal to the cubitum space.
30. Check patient's capillary refill.
a. Squeeze patient's fingers/toes and nail beds will turn white .
b. Release patient's fingers/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.
31. Clean plaster off patient's skin using a damp wash cloth, towel or alcohol pad.
NOTE: Use alcohol pads or fresh water from the faucet and not from the casting bucket .
32. Fit patient with sling.

33. Administer a crutch ambulation treatment if splint applied to lower extremity.( See Task 081-836-
0041 ).

34. Give patient verbal and written instruction 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 (ER).
b. Present patient with cast care booklet or some form of written instruction.
c. Instruct patient to keep leg elevated and flex and extend toes to increase circulation to the foot.
35. Annotate the procedure applied to patient in medical record or SF 513.
NOTE: Record the procedure applied and cast care instruction provide to the patient in patient's medical
record or SF 513 and sign your name.
36. 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. Gathered equipment. —— ——
7. Assembled materials. —— ——

8. Prepared splint materials. —— ——
9. Prepared Bulky Jones for lower extremity. —— ——

10. Prepared purified cotton roll ( Bulky Jones). —— ——
11. Measured patient's injured ankle with goniometer. —— ——

12. Applied purified cotton roll to the injured ankle foot and leg. —— ——

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