Page 243 - Orthopedic Casts and Splints2

Performance Steps

8. Cut the medial aspect of the cast.
NOTE: All casts are cut medial and lateral, with a few exceptions ( Long arm cast-anterior /posterior)
a. Place privacy pad or bed sheet on patient's lap or above cast area.
b. Demonstrate the cast removal process.
NOTE: Inform patient that the cast blade oscillate, it does not rotate.
c. Instruct patient to place hearing and eye protection on.
NOTE: It is the technician's responsibility to offer and encourage the patient to wear safety apparatus.
However, it is the patient's ultimate decision whether to use or not to use protective equipment .
d. Technician dons safety equipment.
NOTE: The technician must wear goggles, hearing protection .
e. Place the cast cutter plug in the electrical wall outlet.
CAUTION: The dust that is produce during the removal of the cast is a carcinogenic. All cast saws must
be attached to a cast cutter vacuum.
f. Grasp the cast cutter handle between the thumb and index finger.
g. Rest the thumb on the cast handle maintaining contact throughout the procedure.
h. Turn on the cast saw.
i. Apply pressure to the saw using an up and down motion of the wrist and lifting the blade in
the direction of the cut.
CAUTION: Do not bring the blade out of the cutting grove, do not drag the saw or leave it in one place
too long, this will cause the blade to produce friction (heat up), burn or cut the patient .

NOTE: When resistance is absent , lift the saw blade up and advance in the direction of the cut.

NOTE: Always cut in a straight line and away from the patient.
9. Cut the lateral aspect of the cast( follow step 8 ).
a. Turn the cast saw off.
b. Unplug cast cutter cord from wall outlet.
10. Separate the cast.
a. Place cast spreader edge in the pre cut line on medial and lateral aspect of cast.
b. Pull the handles together.

11. Cut the underlying cast padding.
CAUTION: Always cut away from the patient.

12. Remove the anterior and posterior shells for splint fabrication, if required.
13. Inspect patient's skin.
NOTE: Reports the presence of any unusual skin conditions such as drainage, blisters, rashes, and
pressure sores to the physician and follow physician's instruction.
14. Re-pad the cast.
a. Insert felt or webril between the cast's cut edges.
NOTE: This separation should be approximately 1/4- 1/2 inches in order to prevent window edema and
promote circulation.
NOTE: If there is a need to do a wound check, dressing change, or suture removal, the anterior part,
the posterior part, or both, are removed, lined with Webril, and replaced.
b. Place bivalved cast, if applicable, as splints to the extremity.

15. Secure the elastic bandage clips with adhesive tape.
a. Wrap the bivalved cast with an elastic bandage.
b. Secure the bandage with clips.
c. Tape clips .
16. Check patient's capillary refill.
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