Page 250 - Orthopedic Casts and Splints2

WEDGE A CAST
081-834-0045
Conditions: Given an orthopaedic patient with a casted extremity sitting or supine on a orthopaedic
examination bed, family member, nursing personnel, physician, physician's verbal or written order,
patient's medical record, or Standard Form 513(consultation form), marking pen, cast cutter with vacuum,
cast spreader, cast bender( duck bills), (3) packages of disposable foam ear plugs, (3) safety goggles,
work cart/station, fiberglass casting gloves, examination gloves, scissors, roll of 2 inch adhesive tape, (2)
elastic bandages, (2) 3 or 4 inch fiberglass/plaster rolls, (2) hospital pads(chux), bed sheet, pillow,
ruler, tape measure, bucket of tepid water w/ plastic bag, box of alcohol pads, damp wash cloth or
towel, sink w/ faucet, tube of surgical lubricant, orthopaedic bump, thermometer and (2) plastic or
wooden spacers.

Standards: Is reached when the physician has drawn a transverse line on the cast and the outline is cut
or segment of fiberglass/plaster removed. A cast spreader is used to open the segment and a
(plastic/wooden)spacer is inserted . With successful placement of spacer and correct angulation of the
fracture the spacer is secured by plaster/fiberglass roll or elastic bandage . Capillary refill is administrated
to the phalanges and passed successfully.

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 physician will draw a line on the cast and a portion of the cast will be removed or a
plastic/wooden spacer inserted.
CAUTION: This is a very painful procedure for the patient. Make every attempt to do this procedure in a
treatment room away from other patients.
4. Inspect cast.
a. Place examination gloves on hands.
CAUTION: Always practice Body Substance Isolation (BSI) prior to applying traction, splints or casts to
patients.
b. Ask patient if cast was exposed to water, cast padding was pulled out, or the location of
wound.
NOTE: Depending on the length of time the cast has been on, the technician should touch the cast
looking for soft spots, missing webril, cast exposed to water or location of wound.

5. Gather equipment to include cast saw with vacuum, cast spreader, ear plugs, safety goggles,
scissors, elastic bandages, bucket of tepid water w/ plastic bag. Place on work cart/station.
CAUTION: The temperature of the water must be tepid ( 70-80 degrees) to reduce further injury
(possible burns) to the patient. The technician should draw room temperature water and initially use a
thermometer to gauge water temperature.

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