Page 251 - Orthopedic Casts and Splints2

Performance Steps

6. Assemble materials to include webril, plaster or fiberglass rolls, plaster
splints(4x15/5x30),examination gloves, fiberglass casting gloves, plastic or wood wedges. Open
and remove (2) plaster rolls from packages, (2) plaster reinforcement sheets and place on work
cart/station.
7. Open wedge go to step 9.

8. Closed wedge go to step 10.
9. Open wedge.
NOTE: The physician will determine where to place the wedge and size used.
a. Place hospital pad or bed sheet on patient's lap or above cast area.
b. Physician will draw a line on the cast
NOTE: Determining where the line is drawn is the responsibility of the physician.
c. Explain the cast wedge process to patient.
NOTE: Inform patient that the cast will be cut and a wedge(plastic or wooden) will be inserted to assist
with bone alignment. The cast blade oscillate(vibrates) it does not rotate reducing burns or cuts caused
by the blade.
d. Instruct patient to use hearing and eye protection .
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 the protective equipment .
e. Technician dons safety equipment.
NOTE: The technician must wear goggles, hearing protection .

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. Place cast saw plug in the wall outlet.
g. Grasp the cast saw handle between the thumb and index finger.
h. Turn the cast saw on.
i. Apply pressure to the saw using an up and down motion of the wrist and lifting the blade in the
direction of the marked outline.
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 heat up, burn or cut the patient. Always cut away from 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.
j. Turn the cast saw off.
k. Unplug cast saw cord from wall outlet.
l. Place edge of cast spreader in the cut section of plaster and pull handles together.
m. Place wooden or plastic block in cut section of cast.
NOTE: Physician will place wedge in cut section.
n. Remove cast spreader when block is implanted.
o. Secure block with elastic bandage or casting material.
NOTE: It is the physician's preference to use elastic bandage or casting material.
10. Closed wedge.
a. The physician draws a line circumferential around the cast leaving 2-3 inches distance from the
drawn edges
NOTE: Physician will determine where specifically the lines are drawn and the distance between the
lines.
b. Nursing assistant grasps the distal edge of casted extremity of the patient.
NOTE: Grasping the distal edge of the extremity provides traction to the fractured bone prior to cast
manipulation.
c. Patient is offered hearing and eye protection

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