Page 252 - Orthopedic Casts and Splints2

Performance Steps
NOTE: Patient's are always offered hearing and eye protection prior to cast removal.
d. Plug the cast saw plug in the wall outlet.
e. Turn the cast saw on.
f. 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.
g. Turn the cast saw off.
h. Remove section of casting material.
i. Close the wedge.
NOTE: The physician will close the wedge.
j. Apply fiberglass, plaster roll or plaster splint to closed wedge.
11. Check patient capillary refill.
a. Squeeze patient's phalanges and nail beds will turn white .
b. Release patient's phalanges and nail beds will return pink .
CAUTION: If capillary refill is delayed for more than 2 seconds inform physician and follow physician's
instruction.

12. Give patient verbal and written instruction on cast care.
a. Instruct the 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 numb. 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 extend, flex, and wiggle fingers ( demonstrate for patient) to reduce swelling.
d. Instruct patient not to stick anything down the cast, do not remove the cast, and do not alter the
cast ( e. g. writing on it, coloring )
13. Annotate the procedure.
NOTE: Record the procedure applied and cast care instruction provided to patient in medical record or
Standard Form 513 and sign your name.
14. Escort patient or direct family member 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 the patient. —— ——

3. Explained the procedure to the patient. —— ——
4. Inspected cast. —— ——

5. Gathered equipment. —— ——
6. Assembled materials. —— ——
7. Opened wedge procedure —— ——

8. Closed wedge procedure —— ——
9. Checked patient capillary refill. —— ——

10. Gave patient verbal and written instruction on cast care. —— ——

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