Page 262 - Orthopedic Casts and Splints2

APPLY A COAPTATION SPLINT
081-834-0047
Conditions: Given an orthopaedic patient requiring a Coaptation splint , 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), pen , work cart/station, (3) rolls
of 4 inch plaster , box of 4 x 15 inch plaster reinforcement sheets, (3) rolls of 4 inch webril,
examination gloves, scissors, roll of 2 inch adhesive tape, (2) hospital pads(chux), bed sheet, pillow,
goniometer, ruler, tape measure, bucket of tepid water w/ plastic bag, sling, cast care booklet or
equivalent, box of alcohol pads, damp wash cloth or towel, sink w/ faucet, orthopaedic bump,
thermometer and trash receptacle.

Standards: Is reached when the injured humerus/shoulder are immobilized with the Coaptation splint 1
inch superior to the acromioclavicular joint( AC joint ) anteriorly around the elbow, ending posteriorly 2
inches distal to the axilla region, with the elbow at a 90 degree angle. The splint restricts rotation of the
humerus, shoulder and elbow, with hand, thumb and fingers having full range of motion. Capillary refill
test is administered to the fingers and passed successfully.

Performance Steps
1. Receive the order from the physician (review if in writing)

2. Identify yourself to patient.
NOTE: Tell the patient your name and job title.
3. Explain the procedure to the patient.
NOTE: The Coaptation splint is applied from 1 inch superior to the acromioclavicular joint (AC joint) to 2
inches distal to the axilla region with the elbow flexed at a 90 degree angle. The splint allows full range
of motion of the wrist , fingers and thumb with limited motion of the forearm and restrictive motion of the
humerus.

CAUTION: During cast application a chemical response(exothermic reaction) will occur between the
water(H2O) and the plaster ( gypsum). This is a safe and common occurrence. The cast will initially
become warm and cool down within 2-5 minutes. However, if it doesn't cool down or there is an increase
of heat intensity during the cast application, the cast may need to be removed.

4. Inspect patient's upper extremities.
a. Place examination gloves on hands.
CAUTION: Always practice Body Substance Isolation (BSI) prior to applying traction, splints or casts to
patients.
b. Inspect both arms for any skin conditions(e.g. cuts, abrasions, laceration and skin rashes).
NOTE: Inform physician if conditions are present and follow physician's instruction.
c. Examine both arms and wrists for jewelry and remove if found.
NOTE: All jewelry on both hands and wrist must be removed. Give jewelry to family member or secure
with patient's belongings in NCOIC office.

5. Check patient's capillary refill.
a. Squeeze patient's fingers and nail beds will turn white .
b. Release patient's fingers and nail beds will return pink .
CAUTION: If capillary refill is delayed for more than 2 seconds inform physician and follow physician's
instruction.

259