Page 263 - Orthopedic Casts and Splints2

Performance Steps

6. Gather equipment to include scissors, thermometer and bucket of tepid water w/ bag. Place on
work cart or 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.

CAUTION: The technician must change the water after each application as the residue in the cast
bucket will act as an accelerator causing the casting material to increase in heat emission.
7. Assemble materials to include webril, plaster rolls, examination gloves, hospital pad (chux), bed
sheet, sling, plaster reinforcement splint, alcohol pads or damp wash towel. Place on work
cart/station.
NOTE: Physician's order, technician's preference, availability of supplies, and/or patient's extremity size
will determine which casting material (fiberglass/plaster) will be used.
8. Prepare cast padding ( webril) for Coaptation splint.
a. Place work cart with orthopaedic bump at the edge of the bed.
b. Place hospital pad or bed sheet on patient's lap.
NOTE: All patient's should be given a covering( e.g. chux, bed sheet) to reduce damaging their clothing
during the casting process and for privacy.
c. Position the patient's uninjured elbow at a 90 degree angle to the upper extremity. Locate the
ac joint and 2 inches distal to the axilla region.
CAUTION: The patient will be experiencing sever pain. Do not attempt to force the elbow to a 90 degree
angle. Simply measure and apply splint in position of comfort
d. Measure from the 1 inch proximal to the AC joint to 2 inches posteriorly around the elbow, to 2
inches distal to the axilla region.
NOTE: Instruments of measurements may vary ( e. g. tape measure, ruler, or webril).
e. Place webril on work cart/station.
f. Roll out second layer and bisect the middle of the previous padding.
g. Layer the padding 2-4 thickness.

9. Prepare plaster splint for the anterior and posterior aspect of the upper arm.
a. Open box of 4 x 15 plaster reinforcement sheets. Remove sheets from box and unwrap
package . Peel back the edges of (10-15) sheets, remove from the stack. Place on work
cart/station.
b. Remove (1) plaster sheet from the stack of (10-15)
c. Place sheet from the base of the deltoid muscle around elbow to 2 inches from the axilla
region .
NOTE: To increase patient cleanliness the sheet does not have to rest on the hand/forearm.
d. Place sheet on stack , cut excess length for all sheets, and place on work cart/station for
later use.
NOTE: Discard excess materials in the trash receptacle.

10. Measure patient's injured elbow w/ goniometer.
a. Place the stationary arm of the goniometer bisecting the lateral aspect of the humerus.
b. Place the moving arm of the goniometer bisecting the forearm.
c. Place the protractor of the goniometer on the olecranon process ( elbow ).
d. Set the elbow until the goniometer measures 90 degrees of flexion.

11. Apply splint to injured upper arm.
NOTE: Assistance may be used to secure the splint to the injured arm.
a. Place the plaster sheets in bucket of tepid water and remove when bubbles cease to rise.
b. Squeeze the sheets together to eliminate excess water.
c. Place the plaster sheets centered and 1/2 inch from the edge of the padding .
d. Laminate plaster splint.
e. Fold over the edges of the padding.
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