Page 274 - Orthopedic Casts and Splints2

Performance Steps

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

29. Clean plaster resin off patient's skin using a damp wash cloth, towel or alcohol pad.
NOTE: Use alcohol pad or fresh water from the faucet and not from the casting bucket.

30. Apply cast shoe.
31. Administer a crutch ambulation instruction ( See task number 081-836-0041)
32. Give patient verbal and written instructions on cast care.
a. Instruct 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 number. 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 keep leg elevated and flex and extend toes to increase circulation in the
foot.
d. Instruct patient not to stick anything down the cast, do not remove the cast, and do not alter
the cast ( e. g. writing or coloring the cast).
e. Instruct patient to use crutches and not to place any pressure on the cast for 24-48 hours.

33. Annotate patient's medical record or SF 513.
NOTE: Record the procedure applied and cast care instruction provided to the patient in patient's
medical record or Standard Form 513 and sign your name.
34. Escort patient to front desk to make a follow up appointment.

Evaluation Preparation:

Performance Measures GO NO GO

1. Received or reviewed the order from the physician. —— ——
2. Identified yourself to patient. —— ——

3. Explained the procedure to patient. —— ——
4. Inspected injured leg/ankle with patient supine on the examination bed. —— ——

5. Checked patient's capillary refill. —— ——
6. Gathered equipment. —— ——

7. Assembled materials. —— ——
8. Prepared stockinette. —— ——
9. Prepared plaster reinforcement splint (posterior). —— ——

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