Page 278 - Orthopedic Casts and Splints2

Performance Steps

3
Quadrilateral Weight Bearing Cast

NOTE: The Quadrilateral Thigh Bearing cast is applied from 4 inches distal to the groin( on the medial
side) and flared 3 inches proximal to the greater trochanter( on the lateral side) to the web spacing of
the toes with ROM hinges applied to the injured knee to promote range of motion .
(Refer to Figure 3-x).
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 injured leg/ankle.
a. Place examination gloves on hands.
CAUTION: Always practice Body Substance Isolation (BSI ) prior to applying traction, splints or casts
to patients.
b. Remove patient's shoes, socks and pants.
NOTE: Provide patient with paper shorts or hospital scrubs. If unavailable, cut the pants at the seam.
c. Inspect patient's injured leg for any skin conditions ( e. g. cuts, abrasions, lacerations and
skin rashes ).
NOTE: Inform physician if any of the above conditions are present and follow physician's order.
d. Examine both legs for jewelry and remove if found.
NOTE: All jewelry must be removed. Give jewelry to family member or secure with patient's belongings
in NCOIC office.

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