Page 287 - Orthopedic Casts and Splints2

APPLY A SHORT ARM CAST WITH FINGER SPLINT OUTRIGGER
081-834-0056
Conditions: Given an orthopaedic patient requiring a Short Arm Cast ( SAC) with outrigger, sitting or
supine on an orthopaedic examination bed, nursing personnel, physician, physician's verbal or written
order, patient's medical record, or Standard Form 513 (consultation form), pen , work cart/station, 6-10
inch aluminum splint , (3) rolls of 3 inch plaster, box of 4 x 15 inch plaster reinforcement sheets, (3) rolls
of 2 or 3 inch fiberglass, (3) rolls of 2 or 3 inch webril, roll of 2 or 3 inch stockinette, stockinette container,
fiberglass casting gloves, 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, tube of
surgical lubricant , orthopaedic bump, thermometer, and trash receptacle.

Standards: Is reached when the short arm cast is applied to the patient's injured arm from the distal
palmar crease/metacarpophalangeal joints to 1 inch distal to the cubitum space( bend of elbow). The
wrist is immobilized by the cast between 0-15 degrees of dorsal extension( absent of ulnar, radial,
supination or pronation). An aluminum splint is secured to the volar aspect of the cast, from 1 inch
proximal to the cast edge to 2 inches distal to the injured finger (s) . The cast restricts rotation of the
wrist with free range of motion of the elbow, thumb and uninjured fingers. Capillary refill test is
administered and passed.

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 your job title.
3. Explain the procedure to the patient.
NOTE: The Short Arm Cast ( SAC) with aluminum splint is applied from 1 inch distal to the cubitum
space( bend of elbow) to the distal palmar crease(DPC)/ metacarpophalangeal joints (MCPJ's) , with the
wrist in 0-15 degrees of dorsal extension. The cast allows complete elbow flexion and extension,
restricts wrist movement and injured fingers. The thumb and uninjured fingers will have full range of
motion (ROM).

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.

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