Page 305 - Orthopedic Casts and Splints2

Performance Steps

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Lateral view of Cobra Cast

NOTE: The Short Arm Cobra cast will be applied from the 1 inch distal to the tips of the phalanges to
1inch distal to the cubitum space with wrist between 0-15 degrees of dorsal extension. The phalanges
will be flexed between 70-90 degrees. The wrist will be absent of radial, ulnar deviation, pronation,
supination with the thumb having full range of motion(ROM).(Refer to Figure 3-x).

CAUTION: During splinting application a chemical response(exothermic reaction) will occur between
the water (H2O) and the plaster (gypsum). This is a safe and common occurrence. The splint 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 splint may need to be removed.

4. Inspect patient's arms.
a. Place examination gloves on hands.
CAUTION: Always practice Body Substance Isolation (BSI) prior to applying traction, splints or casts
to patients.
b. Place patient sitting or supine on examination bed.
c. 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.
d. 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 capillary refill of patient's hands/fingers.
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