Page 308 - Orthopedic Casts and Splints2
P. 308

Performance Steps

                  14. Place fiberglass casting gloves on hands.
                 Caution: The use of fiberglass casting gloves are mandatory to prevent the technician from receiving
                 chemical burns while applying a fiberglass cast.

                  15. Open fiberglass casting package and go to step 16.
                 NOTE: Open one fiberglass package at a time. As fiberglass roll comes in contact with the air, the roll
                 will start to cure and harden.
                  16. Apply 1st plaster/fiberglass roll.
                 NOTE: Examination gloves are recommended when using plaster to protect the technician's hands as
                 the resin in the plaster rolls may cause the skin on the hands to dry up.
                        a. Hold plaster or fiberglass roll vertically with one hand.
                 NOTE: Alternate method may be used.
                        b. With opposite hand unroll the plaster or fiberglass 1/2-1 inch and grasp edge with thumb,
                          index and middle
                 NOTE: Placing the thumb under the forward edge of the roll can also be used.
                        c. Place the plaster or fiberglass roll in bucket of tepid water and remove when bubbles cease
                          to rise.
                 CAUTION: Removing the casting material when bubbles are present ensures dry spots will be visible
                 during application. Dry spots cause integrity break down of the cast.
                        d. Squeeze the roll together(do not wring the roll).
                 NOTE: To evenly distribute the water and prevent telescoping of the roll during application gently
                 squeeze the roll inward.
                        e. Place the edge of the casting material on the ulnar styloid and begin wrapping around the
                          wrist two rotations to secure the edge .
                 NOTE: The cast is most susceptible to losing strength in the palm region. Therefore, a twitching or cut
                 method is authorized.

                 The Twisting method: As the roll is pushed through the palm pinch the sides of the plaster roll
                 together (not recommended for fiberglass) and twist . Evenly space the casting material on the webril
                 and smooth out with volar side of fingers. The twisting method provides strength to the cast .

                 The CUT method: As the roll is pushed through the palm make a horizontal cut to the proximal edge
                 of the plaster/fiberglass roll and smooth out with volar aspect of fingers or palm.The cutting method
                 provides cast cosmetics. Each technician may have their own preference to these methods.
                        f. Continue through the palm, around the phalanges, back up the forearm, ending 1/2 inch
                          proximal to the edge of the webril.
                        g. Overlap the plaster/fiberglass by 1/2 or 1/4 the previous wrap. The top of the
                          plaster/fiberglass should bisect the middle of the previous layer and present an evenly
                          applied cast.
                  17. Laminate the casting material.
                        a. Place palm of each hand on the cast.
                 CAUTION: To reduce cast indentations, which can cause pressure sore to the patient's skin under the
                 cast, keep finger tips off the cast during application and molding process. If the patient feels pressure
                 sore or hot spots developing under the cast, the cast must be removed immediately.
                        b. Rub the cast material in the direction it was applied.
                 NOTE: Laminating the cast material fills in the pores which assist it providing strength to the cast.
                        c. Continue rubbing the cast until the tone/texture changes from a glossy/creamy color to a dull
                          white color
                  18. Apply reinforcement splint to volar/dorsal aspect of cast.
                 NOTE: The reinforcement splint is used to strengthen and support the cast.
                        a. Place the splint in tepid water, wait for bubbles to subside and remove splint from water.
                        b. Squeeze the splint together to eliminate excess water.



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