Page 323 - Orthopedic Casts and Splints2

Performance Steps

15. Apply cast padding( webril) to injured thumb, wrist and forearm.
CAUTION: If the cast padding is wrinkled it must be removed and new padding applied. Wrinkled padding
can cause pressure sores which can lead to ulcers
a. Hold webril with one hand.
b. With 2nd hand unroll the webril 1/2 - 1inch and grasp edge with index and middle finger .
c. Place the edge of the webril on the ulnar styloid and begin wrapping around the wrist two
rotations.
NOTE: The webril application is started at the wrist to provide an anchor and extra padding to the ulnar
styloid.

CAUTION: Keep the cast padding on the extremity throughout the application to avoid circulation
compromise of the patient's hand/fingers.
d. Continue through the palm around the thumb ending 1/2 inch distal to the edge of the
stockinette, back up the forearm, figure eight around the elbow, ending 1/2 proximal to the
edge of the stockinette.
e. With each turn overlap the webril by 1/2-1/4 the previous wrap. The top of the webril should
bisect the middle of the previous layer covering up the shallow line and present evenly
applied padding.
NOTE: The cast padding can be cut or torn (horizontally ) when wrapping through the palm and around
the thumb to provide a better fit. The technician preference will determine which technique to use.
16. Prepare casting materials.
a. If using fiberglass casting materials go to step 17 and 18.
b. If using plaster casting materials go to step 18.

17. Place fiberglass casting gloves on hands.
CAUTION: The use of fiberglass casting gloves are mandatory to prevent the technician from receiving
chemical burns while using fiberglass casting materials
18. Open fiberglass casting package and go to step 19.
NOTE: Open one fiberglass package at a time. As the fiberglass roll comes in contact with the air, the roll
will start to cure and harden.
19. Apply 1st plaster/ fiberglass roll.
NOTE: Examination gloves are recommended to protect the technician's hands as the resin in the plaster
may cause the skin on the hands to dry up.
a. Hold plaster or fiberglass roll vertical 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 fingers.
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 .

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