Page 330 - Orthopedic Casts and Splints2

Performance Steps
CAUTION: If capillary refill is delayed for more than 2 seconds inform physician and follow physician's
instruction.
6. Gather equipment to include scissors, thermometer, goniometer, ruler and bucket of tepid water
w/ plastic bag. Place on work cart or station.
CAUTION: The temperature of the water must be tepid ( 70-80 degrees) to reduce further injury
(possible burns) to the patient. The technician should draw room temperature water and initially use a
thermometer to gauge water temperature.

CAUTION: The technician must change the water after each application as the residue in the cast
bucket will act as an accelerator causing the casting material to increase in heat emission.

7. Assemble materials to include webril, plaster rolls, examination gloves, hospital pad (chux), bed
sheet, sling, plaster reinforcement sheet, alcohol pads/damp towel. Open and remove (4) plaster
rolls from packages and place on work cart/station.
NOTE: Physician's order, technician's preference, availability of supplies, and/or patient's extremity size
will determine which casting material (fiberglass/plaster) will be used.
8. Prepare cast padding ( webril) for 1st splint.
a. Place work cart with orthopaedic bump at the edge of the bed.
b. Place hospital pad or bed sheet on patient's lap.
NOTE: All patient's should be given a covering( e.g. chux, bed sheet) to reduce damaging their clothing
during the casting process and for privacy.
c. Position the patient's uninjured elbow on the bump at a 90 degree angle to the floor. Locate
the DPC and MCPJ's.
NOTE: The DPC is the distal diagonal line on the volar aspect of the hand. The MCPJ's are the knuckles
on the dorsal side of the hand.
d. Measure from the MCPJ's, posteriorly around the elbow, to the DPC.
e. Place webril on work cart/station.
f. Roll out second layer and bisect the middle of the previous padding.
g. Layer the padding 2-4 thickness.

9. Prepare cast padding ( webril) for 2nd splint.
a. Measure from the base of the deltoid muscle, laterally around the elbow, to 2 inches distal to
the axilla region.
b. Place webril on work cart/station.
c. Roll out second layer and bisect the middle of the previous padding.
d. Layer the padding 2-4 thickness.
10. Prepare plaster splint for the volar and dorsal aspects of the forearm
a. Open box of 4 x 15 plaster reinforcement sheets. Remove sheets from box and unwrap
package . Peel back the edges of (10-15) sheets, remove from the stack. Place on work
cart/station.
NOTE: The technician may choose to use 4 inch plaster rolls.
b. Locate DPC and the MCPJ's .
c. Remove (1) plaster sheet from the stack of (10-15).
d. Place sheet next to uninjured arm to obtain sheet length, the DPC and MCPJ's contours.
NOTE: To increase patient cleanliness the sheet does not have to rest on the patient skin or extremity.
e. Place sheet on stack , cut excess length for all sheets, and place on work cart/station for
later use.
NOTE: Discard excess material in the trash receptacle.

11. Prepare plaster splint for the anterior and posterior aspect of the upper arm.
a. Locate the base of the deltoid muscle and 2 inches from the axilla region.
b. Remove (1) plaster sheet from the stack of (10-15).
c. Place sheet from the base of the deltoid muscle, around the elbow to 2 inches distal to the
axilla region.

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