Page 331 - Orthopedic Casts and Splints2

Performance Steps
d. Place sheet on stack , cut excess length for all sheets, and place on work cart/station for
later use.
12. Measure patient's injured wrist w/ goniometer.
a. Position the patient's injured elbow on the bump at a 90 degree angle to the upper torso.
b. Place the stationary arm of the goniometer bisecting the lateral aspect of the ulnar.
c. Place the moving arm of the goniometer bisecting the 5th phalange.
d. Place the protractor of the goniometer on the ulnar styloid.
e. Set the wrist until the goniometer measures between 0-15 degrees of dorsal extension.
13. Measure patient's injured elbow w/ goniometer.
a. Place the stationary arm of the goniometer bisecting the lateral aspect of the humerus.
b. Place the moving arm of the goniometer bisecting the forearm.
c. Place the protractor of the goniometer on the olecranon process ( elbow ).
d. Set the elbow until the goniometer measures 90 degrees of flexion.
14. Apply 1st splint to injured wrist and forearm.
NOTE: Assistance may be used prior to securing splint.
a. Place the plaster sheets in bucket of tepid water and remove when bubbles cease to rise.
b. Squeeze the sheets together to eliminate excess water.
NOTE: Do not wring the sheet, this will cause the roll to dry up quickly
c. Place the plaster sheets centered and 1/2 inch from the edge of the padding .
d. Laminate plaster splint.
e. Fold over the edges of the padding.
f. Place additional layer of padding over folded edges.
g. Place the padded splint from the base of the MCPJ's posteriorly around the elbow to the DPC.

15. Apply 2nd splint to injured upper arm.
NOTE: Assistance (nurse, family member ) may be used to secure the 1st splint, during 2nd splint
application.
a. Place the plaster sheets in bucket of tepid water and remove when bubbles cease to rise.
b. Squeeze the sheets together to eliminate excess water.
c. Place the plaster sheets centered and 1/2 inch from the edge of the padding .
d. Laminate plaster splint.
e. Fold over the edges of the padding.
f. Place additional layer of padding over folded edges.
g. Place the padded splint from the base of the deltoid muscle down the arm over the elbow,
posteriorly up the arm, ending 2 inches from the axilla region.
NOTE: The elbow should be flexed at 90 degrees.

16. Secure DSTS to injured arm.
a. Hold elastic roll with one hand.
b. Place the edge of the elastic bandage on the ulnar styloid and begin wrapping around the wrist
two rotations to secure the edge .
c. Continue through the palm, back up the forearm, figure of eight around the elbow, to the axilla
region.
d. Secure elastic bandage with clips.
e. Tape down the elastic bandage between the clips.
f. Remove the clips and dispose in trash receptacle.

17. Mold splint to forearm/wrist.
NOTE. The interosseous mold is used to prevent movement of the wrist in the cast and promote fracture
healing .
a. Place the heel of one hand on the volar aspect of the distal wrist.
b. Place the heel of the second hand on the dorsal aspect of the distal wrist.
c. Squeeze the heels of each hand together.

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