Page 335 - Orthopedic Casts and Splints2

APPLY LONG DOUBLE SUGAR TONG SPLINT
081-834-0065
Conditions: Given an orthopaedic patient requiring a Long Double Sugar Tong Splint (LDSTS) sitting or
supine on a orthopaedic examination bed, nursing personnel, family member, physician, physician's
verbal or written order, patient's medical record, or Standard Form 513(consultation form), pen , work
cart/station, (4) rolls of 6 inch plaster , box of 5 x 30 inch plaster reinforcement sheets, (4) rolls of 6 inch
webril, examination gloves, scissors,(4) elastic bandages, roll of 2 inch adhesive tape, (2) hospital
pads(chux), bed sheet, pillow, disposable paper shorts or hospital gown, goniometer, ruler, tape
measure, bucket of tepid water w/ plastic bag, thermometer, cast care booklet or equivalent, box of
alcohol pads, damp wash cloth or towel, sink w/ faucet, orthopaedic bump, thigh holder, 1 pair of
crutches and trash receptacle.

Standards: Is reached when a posterior splint and medial/lateral splint are secured to the patient's
injured leg from the tips of the toes to 4 inches distal to the groin with (4) elastic bandages.The ankle is
measured at 90 degrees of dorsiflexion, absent of inversion or eversion, with toes having full range of
motion. The knee is measured between 0-15 degrees of flexion. Capillary refill test is administrated to the
toes and passed successfully.

Performance Steps

1. Receive the order from the physician( review if in writing)
2. Identify yourself to the patient.
NOTE: Tell the patient your name and job title.
3. Explain the procedure to the patient.
NOTE: The Long Double Sugar Tong splint (LDST) is applied from the tips of the toes, posteriorly up the
leg, to 4 inches distal to the groin ( inguinal region). The ankle will be dorsiflexed at 90 degrees,
absent of eversion or inversion with the knee flexed between 0-15 degrees. The toes will have full range
of motion(ROM).

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 legs.
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 supine on examination bed.
c. Remove patient pants and place a sheet over the patient's lap.
d. Inspect both legs for any skin conditions(e.g. cuts, abrasions, laceration and skin rashes).
NOTE: Inform physician if conditions are present and follow physician's instruction.
e. Examine both legs for jewelry and remove if found.
NOTE: All jewelry must be removed. Give jewelry and clothing to family member or secure with
patient's belongings in NCOIC office.
5. Check capillary refill of patient's toes.
a. Squeeze patient's toes and nail beds will turn white .
b. Release patient's toes and nail beds will return pink .
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.
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