Page 340 - Orthopedic Casts and Splints2

APPLY RADIAL GUTTER SPLINT
081-834-0066
Conditions: Given an orthopaedic patient requiring a Radial Gutter Splint, sitting or supine on a
orthopaedic examination bed, family member, nursing personnel, physician's verbal or written order,
patient's medical record, or Standard Form 513(consultation form), pen , work cart/station, (2) rolls of 4
inch plaster, box of 4 x 15 inch plaster reinforcement sheets, (2) rolls of 4 inch webril, (2) 2 inch
elastic bandages, examination gloves, scissors, roll of 2inch adhesive tape, (2) hospital pads (chux),
bed sheet, goniometer, ruler, tape measure, bucket of tepid water w/ plastic bag, sling, cast care booklet
or equivalent, box of alcohol pads, damp wash cloth or towel, sink w/ faucet, orthopaedic bump,
thermometer and trash receptacle.

Standards: Is reached when a splint is secured to the patient's injured arm from the tip of the index and
middle fingers to 1 inch distal to the cubitum space by (2) elastic bandages. The wrist is measured
between 0-15 degrees of dorsal extension(absent of ulnar or radial deviation, pronation or supination).
The immobilized fingers are measured between 70-90 degrees of flexion with the thumb, ring and pinky
fingers having full range of motion. Capillary refill test is administered to fingers and thumb and
successfully passed.

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 Radial gutter splint (RGS) is applied from the tip of the index and middle phalanges to 1 inch
distal to the cubitum space. The injured phalanges will be flexed between 70-90 degrees, with the wrist
between 0-15 degrees of dorsal extension and absent of radial, ulnar deviation, pronation and
supination. The uninjured fingers and thumb 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 arms.
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 sitting or supine on examination bed.
c. Roll patient's shirt sleeve above elbow on injured side.
d. Inspect both arms 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 arms and wrists for jewelry and remove if found.
NOTE: All jewelry on both hands and wrist must be removed. Give jewelry to family member or secure
with patient's belongings in NCOIC office.
5. Check capillary refill of patient's hands/fingers.
a. Squeeze patient's fingers and nail beds will turn white .
b. Release patient's fingers 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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