Page 341 - Orthopedic Casts and Splints2

Performance Steps
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 (2) plaster
rolls from packages and place on work cart/station.
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 (2) plaster rolls from
packages and place on work cart/station.

8. Prepare cast padding ( webril) for radial gutter 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 45 degree angle to the floor.
d. Measure from 1 inch distal to the tips of 1st and 2nd phalanges to 1 inch distal to the cubitum
space.
NOTE: Measuring devices such as webril, tape measure or plaster sheets may be used.
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 plaster splint for the radial side of the hand and 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. Remove (1) plaster sheet from the stack of (10-15).
c. Place sheet next to uninjured arm to obtain sheet length.
NOTE: To increase patient cleanliness the sheet does not have to rest on the hand/arm.
d. 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.

10. Measure patient's injured wrist w/ goniometer.
a. Position the patient's injured elbow on the bump at a 45 degree angle to the upper extremity.
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.
11. Measure patient's 1st and 2nd phalanges w/ goniometer.
a. Place the stationary arm of the goniometer bisecting the lateral aspect of the radius.
b. Place the moving arm of the goniometer bisecting the 1st phalange.
c. Place the protractor of the goniometer on the radial styloid.
d. Set the injured phalanges until the goniometer measures between 70-90 degrees of flexion.

12. Apply radial gutter splint to injured hand/arm.
NOTE: Assistance may be used prior to securing splint.
a. Place a strip of webril between the injured phalanges.
b. Place the plaster sheets in bucket of tepid water and remove when bubbles cease to rise.
c. Squeeze the sheets together to eliminate excess water.
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