Page 345 - Orthopedic Casts and Splints2

APPLY THUMB SPICA SPLINT
081-834-0067
Conditions: Given an orthopaedic patient, requiring a Thumb Spica Splint, sitting or supine on a
orthopaedic examination bed, family member, nursing personnel, physician, 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 the splint is secured to the patient's injured arm from the tip of the thumb 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 thumb is
in direct opposition to the index finger with all 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 Thumb Spica splint (TSAS) is applied from tip of the thumb to 1 inch distal to the cubitum
space, with the wrist between 0-15 degrees of dorsal extension and absent of radial, ulnar deviation,
pronation and supination. The fingers will have full range of motion(ROM) with the thumb having
restricted movement.

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. 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.
d. 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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