Page 346 - 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 wash cloth or towel. Open and remove (2)
plaster rolls from packages and place on work cart/station.

8. Prepare cast padding ( webril) for thumb Spica 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 tip of the thumb to 1 inch distal to the cubitum space.
NOTE: Instruments of measurements may vary ( e.g. tape measure, ruler or webril)
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.
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. Apply thumb spica splint to injured thumb.
NOTE: Assistance(e.g. family member or nurse) may be used prior to securing splint.
a. Position the patient's injured thumb in opposition to the index finger.
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.
NOTE: Do not wring the sheet, this will cause the roll to dry up quickly
d. Place the plaster sheets centered and 1/2 inch from the edge of the padding .
e. Laminate plaster splint.
f. Fold over the edges of the padding.
g. Place additional layer of padding over folded edges.
h. Place the padded splint from the tip of the injured thumb to 1 inch distal to the cubitum space.
12. Secure thumb Spica splint to injured thumb and arm.

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