Page 350 - Orthopedic Casts and Splints2

Performance Steps

6. Gather equipment to include scissors, thermometer, goniometer, ruler and bucket of tepid water
w/ plastic bag. Place on work cart or station.
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 or damp wash cloth or towel. Open and
remove (6) plaster rolls from packages and place on work cart/station.
NOTE: Physician's order, technician's preference, availability of supplies, and/or patient's extremity size
will determine which casting material (fiberglass/plaster) will be used.
8. Prepare cast padding ( webril) for 1st splint.
a. 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.
b. Locate the fibula head on the uninjured leg.
CAUTION: The peroneal nerve is located on the lateral side of the knee. If constricted the nerve may die
and cause drop foot( known as nerve palsy ). This is an irreversible condition. Pad the area to prevent
further injury to the patient.
c. Place the uninjured knee between 0-15 degree of flexion.
d. Measure from 4 inches distal to the groin to 2 inches proximal to the medial malleolus.
NOTE: Instruments of measurements may vary ( e. g. tape measure, ruler or webril)
e. Place measure webril on work station/cart.
f. Roll out second layer and bisect the middle of the previous padding.
g. Layer the padding 2-4 thickness.
9. Prepare cast padding ( webril) for 2nd splint.
a. Measure from 2 inches distal to the greater trochanter to 2 inches proximal to the lateral
malleolus.
b. Roll out second layer of padding and bisect the middle of the previous padding.
c. Layer the padding 2-4 thickness.

10. Prepare plaster sheets.
a. Open box of 5 x 30 inch plaster reinforcement sheets. Remove and unwrap package. Locate
edge of six stacks and remove from package. Place on work cart/station.
b. Place (3) stack of sheets on each padding and cut excess as needed.
11. Measure patient's injured knee w/ goniometer.
NOTE: There are several ways to maintain the knee at 0-15 degree of flexion. The patient could maintain
the position, nursing personnel or family member can assist, or a orthopaedic bump placed under the
heel could be used. It is the technician's preference.
a. Place orthopaedic bump under patient's heel of the injured leg .
CAUTION: Depending on the orthopaedic device used, the circulation to the toes and foot may be
constricted. Always communicate with the patient and remove device if patient complains about toes
falling asleep or technician observes a color change in the foot.
b. Place the stationary arm of the goniometer bisecting the lateral aspect of the femur.
c. Place the moving arm of the goniometer bisecting the fibula.
d. Place the protractor of the goniometer on the lateral aspect of the knee.
e. Set the knee until the goniometer measures between 0-15 degrees of flexion.
12. Apply medial splint to injured leg.
NOTE: Assistance may be used prior to securing

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