Page 356 - Orthopedic Casts and Splints2

Performance Steps

8. Gather equipment to include finger traps with stand, scissors, padded felt with stockinette, (2)
5lb weight plates, weight carrier. Place on work cart/station.
9. Assemble materials to include; examination gloves, traction cord, padded felt w/ stockinette and
place on work cart/station.
10. Apply finger traps to fingers on injured hand .
NOTE: Use of finger traps may be required based on patient's inability to maintain arm/wrist in the
correct position, there is no assistance available, and fracture reduction is needed.
a. Remove patient's shirt.
b. Place patient supine on bed with humerus off the bed.
NOTE: To prevent the patient from falling off the bed, position the patient's legs towards the
opposite corner of bed.
c. With one hand, grasp patient's injured hand and abduct from upper torso.
d. With 2nd hand, grasp finger trap set and place individual finger traps on fourth and fifth
phalange past the metacarpophalangeal joints( MCPJ's)
NOTE: Physician's order will determine which phalanges are used.
11. Measure injured wrist between 0-15 dorsal extension
a. Place the stationary arm of the goniometer vertically, bisecting the ulnar side of the forearm.
b. Place the moving arm of the goniometer vertically , bisecting the lateral side of the 5th
phalange ( pinky finger ).
c. Place the protractor of the goniometer on the ulnar styloid.
d. Set wrist until the goniometer measures 0-15 degrees of dorsal extension.

12. Place padded stockinette on biceps muscle of injured arm.
13. Attach the weight carrier hook through perforated holes on the stockinette.

14. Apply the weight plates to weight carrier.
NOTE: Physician will determine amount of weight plates to use.

NOTE: Inform patient prior to adding or removing weight plates.
15. Inspect distance of patient's humerus suspended off the bed.
NOTE: If patient's humerus is touching the bed, remove weight plates and adjust patient's arm.
16. Check capillary refill of patient's 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.
17. Refer to task 081-834-0002 for casting application.

Performance Measures GO NO GO

1. Received the order from the physician( reviewed if in writing) —— ——
2. Identified yourself to the patient. —— ——

3. Positioned the patient (supine) in the middle of the bed. —— ——
4. Explained the procedure to the patient. —— ——
5. Inspected patient's arms. —— ——

6. Checked capillary refill of patient's fingers. —— ——

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