Page 43 - Orthopedic Casts and Splints2

Performance Steps
a. Put on examination gloves.
CAUTION: Always practice Body Substance Isolation ( BSI ) when applying traction, splints or casts
to patients..
b. Remove patient's jewelry.
CAUTION: Always have the same gender chaperone when patient's personal property/clothing are to
be removed.

NOTE: Give jewelry to family member (s), or nursing personnel.
c. Inspect both arms for any skin conditions ( e. g. cuts, abrasions, lacerations, or skin rashes
).
NOTE: Inform nurse if skin conditions are present before continuing.
d. Pad the ulnar styloid of the injured arm.
NOTE. Webril or felt may be used. Padding is used to reduce any chafing of the skin that may occur
while patient's injured arm is in Dunlop traction .

9. Check patient capillary refill of both hands.
CAUTION: Prior to starting any procedure on a patient, circulation is always checked.
a. Squeeze the patient's fingers and the nail beds will turn white.
b. Release the patient's fingers and the nail beds will return pink .
CAUTION: If capillary refill is delayed for more than 2 seconds inform physician and follow physician's
order.
10. Apply skin adherent to patient's injured arm.
Note: The technician should use tincture of benzoin/mastisol adhesive in conjunction with
adhesive/non adhesive vent foam straps.
a. Ask patient if they have ever had a skin rash after use of benzoin or after eating shell fish.
NOTE: If patient is unable to answer, ask family member. If family member is not present use a
substitute application ( mastisol ).
b. If no known allergies exists apply tincture of benzoin to the medial/lateral aspect of the
injured arm beginning one finger width below the cubitum space and ending at the wrist.
c. If known allergies exists apply mastisol as in step 10 b.
11. If using the Nelson finger exerciser go to step 13.

12. If using adhesive vent foam with spreader block go to step 14.
13. Secure adhesive vent foam strap with Nelson finger exerciser to injured arm.
NOTE: The adhesive vent foam strap should rest 1 inch distal to the cubitum space .
a. Have the patient hold the handle of the Nelson finger exerciser .
NOTE: The square end of the Nelson finger exerciser should point toward the head of the bed, with
the patient's thumb aligned with the humerus.
b. Place vent foam strap beginning one inch distal to the cubitum space, up the volar side of
the forearm, continuing distal to the hand, resting on the base of the Nelson exerciser and
ending on the dorsal side of the forearm opposite the start.
c. Place the edge of the elastic bandage on the ulnar styloid and begin wrapping around the
wrist two rotations to secure the edge.
d. Fold down and hold excess ends of the vent foam strap while continuing to wrap the elastic
bandage until the vent foam strap is completely covered and secure with clips.
e. Tape the elastic bandage between the clips.
f. Remove the clips and dispose in trash receptacle.
14. Secure adhesive vent foam strap with spreader block to injured arm.
a. Place vent foam strap beginning one inch distal to the cubitum space, up the volar side of
the arm, continuing distal to the hand and ending on the dorsal side opposite the start.
b. Place the edge of the elastic bandage on the ulnar styloid and begin wrapping around the
wrist two rotations to secure the edge.

40