Page 86 - Orthopedic Casts and Splints2

Performance Steps

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Plaster Muenster

NOTE: The Muenster cast is applied from the distal palmar crease(DPC)/ metacarpophalangeal joints
(MCPJ's) to 1 inch distal to the cubitum space (bend of arm) with flanges(side supports) 3 inches
proximal to the elbow(olecranon). The cast allows complete elbow flexion and extension and restricts
rotation of forearm The fingers and thumb will have full range of motion ( refer to Figure 3-x).

CAUTION: During cast application a chemical response(exothermic reaction) will occur between the
water(H2O) and the plaster ( gypsum). This is a safe and common occurrence. The cast 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 cast may need to be removed.

4. Inspect patient's arms.
CAUTION: Always practice Body Substance Isolation (BSI) prior to applying traction, splints or casts to
patients.
a. Put on examination gloves.
b. Inspect both arms for any skin conditions(e.g. cuts, abrasions, laceration and skin rashes).
NOTE: Inform physician if skin conditions are present and follow physician's instruction.
c. Examine both arms and wrists for jewelry and remove if found.
NOTE: All jewelry on fingers and wrists must be removed. Give jewelry to family member or secure
with patient's belongings in NCOIC office.

5. Check patient's capillary refill.
a. Squeeze patient's fingers and nail beds will turn white

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