Page 95 - Orthopedic Casts and Splints2

Performance Steps

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NOTE: The LAC is applied from the distal palmar crease (DPC) to 2 inches distal to the axilla region
/base of the deltoid muscle, with elbow flexed at a 90 degree angle. The wrist will be place in a
neutral position (0-15 degrees dorsal extension), absent of radial, ulnar deviation, pronation, supination
with the fingers and thumb having full range of motion(ROM).(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.
a. Place examination gloves on hands.
CAUTION: Always practice Body Substance Isolation (BSI) prior to applying traction, splints or casts
to patients.
b. Inspect both arms for any skin conditions(e.g. cuts, abrasions, lacerations and skin rashes).
NOTE: Inform physician if 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 NCO office.

5. Check patient's capillary refill of both hands.
a. Squeeze patient's fingers and nail beds will turn white
b. Release patient's fingers and nail beds will return pink .
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