Page 98 - Orthopedic Casts and Splints2

Performance Steps
a. Place the stationary arm of the goniometer horizontally , bisecting the middle of the humerus
and deltoid
b. Place the moving arm of the goniometer vertically , bisecting the middle of the forearm and
the 2nd and 3rd phalanges..
c. Place the protractor of the goniometer on the olecranon( elbow), forming a 90 degree angle.
d. Set elbow until the goniometer measures 90 degrees of flexion
15. Apply cast padding (webril) to injured arm.
CAUTION: If the cast padding is wrinkled it must be removed and new padding applied. Wrinkled
padding can cause pressure sores which can lead to ulcers
a. Hold the roll with one hand.
b. With opposite hand unroll the cast padding 1/2 -1 inch and grasp edge with thumb, index
and middle fingers.
c. Place webril end on the ulnar styloid and begin wrapping around the wrist two rotations.
NOTE: The webril application is started at the wrist to provide an anchor and extra padding to the ulnar
styloid.
CAUTION: Keep the cast padding on the extremity throughout the application to avoid circulation
compromise of the patient's hand/fingers.
d. Continue through the palm ending 1/2 inch distal to the edge of the stockinette, back up the
forearm, figure eight around the elbow, ending 1/2 inch proximal to the edge of the
stockinette.
e. With each turn overlap the webril by 1/2- 1/4 from the previous wrap. The top of the webril
should bisect the middle of then previous layer covering up the shallow line and present
evenly applied padding.
NOTE: The cast padding can be cut or torn (horizontally ) when wrapping through the palm and elbow
to provide a better fit. The technician preference will determine which technique to use.
16. Prepare casting materials.
a. If using fiberglass casting materials go to step 17 and 18.
b. If using plaster casting materials go to step 19.
17. Place fiberglass casting gloves on hands.
CAUTION: The use of fiberglass casting gloves are mandatory to prevent the technician from receiving
chemical burns while using fiberglass casting materials
18. Open fiberglass casting package and go to step 19.
NOTE: Open one fiberglass package at a time. As the fiberglass roll comes in contact with the air, the
roll will start to cure and harden.

19. Apply 1st plaster/ fiberglass roll.
NOTE: Examination gloves are recommended to protect the technician's hands as the resin in the
plaster may cause the skin on the hands to dry up.
a. Hold plaster or fiberglass roll with one hand.
NOTE: Alternate method may be used.
b. With opposite hand unroll the plaster/fiberglass 1/2 -1 inch and grasp edge with thumb, index
and middle fingers.
NOTE: Placing the thumb under the forward edge of the roll can also be used.
c. Place the plaster or fiberglass roll in bucket of water and remove when bubbles cease to
exist.
CAUTION: Removing the casting material when bubbles are present ensures dry spots will be visible
during application. Dry spots cause integrity break down of the cast.
d. Squeeze the roll together( do not wring the roll).
NOTE: To evenly distribute the water and prevent telescoping of the roll during application gently
squeeze the roll inward.

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