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VOLUME 1: Short Arm Cast

 Application Considerations  Dangers & Complications  Step-by-Step Application Instructions  Cast Removal  Summary  Disclaimer

Application Considerations (

Casting is “ART”)

 To achieve its function, the finished cast must “fit” like a glove and be the appropriate “dimensions” as determined by the injury.

 The artist must understand what he or she is trying to create.

 Every step has a purpose.

 The artist must understand and be able to control the materials he or she is using.

Dangers & Complications

The unyielding nature of rigid casting materials leads to two potential serious dangers: 

Pressure



Constriction

Dangers & Complications Pressure

 Special attention must be paid to bony prominences and superficial peripheral nerves by applying extra padding to these areas.

 Care must be taken when molding the cast to prevent the indention of the material and the creation of a pressure point.

Dangers & Complications

Constriction  From Without – resulting from the improper application of the casting material (wrapping too tight).

 From Within – resulting from excessive swelling that occurs after cast application.

Dangers & Complications

Prevention – “RICE” R – Rest I – Ice C – Compression E – Elevation

Dangers & Complications

Warning Signs – 4 P’s  Pain  Pallor (pulseless)  Poikilothermia (cool)  Paresthesia / Paralysis

Step-by-Step Application Instructions (Short Arm Cast)

Gather your supplies.

Stockinet Padding Gloves Casting Tape

Cut stockinet to assure “fit” and “dimensions.” Functional End (Single Layer) Comfort End (Double Layer)

Apply a double layer of stockinet to the thumb to fold back over the fiberglass before the final wrap.

Apply the padding so that the “dimensions” are established and the “fit” is retained.

Two Fingers from the Crease of the Elbow Distal Palmar Crease

Begin wrapping spirally without exposing the roll to water.

Before passing through the web-space, cut the casting tape to avoid material build-up.

Wrap a second time around the hand and through the web-space, cutting as before.

Proceed wrapping up the arm, overlapping by one-half.

When you reach the proximal end of the cast, cut off the remaining roll and place it on the foil pouch.

Roll back the stockinet distally, proximally, and around the thumb.

Complete one final pass through the web-space using the cut technique and covering all edges of the rolled back stockinet.

Smooth and mold to finish the cast.

Dip the remaining roll in water and begin wrapping from the proximal end covering the edge of the rolled back stockinet .

Cast Removal

 Follow normal safety precautions for use of a power tool.  Always use a sharp blade for cutting efficiency.

 The blade should be kept perpendicular to cast surface.

 The blade should penetrate straight down through the casting material and then be brought out. This should be done repeatedly for the length of the cut.

Summary

 Understand the potential dangers and complications before you begin.

 The “fit” and “dimensions” are established with the stockinet, padding and proper molding.

 Understand how to control the materials you use so you stay in control of the process.

 Everything you do should have a purpose.

 Practice – Practice – Practice.

Disclaimer

The information provided on this CD is general medical information and not medical advice. The treating physician must use his or her professional judgment in selecting proper treatment and is responsible for the appropriate application of casts and splints.

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