Cast

CASTING

Types of CASTS

1. Plaster Casts ( POP) – mold very smoothly to the

body contour.2. Non Plaster/ Synthetic Casts–

fiberglass casts that are commonly used today

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CASTS & MOLDSShort arm circular cast – wrist and fingerShort arm posterior mold- wrist and finger with compound affectionLong arm circular cast- radius/ ulnaFuenster’s or munster’s cast- radius/ ulna with callus formation.Long arm posterior mold- fx of radius & ulna w/ compound affection

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CASTS & MOLDSHanging cast shaft of humerusFunctional arm cast – humerus (allows abduction & adduction)Shoulder spica – humerus and shoulder jointAirplane – humerus and shoulder compound affection

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CASTS & MOLDSRizzer’s jacket – scoliosisMinerva – upper dorsal cervical spine1 & ½ hip spica – hip & femurBody cast – lower dorso-lumbar spineDouble hip spica – hip & femurLong leg cast- tibia, fibulaLong leg posterior mold- fx of the tibia & fibula w/ compound affectionBasket – severe leg trauma w/ open wound or inflammation

5Christian S. Tu, RN

CASTS & MOLDSCylindrical leg cast- patellaQuadrilateral/ ischial weight bearing cast – shaft of femur w/ CFCast brace – fx of the femur distal 3rd

Short leg circular cast – ankle & footPTB- tibia/ fibula w/ CFDelbit cast- Tibia & fibulaShort leg posterior mold – ankle & foot w/ compound affectionBoot leg cast for traction – hip & femoral fxInternal rotator splint – post hip operation

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CASTS & MOLDSCollar cast – cervical affectionPantalon cast – pelvic bone fractureFrog cast – congenital hip dislocationSingle hip spica – hip & 1 femur1 & ½ spica mold – hip & femur w/ compound affectionDouble hip spica- pelvic affection w/ CF +2 femur 7

CASTS & MOLDS

Single hip spica mold- pelvic bone fx w/ CF

Night splint – post polio

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• immobilized a body part

• Exert uniform compression

• Provide for early mobilization

• Correct or prevent deformities

• Stabilize and support unstable joints

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1. Prepare the client 2. Assist during application of casts PRN3. After cast application, provide cast care4. Initiate pain relief measures as indicated5. Observe for signs of cast syndrome

especially with client who are immobilized in large cast.

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6. Provide nursing care for compartment syndrome, if indicated

7. Notify the physician immediately if signs of other neurovascular complications occur

8. Notify the physician if “hot-spots” occur9. Provide client teaching10. Ensure proper technique and procedure

in cast removal.

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1. Support fresh cast with the palm of the hand to prevent indentations from tips of the fingers

2. Expose the cast to warm, circulating, dry air.

• Plaster cast - 5-15 minutes up to 48 hours

• Synthetic cast – 30 minutes

Dry cast : white, odorless, close to room temperature and resonant to percussion.

Wet Cast: gray, cool, musty smelling and dull to percussion.

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Potential Pressure Areas/ Points

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• Check neurovascular status• Alternate ambulation with periods of elevation to

the cast when seated• Perform active ROM hourly when awake by

wiggling fingers/ toes.• AVOID getting plaster cast wet, especially the

padding under the cast• DO NOT cover cast with plastic or rubber boots.

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• NO weight bearing exercises for 24 hours after cast application

• Clean plaster cast using slightly damp cloth, by rubbing soiled areas with scouring powder and by wiping off residual moisture

• AVOID walking on wet floors or sidewalks to prevent falls

• DO NOT place objects under the cast to pressure and skin injury.

Cast Care

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1. Neurovascular problems (Compartment Syndrome)

2. Pressure Ulcers/ Sores – severe initial pain over bony prominences, foul odor, purulent drainage & presence of “hot spots”

3. Immobility/ Disuse Syndrome – results to multi-system problems

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6 P’s• Pain – aggravated by moving or elevating affected

extremity; usually not relieved by analgesics• Pallor• Pulselessness• Paresthesia – occur early in the syndrome which

progresses to….• Paralysis – late sign• Puffiness – late sign

Signs & Symptoms of COMPARTMENT SYNDROME

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