CARE OF CLIENT
WITH CAST
CAST is a hard covering that is used
to support fractured arms, legs or
other body parts.
1. PLASTER OF PARIS
- WHITE IN COLOR,
- MADE UP OF GYPSUM SULPHATE
- DRIES 1-3 DAYS
PLASTER OF PARIS
2. SYNTHETIC (FIBERGLASS) MATERIAL
– MOLDABLE PLASTIC WITH VARIETY OF
COLORS, PATTERNS, AND DESIGNS.
- DRIES 20-30 MINUTE
- LIGHTER, COOLER & WATERPROOF
CHARACTERISTICS OF A GOOD CAST (PLASTER OF PARIS) WHEN APPLIED
•White
•Shiny
•Odorless
•Light in weight
•Not too tight
•Not too loose
•Resonant on percussion
CAST APPLICATION
1. Apply the stockinet first.
2. Apply the wadding/padding
sheet.
3. Fiber glass or the plaster cast
CARING A CAST WHILE IT DRIES:
1. Keep the cast uncover to dry.
2. Check for cracks or breaks in the
cast.
3. Keep the cast always clean
4. Turn patient every 2 hours while the
cast dries
5. Prevent any indentation in the cast
due to pressure.
6. Avoid resting the cast on hard
surfaces or sharp edges
7. Avoid using the abduction bar in lifting or
carrying the patient
Place a plastic lining at he edge of the cast if
the cast is near the groin to avoid soiling and
wetting the cast
CAST CARE INSTRUCTIONS/
HEALTH TEACHINGS:
1. Keep the cast always clean and
dry.
2. Report presence of cracks or
breaks in the cast.
3. Rough edges should be padded
to protect the skin from
irritations.
4. Avoid using any objects in
scratching the skin under the cast.
5. May use a hairdryer in a cool setting to
relieve itchiness. Never blow warm or hot
air into the cast.
6. Avoid putting powders or lotion inside
the cast.
7. Cover the cast while eating to prevent
food spills and crumbs from entering the
cast.
8. Elevate the cast on a cloth-covered
pillow above the level of the heart to
decrease swelling.
9. Encourage the client to move his/her
fingers or toes to promote circulation.
10. Avoid using the abduction bar in
turning, lifting or carrying the client.
11. Report alarming signs
ALARMING SIGNS
1. Fever
2. Pain
3. Swelling
4. Drainage
5. Discolorations
5. Numbness or tingling sensation
7. Cold fingers or toes
ASSESSING A CASTED
EXTREMITY
1. PAIN
1.1. Asked the patient if he feels any
pain in the casted extremity and if the
pain is increasing.
1.2. Asked presence of pain on passive
extension.
1.3. Asked the patient to identify the
exact location, describe the character
and intensity of any pain.
MANAGEMENT
1. Elevating the involved part
2. applying cold packs
3. administering analgesic agents as
prescribed
2. BLOOD SUPPLY/CIRCULATORY FUNCTION
/CAPILLARY REFILL
Discoloration
2.1. Assess capillary refill by applying
pressure to one of the toenails or
fingernails and check for discoloration.
3. TEMPERATURE OF THE SKIN
Coolness
3.1. Assess temperature by touching
fingers or toes if warm to touch.
4. NEUROLOGIC FUNCTION
Numbness or tingling sensation/paresthesia
Absence or diminished sensation
4.1. Asked patient if he/she can move
fingers or toes of the casted extremity.
4.2. Asked patient for the presence of
numbness or tingling sensation
4.3. Asked the patient if he feels when
you touch his fingers or toes to assess
nerve paralysis
5. INFECTION
Swelling, foul odor, fever
4.1. Assess presence of swelling below or above
the casted extremity
4.2. Assess presence of foul odor in the casted
extremity
4.3. Check for the presence of drainage and
note the color and amount.
4.4. Mark the circumference of the stain on
the cast as a gauge for any increase in the
amount of drainage
CAST TECHNIQUES
Bivalving
Windowing
Reinforcing
BIVALVING
Cuttingthe cast into
two halves from the
upper portion to the
bottom part for the
purpose of relieving
tightness of the
casted extremity
PETALLING THE CAST
1. Pulled the stockinet over the cast and
taped down, if edges of the cast are
rough and crumbling to prevent skin
irritation
2. Cut a tape into 4 inch strips
3. Place half of the tape on the inside of
the cast and pulled it over the top of the
cast
4. Anchor remaining tape to outside of the
cast
MATERIAL S & INSTRUMENTS IN CAST
APPLICATION
MATERIALS & INSTRUMENTS USES
1. Plaster of Paris/ Fiberglass Casting materials
2. Stockinet To protect the skin
3. Wadding sheet/gauze To serve as padding
bandage
4. Bandage scissor To cut wadding sheet and stockinet
5. Trimming knife To smoothen the edges of the cast
6. Newspaper To protect the floor/area
7. Disposable gloves To protect the hands of the
operator
8. Pail of water at room To wet the cast
temperature
MATERIAL S & INSTRUMENTS IN CAST
REMOVAL
MATERIALS & USES
INSTRUMENTS
5. Stryker cast cutter Used in bivalving &
windowing & removal of
cast
6. Cast spreader To widen a bivalve cast
3. Bandage scissor To cut wadding sheet and
stockinet
PLASTER CAST CUTTER
SHORT LEG HIP SPICA
CAST:
Applied from the
chest to the thighs or
knees.
To hold the hip
muscles and tendons
in place after surgery
to allow healing.
WALKING CAST
Affection of
tarsals and
metatarsals with
callus formation
BASKET CAST
For massive bone injury of the patella to
facilitate wound dressing
PATELLAR TENDON BEARING CAST
Affection of tibia-fibula with callus formation
QUADRILATERAL/ISCHIAL WEIGHT BEARING CAST
Affection of the shaft of femur with callus
formation
PANTALON CAST
Affection of the
pelvis
DELVIT CAST
Affection of the 3rd of the tibia –fibula
with callus formation
CAST BRACE
Fracture of the
distal 3rd of
femur and
proximal 3rd of
tibia with
callus
formation
TYPES OF CAST IN THE TRUNK
AND NECK
1. BODY CAST
encircles the trunk, stabilizing the spine
Affection of the lower dorso-lumbar spine
2. MINERVA CAST
Applied around the neck and trunk of the
body.
Affection of the cervical and upper dorsal
spine
3. RIZZER’S JACKET
Affection of thoraco-lumbar spine and to
correct scoliosis (S-shape)
SHOULDER SPICA
CAST
Applied around
the trunk of the
body to the
shoulder, arm,
and hand.
Affection of the
upper portion of
the humerus and
shoulder joint
How can a person move around while in a
cast?
With the use of assistive devices :
crutches
walkers
wagons
wheelchairs
reclining wheelchairs
quiz
I. IDENTIFY THE FOLLOWING:
___1. Applied from the upper arm to the wrist to
hold the elbow muscles and tendons in place
after a dislocation or surgery.
___2. Applied to the area below the knee to the
foot for fracture of the lower leg, severe
ankle sprains/strains, or fractures.
___3. Affection of tibia-fibula with open wound,
inflammation or swelling
___4. Applied below the elbow to the hand and is
used for fractures of forearm or wrist.
___5. Applied around the neck and trunk of the
body for cervical and upper dorsal spine
fracture or affectation
___6. Used for pelvis, hip, or thigh fractures.
Applied from the chest to the feet and a bar is
placed between both legs to keep the hips and
legs immobilized.
___7. Cast used for massive bone injury of the
patella to facilitate wound dressing
___8. Equipment used in windowing or bivalving
___9. The fiberglass type of cast dries for how
long?
__10. The Plaster of Paris is made up of what?
II. ENUMERATION
1 – 3 Enumerate at least 3 cast care
instructions
4 – 7 Enumerate at least 4 alarming signs of
compartment syndrome
8 – 10 What are the 3 types of cast
techniques
11 – 12 Principles of application of cast
13 – 15 Purposes of cast
16 – 18 3 Layers of casting
19 – 20 Types of cast
