APPLYING A PLASTER CAST

Prepared by: Santiago, Aizelle G.

CIRCULAR CASTS
BONY POINTS: Always pad these parts of limb, especially if the patient is thin.
® A cast will be uncomfortable and pressure sores may form.

TUBULAR STOCKINETTE: thread this over his limb, leaving it long enough to
extend several centimetres above and below the cast. If necessary, cut a hole
for patient’s thumb.

NO STOCKINETTE: wind ordinary cotton bandages on to his limb.

ORTHOPEDIC PADDING/COTTON WOOL: Roll this smoothly over his whole limb,
evenly with no folds or lumps, and without obscuring the shape of the limb.
Don’t pull it tight or it will tear. You may need 2 or 3 layers to build up a
thickness of about 1 cm. Put extra padding over bony prominences. Apply it
from well above to well below where the cast will end.
PARTS OF A LIMB
CIRCULAR CASTS
BONY POINTS: Always pad these parts of limb, especially if
the patient is thin.
® A cast will be uncomfortable and pressure sores may
TUBULAR
form. STOCKINETTE: thread this over his limb, leaving it long
enough to extend several centimeters above and below the cast. If
necessary, cut a hole for patient’s thumb.

NO STOCKINETTE: wind ordinary cotton bandages on to his limb.

ORTHOPEDIC PADDING/COTTON WOOL: Roll this smoothly over his

whole limb, evenly with no folds or lumps, and without obscuring
the shape of the limb. You may need 2 or 3 layers to build up a
thickness of about 1 cm. Put extra padding over bony prominences.
PLASTER OF PARIS
PADDING
Soft resilient material such as wool, felt and special orthopedic
padding is placed on the skin before plaster application.

Padding serves to:

1. Prevent sores
2. Increase comfort
3. Act as a “spacer” to aid removal.
 
Padding is extremely important in following situations:
1. When swelling is present or expected, i.e., in almost every
acute condition
2. When limb is thin and bones are very superficial
3. When the electric plaster cutters are used for removal
4. When wedging is contemplated
SHORT ARM CASTING
LONG LEG CASTING
 PLASTER CRAFT

 A cast
which
has been
properly
split.
NO!
 AN EXPLANATION TO THE PATIENT FOR ALL
CASTS
 Explain why you are applying the cast, and when you expect to
remove it.

 Tell the patient not to use his limb or bear weight on his leg for 48
hours while his cast dries out. Warn him to raise it to prevent
swelling, to keep it dry, and to return immediately if he has pain,
numbness, stiffness, or if his fingers or toes become cold, blue, or
swollen.

 He must also return if his cast becomes loose.

 Explain that he must exercise his muscles inside the cast, and the
joints which are not immobilized, especially his fingers and toes.
 A FRACTURE
PASSPORT is a
useful reminder to
the patient, and
yourself, especially
if his notes are
lost.
 Record both the
date of his
fracture, the date
the cast is applied,
and the date it is to
be removed.
 The best way to
write on a damp
cast is to use a blue
indelible pencil.
Caring for Clients With Casts
1. Assisting With the Application of a POP Cast
* Nursing Interventions:
> handle a wet cast only with the palm of your hands
> cool settings on a hair dryer can be used to dry a
plaster cast (heat cannot be used on a plaster cast
because the cast heats up and may burn the skin)
> turn the extremity every once in a while so that all
sides of the cast will dry
> examine the cast for possible pressure areas
> keep the cast and extremity elevated
> POP casts need 24 to 48 hrs. to dry / fiberglass casts -
20 to 30 min.
2. Monitoring a Patient After Casting
* Nursing Interventions
> monitor the neurovascular status of the affected
extremity; notify MD if NV compromise occurs
> instruct the client in isometric exercises to
prevent muscle atrophy
> instruct patients not to stick objects inside the
cast
> monitor for warmth / wet spots on the cast
> monitor for foul odor
> monitor the client’s temperature
3. Cast care instructions:
> Keep the cast clean and dry.
> Elevate the cast above the level of the heart to decrease swelling.
> Encourage patient to move his/her fingers or toes to promote
circulation.
> Check for cracks or breaks in the cast.
- Rough edges can be padded to protect the skin from scratches.
> Do not scratch the skin under the cast by inserting objects inside the
cast.
- Can use a hairdryer placed on a cool setting to blow air under the cast
and cool down the hot, itchy skin. Never blow warm or hot air into
the cast.
- Do not put powders or lotion inside the cast.
> Cover the cast while patient is eating to prevent food spills and crumbs
from entering the cast.
Tips to keep body casts clean and dry and
prevent skin irritation around the genital
area:
1. Use a diaper or sanitary napkin around the
genital area to prevent leakage or splashing
of urine.
2. Place toilet paper inside the bedpan to
prevent urine from splashing onto the cast
or bed.
3. Keep the genital area as clean and dry as
possible to prevent skin irritation.