CASTING
 A rigid external immobilizing device that is
molded to the contours of the body.
 A temporary immobilization device which
is make up of gypsum sulfate anhydrous
which calcifies when mixed with water and
forms into hard cement
FUNCTIONS
To Immobilize
 Protect from further injury
 Prevent Malunion
To prevent or correct deformity
 Facilitate healing of bones
 Realign bone deformity/support/maintain
To promote healing and early weight bearing
 Hasten the healing process
 Prevent malalignment when healing occurs
PRIMES ACRONYMS
 Prevent and correct deformities
 Reduce pain spams and swelling
 Immobilization
 Model prior to artificial limbs
 Elevation
 Support
MATERIALS USED IN CASTING
1. FIBERGLASS
 Lighter in weight
 COSTLY
 Strong and more durable
 Water resistant
 Dries completely within 20 to 30 minutes
2. PLASTER CAST OR WET CAST
 Rolls of crinoline with powdered anhydrous
calcium sulfate (gypsum crystal) mixed with
water swells and forms into a hard cement
 Traditional
 Plaster of Paris
 LESS COSTLY
 Requires 24 to 72 hours to dry completely
 Achieve a better mold not a durable and take
longer to dry. Requires 24 to 72 hours to dry
completely
ADDITIONAL INFORMATION!!!
It is allow to hair blow dry a cast?
 Yes, wag lang iseset sa mainit because the
skin will start to wet and it will cause burn
the skin kapag matagal ng nakatutok (do the
BIVALDING – cut into two halves), i-set
lang yung cool
 Can be applied to an electric fan
 Do not place in the air conditioner, because
it will be moist inside the cast to prevent
skin irritation.
 It is allowed to dry the cast via room
temperature
*** Do not put powder inside the cast because it will
cause dryness of the skin and irritation.
How will you help your patient with Plaster Cast
if it is 48 to 72 to dry the cast?
 Ibaba sa bed with support of pillow or rolled
clothe and maintain the position or
alignment of the cast
After 72 hours of applying cast, then became itchy
inside the cast what will be your nursing
intervention.
 Divert the attention of the patient such as
tapping the area
 Use cool blow air on edges of the cast to
help the patient to reduce itchiness
 Give Antihistamine
Possible Nursing Diagnosis
 Risk for Impaired Skin Integrity only
because of physical inability
 Risk for infection
Signs if the cast is not ok
 Fever
 Numbness, tingling, burning, tingling
(mahapdi)
NCM 116 SKILLS – PRELIMS RACC
  Cold, pale and blueish FUENSTER/
 Crack MUNSTER
Exercise
 Do not do the ROM Radius-Ulna
 Isometric exercise – tighten muscles with Callus
 Elevate after 24 to 72 hours after casting to Formation
prevent edema/swelling

MATERIALS/ INSTRUMENTS IN
CAST APPLICATION OR REMOVAL

 Stockinette
 Wadding sheet and gauze bandage
 Plaster of Paris/ fiberglass
 Stryker cast cutter HANGING
 Bandage scissors CAST

COMPLICATIONS ASSOCIATED WITH Affectation Of

WEARING A PLASTER CAST Shaft Of
Humerus
 Allergic reactions.
 Compartment syndrome.
 Deep vein thrombosis.
 Infection.
 Neurovascular deficit.
 Pressure ulcers. FUNCTIONAL
UPPER EXTREMITIES Affectation Of
SHORT ARM Shaft Of
CIRCULAR Humerus
With Callus
Wrist And Formation
Finger
Affectation

SHOULDER
SPICA

Affectation
LONG ARM Humerus
CIRCULAR And
Shoulder Joint
Radius Ulna
Affectation

AIRPLANE
CAST

Affectation Of
Shaft Of
Humerus With
Compound
Affection

NCM 116 SKILLS – PRELIMS RACC

COLAR CAST CYLINDER
CAST
Cervical
Affectation Fracture Of
The Patella

BASKET
CAST
LOWER EXTREMITIES Patella
SHORT Affection
LEG with
CIRCULAR Severe
Wound
Ankle And Which Needs
Toes Frequent
Affection Wound
Dressing
PANTALO
N CAST

Fracture Of
LONG LEG The Pelvis
CIRCULAR

Tibia, Fibula
Affectation

CAST
BRACE
PATELLAR
TENDON Proximal
WITH Tibia And
BEARING Fibula,
CAST (PTB) Distal 3Rd
Femur
Tibia – Affectation
Fibula W/ SINGLE
Callus HIP SPICA
Formation CAST

One Side Of
DELVIT The Hip
CAST And One
Femur
Affection Of
D/3
Tibia Fibula
With
Callus
Formation

NCM 116 SKILLS – PRELIMS RACC

ONE AND MINERVA
ONE CASR
HALF HIP
SPICA For Scolios
On
Both HIPS Upper
AND 1 Dorsal
FEMUR TB Cervical C
OF THE Type
HIPS
DOUBLE RIZZER
HIP SPICA JACKET
CAST CAST

Both Hips For

And scoliosis on
Femur thoracic
Affection lumbar S
type

FROG
CAST
CAST APPLICATION-PROCEDURE
Congenital
Hip
1. Slip one layer of stockinet over the affected body
Dislocation
part
2. Additional padding may be used for greater
protection of pressure points and body prominences
3. Gloves must be worn (to prevent having cement on
hand, mag kakadents yung finger and pressure in the
cast that can cause Compartment syndrome or
decrease blood flow)
NOTE: 8 P’s in Compartment Syndrome
 Pain
 Paresthesia
 Poikilothermia
 Pallor
TRUNK AND NECK  Paralysis
 Pulselessness
BODY  Poor Capillary Refill
CAST  Poor Hair Growth
4. Open only one roll of Hygia Cast plus at a time
Lower 5. Immerse the roll in room temperature water. Three
Thoracic & firm squeezes of the roll while immersed will give a
Upper set time of approximately 3-3.5
Lumbar minutes. To lengthen the set time, immerse the roll
Spine and remove it immediately without squeezing. This
will give you a set time of around 4 min. Warmer
water shortens the set time while cooler
water lengthens it.
6. Wrap spirally taking care to avoid excessive
tightness.

NCM 116 SKILLS – PRELIMS RACC

  Leave exposed to circulating air.
 Do not rest the cast on hard surfaces or sharp
edges that can dent soft cast.
 Control swelling and pain
 Elevate immobilized extremity to heart level
 Apply intermittent ice bag if prescribed
 Take analgesic agents as prescribed.
 Report pain uncontrolled by elevation and
analgesics, may indicate compartment
syndrome or pressure ulcer
 Avoid excessive use of injured extremity;
observe prescribed weight-bearing limits
 Manage minor skin irritation
 Pad rough edges with tape
 Reduce itchiness
 Do not insert objects inside the cast.
 Check neurovascular status (8 P's)
 Report promptly to physician:
 Uncontrolled swelling and pain
 Cool, pale fingers or toes
 Paresthesia
 Paralysis
 Signs of systemic infection
PRINCIPLES IN APPLYING A PLASTER  Cast breaks
CAST
Provide for maximal comfort and alleviation of
complications TRACTION
Application of padding is the first step in the
procedure What is Traction?

PADDING MATERIAL:
A. Wadding Sheet
B. Roll of cotton
C. Stockinet
D. Felt
 Maintain a desired position through outcast
application
 Provide the patient for cast application by
providing appropriate education
 Use caution in handling of the cast until it
has set or becomes hard
 Apply it to include the joint above and joint
below the injured area
 Apply it in a circular motion and mold it as
you do the procedure by the palmar
hypothenar

ADDITIONAL INFORMATIONREDUCE
FRACTURE ***
From bali to straight pero hindi parin connect yung
bone pero may OSTEOBLAST to promote healing
and connection of the bone and may callus formation
afterwards; dito na mag lalagay ng cast to maintain
the alignment. OSTEOCLAST to remodel the bone.

NURSING MANAGEMENT

 Promote cast drying

 Do not cover

NCM 116 SKILLS – PRELIMS RACC