CARE OF CLIENT

WITH CAST
 CAST is a hard covering that is
use to support a fractured arms,
legs or other body parts.

 SKELETAL SYSTEM
1. AXIAL
2. APPENDICULAR
Objective Data:
IPPA and always compare
with contralateral side
1. Skeletal component
Bony deformities
Length discrepancies
Alignment
Amputation
2. Joint component
Swelling (effusion)
Deformity
(contractures or
dislocations)
ROM (active and
passive)
3. Muscle component
Size and contour of
muscles
Palpate for muscle tone
Estimate strength
(handshake)
Measure girth (swelling
or bleeding)
Fasciculation (isolated
muscle contraction)
Additional
Assessment
1. Neurovascular
component
Circulatory (skin color,
temp., pulse, capillary
refill, pain)
Neurologic (paresthesia,
reflex)
Note: always compare
affected side to
2. Skin component
Traumatic (cuts,
bruises)
Chronic conditions
(dermatitis)
Heberden’s/distal
or
bouchard’s/proxim
al (OA)
PURPOSES OF CAST
1. Hold a broken or fractured
bone in place as it heals
2. Immobilize a bone especially
after surgery.
3. Support, maintain and
realign a bone when dislocated
4. Prevent or decrease muscle
contractions
5. Correct deformity
BILATERAL CLUB FOOT
A. Kyposis –
exaggerated
outward
curvature of the
thoracic region of
the spine
B. Lordosis –
abnormally
increased inward
curvature of the
lower lumbar
spine
C. Scoliosis – S-
curvature of the
spine Deformity of Spines
 RIZZER’S JACKET
 Use to correct
deformity of the
spine
TYPES OF CAST
MATERIALS
 1. Plaster of Paris
 2. Synthetic (fiberglass)
material
1. PLASTER OF PARIS
- WHITE IN COLOR,
- MADE UP OF GYPSUM SULPHATE
- DRIES 1-3 HOURS
PLASTER OF PARIS
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
2. SYNTHETIC (FIBERGLASS)
MATERIAL
– MOLDABLE PLASTIC WITH VARIETY OF
COLORS, PATTERNS, AND DESIGNS.
- DRIES 20-30 MINUTE
- LIGHTER, COOLER & WATERPROOF
 CAST
APPLICATION
 MATERIAL S & INSTRUMENTS IN CAST
APPLICATION
MATERIALS & USES
INSTRUMENTS
1. Plaster of Paris/ Casting materials
Fiberglass
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
 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
PRINCIPLES IN
APPLICATION OF CAST
1. Apply stockinet and padding first
before applying a cast
2. Apply cast by including the joint above
and the joint below the affected part
3. Apply cast in circular motion and
smoothen with the palm
4. Support with the palm not with the
fingertips
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

 8. 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 any alarming signs
ALARMING SIGNS
 1. Pain
 2. Discolorations
 3. Cold fingers or toes
 4. Numbness or tingling sensation
 5. Swelling
 6. Drainage
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 and if
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
 BIVALVING
Cutting the cast
into two halves
from the upper
portion to the
bottom part for
the purpose of
relieving
tightness of the
casted extremity
 4. 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
 WINDOWING
Putting a window on a cast
at the site of an open
wound of the casted
extremity for the purpose
of visualization, inspection,
dressing as well as
application of medication
 REINFORCIN
G
Strengtheni
ng the cast
by adding
more
materials
when
weakened.
CAST TECHNIQUES
 Bivalving
 Windowing
 Reinforcing
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
3 WAYS OF
IMMOBILIZATION
 CAST
a hard covering that is put on an arm, legs or
other body parts so that a broken bone can
heal.
 SPLINT
A piece of wood, metal, plastic, etc. that is
used to hold a broken bone in the correct
position while it heals
 MOLD
Use as splint in an affected part of the body
wherein there is an open wound,
inflammation, abrasion, swelling or infection
TYPES OF CAST AND
MOLDS & THEIR
INDICATIONS
TYPES OF CAST IN THE UPPER EXTREMITIES
 SHORT ARM CIRCULAR
CAST
 Forearm or wrist fractures
 LONG ARM CIRCULAR
CAST
 Upper arm, elbow, or
forearm fractures. Also
used to hold the arm or
elbow muscles and
tendons in place after
surgery.
 ARM CYLINDER CAST
 To hold the elbow muscles
and tendons in place after
a dislocation or surgery.
TYPES OF MOLD IN THE
UPPER EXTREMITIES
 SHORT ARM POSTERIOR MOLD
 Affection of the carpals and metacarpals
with open wound, inflammation or swelling
 LONG ARM POSTERIOR MOLD
• Affection of the radius-ulna and carpals-
metacarpals with open wound, inflammation
or swelling
 ARM CYLINDER MOLD
 Affection of the radius-ulna with open
wound, inflammation or swelling
GAUNTLET CAST/THUMB
SPICA
Extends from below the elbow to the
proximal palmar crease including the
thumb

Affection of the first metacarpal bone

 HANGING CAST
 Affection of the shaft of the humerus
 FUNCTIONAL CAST
 Affectionof the shaft of the humerus to
allow flexion with callus formation
 AIRPLANE
CAST/ABDUCTI
ON SPLINT
Affection of
the neck of
the humerus
 FUENSTER/MUENSTER CAST
Affection of radius ulna
Conservative treatment of
non-displaced scaphoid
fractures by allowing some
elbow motion during the
long immobilization period
 Scaphoid
fracture
 Is a break of
the scaphoid
bone in the
wrist.
 CALLUS
A mass of exudate and
connective tissue that forms
around a break in a bone and is
converted into bone in a
healing process
TYPES OF CAST IN THE LOWER EXTREMITIES
 SHORT LEG CIRCULAR
CAST
 Applied to the area below
the knee to the foot.
 Affection of tarsals and
metatarsals
 LONG LEG CIRCULAR
CAST
 Affection of tibia fibula
 LONG LEG CYLINDER
CAST
 Applied from the upper
thigh to the ankle.
 Affection of the patella
TYPES OF MOLD IN THE
LOWER EXTREMITIES
 SHORT LEG POSTERIOR MOLD
Affection of tarsals and metatarsals
with open wound, inflammation or
swelling
 LONG LEG POSTERIOR MOLD
Affection of tibia-fibula with open
wound, inflammation or swelling
 LONG LEG CYLINDER MOLD
Affection of the patella with open
wound, inflammation or swelling
 UNILATERAL HIP
SPICA
 Affection
of one hip
and one femur
 ONE AND ONE HALF
HIP SPICA
 Affection
of two hips
and one femur
 BILATERAL HIP
SPICA
 Affectionof two hips
and two femurs or
pelvis, hip, or thigh
 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.
 ABDUCTION BOOTS
 Applied from the upper
thighs to the feet. A
bar is placed between
both legs to keep the
hips and legs
immobilized.
 To hold the hip muscles
and tendons in place
after surgery to allow
healing.
 WALKING CAST
Affection of
tarsals and
metatarsals
with callus
formation
 PATELLAR
TENDON
BEARING CAST
Affection of
tibia-fibula
with callus
formation
 BASKET CAST
For massive bone injury of the
patella to facilitate wound dressing
 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
 FROG CAST
For congenital hip dislocation
 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
COLLAR CAST
AFFECTION OF THE CERVICAL SPINE
 How can a person move around
while in a cast?
 With the use of assistive devices :
 crutches
 walkers
 wagons
 wheelchairs
 reclining wheelchairs
end
POST TEST
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
