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Plaster Cast

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22 views15 pages

Plaster Cast

Uploaded by

mohdshamil208
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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PLASTER CAST

A cast is a temporary circumferential


immobilization device.

Casting is a common treatment following closed


reduction.

Cast materials are natural (plaster of paris),


synthetic acrylic, fiberglass free, latex-free
polymer, or a hybrid of materials
PURPOSES

1. To immobilize and hold bone fragments in


reduction
2. To apply uniform compression of soft tissues
3. To permit early mobilization
4. To correct and prevent deformities
5. To support and stabilize weak joints
TYPES OF CASTS -UPPER
EXTRIMITIES
 Short-arm Cast
 Extends from below the elbow to the proximal palmar
crease.
 Long-arm Cast
 Extends from upper level of axillary fold to proximal
palmar crease; elbow usually immobilized at right angle.
 Short-leg Cast
 Extends from below knee to base of toes.
 Long-leg Cast
 Extends from upper thigh to the base of toes; foot is at
right angle in a neutral position.
 Body Cast
 Encircles the trunk stabilizing the spine.
Spica Cast
Incorporates the trunk and extremity.
1. Shoulder spica cast
A body jacket that encloses trunk, shoulder, and elbow.
2. Hip spica cast
Encloses trunk and a lower extremity.
a. Single hip spica
Extends from nipple line to include pelvis and extends to include pelvis
and one thigh.
b. Double hip spica
Extends from nipple line or upper abdomen to include pelvis and extends
to include both thighs and lower legs.
c. One-and-a-half hip spica
Extends from upper abdomen, includes one entire leg,
Common types of casts.
COMPLICATIONS OF CAST
 1. Impaired blood flow

Signs and Symptoms: absence of pulse in


the extremity below the plaster cast, Pallor,
blanching or cyanosis of the skin, Pain,
coldness of the skin, Swelling, Numbness,
Motor paralysis.

2. Nerve damage
Signs and Symptoms: persistent and
increasing pain, Numbness and Motor
paralysis.
 3. Tissue necrosis and infections
Signs and Symptoms: unpleasant odour,
Feeling of ‘hot’ sensations, Drainage
 4. Volkman’s ischaemic contracture

Signs and Symptoms: all the signs and


symptoms of impaired blood flow.
 Absence of radial/pedal pulse, Infarction
and necrosis of the muscles, Absence of
finger/toe movement, Absence of pain
which was intense in the beginning.
 5. Cast Syndrome

Signs and Symptoms: prolonged nausea and


vomiting. Abdominal distension, Vague
abdominal pain.

6. Complications due to immobility

Signs and Symptoms:


 hypostatic pneumonia, foot drop, renal
calculi, decubitus ulcer on all pressure
points, stiffness of joints, constipation and
retention of urine, lethargy, loneliness and
depression, insomnia.
NURSING ASSESSMENT
1. Assess neurovascular status of the extremity with a cast for
signs of compromise.
a. Pain.
b. Swelling.
c. Discoloration (pale or blue.)
d. Cool skin distal to injury.
e. Tingling or numbness (paresthesia).
f. Pain on passive extension (muscle stretch).
g. Slow capillary refill; diminished or absent pulse.
h. Paralysis.
2. Assess skin integrity of casted extremity. Be alert for:
a. Severe initial pain over bony prominences; this is a warning
symptom of an impending pressure sore.
b. Odor.
NURSING MANAGEMENT
 PAGE 1503 LEWIS
PATIENT AND FAMILY TEACHING GUIDE:
 Cast Care
 Do not
 Do not get plaster cast wet
 Do not remove any padding
 Do not insert any objects inside cast
 Do not bear weight on new cast for 48 hr
(not all casts are made for weight bearing;
check with health care provider when unsure)
 Do not Cover cast with plastic for prolonged
periods
Do
 Instruct patient to check neurovascular status and to
control swelling.
 Watch for signs and symptoms of circulatory
disturbance, including blueness or paleness of
fingernails or toenails accompanied by pain and
tightness, numbness, cold or tingling sensation.
 Dry cast thoroughly after exposure to water
 Use hair dryer on low setting until cast is thoroughly dry
 Elevate extremity above level of heart for first 48 hr.
 Move joints above and below cast regularly
 Report signs of possible problems to health care provider
 Increasing pain
 Swelling associated with pain and discoloration of toes
or fingers
 Pain during movement
 Burning or tingling under cast
 Sores or foul odor under the cast
After Cast Removal
1. Instruct to clean skin with mild soap and
water, blot dry, and apply emollient lotion to
dry skin.
2. Warn against scratching the skin.
3. Advise to continue prescribed exercises.
Gradually resume activities, and elevate
extremity to control swelling.

Evaluation: Expected Outcomes


No pain, discoloration, or sensory or motor
impairment of affected extremity; warm,with
good capillary refill
Ambulates with assistance; performing active
ROM and isometric exercises every 1 to 2
hours

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