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OBJECTIVESAfter this presentation learners will be able to:
Explain the basic functions of a cast/splint
Compare and contrast the use of casts/splints
Discriminate between injuries that require casts or
splints
Integrate knowledge to formulate a complicationprevention plan for patients receiving casts
Explain the factors leading to development of ischemicinjury in casts
Organize proper supplies for cast application
Demonstrate the ability to avoid hypersomnia duringthis presentation
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What is a Cast?
An orthopedic cast is a temporary device used
to immobilize and protect tissue to foster healing Similar to an exoskeleton Historically made of Plaster of Paris
Also made of fiberglass sheeting with resin
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A History Lesson Ancient Egyptians used bark and linen splints
Hippocrates recommended using splints Roman Celsus used bandages hardened withstarch in AD 30
Arabians used egg whites and ground shells Ambrose Pare (1517-1590) made casts of wax,
cardboard, cloth, and parchment Antonius Mathijsen (1805-1878) first to used
bandages soaked in Plaster of Paris
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Cast or Splint
Cast Mainstay treatment More effective
immobilization Most protection
Splint Splints are faster and
easier to apply
Can be static or dynamic Allows for tissue swelling Removed more easily Good for acute phase
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Which One to Use?
Casts Splints
OUCH!!!OUCH!!!
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Plaster Made from gypsum- calcium sulfate dihydrate
Mixed with water an exothermic reaction occurs 2 (CaSO 4 H 2O) + 3 H 2O 2 (CaSO 4.2H2O) + Heat Warm H2O speeds up setting, Cool H 2O slows Fast drying (blue & white box) 5- 8 minutes set Extra-fast ( green & white box) 2-4 minutes set
Up to 24 hours to cure (at least) Warmer =faster cure Air circulation speeds up cure No weight bearing until cure is complete!
Do Not Burn the Patient !!!!
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Fiberglass
Cures rapidly
Less messy Stronger, lighter, wicks moisture better Less moldable $$ More expensive $$ Much shorter shelf life than plaster Requires less skill to apply Less risk of burns (burns still occur!)
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General Principles of Application
Immobilize a joint above and below injury
Avoid pressure points due to: Excessive molding Cast indentations Use enough padding More at bony prominence Not too much at fracture site Consider skin wounds
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Warning Signs of Ischemia
Numbness
Inability to move Discoloration distally Cold Increased pain Remove, loosen or split promptly ! Get Help Quick!!!
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Let`s Cook Up a Cast!!
Supplies Needed
Patient Traction supplies Stockinette Softroll or Webril Plaster rolls Bucket Scissors Gloves Towels
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Putting on the Cast
Let`s see this skill in action!
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Review
Casts and splints are used to immobilize
injured tissues to promote healing Two types of materials Plaster andFiberglass
Skilled application techniques help preventcomplications
Ischemic injury and burns are major seriouscomplications
Proper planning helps prevent injury Still awake?
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QUESTIONS?
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ICE!!!!ELEVATION Airway Breathing circulation
Orthopedic ACLS