This document discusses plaster casts, including their purpose, types, materials, and nursing care. Plaster casts are used to immobilize and protect injured body parts during healing. Common types include short/long arm casts and short/long leg casts. Plaster of Paris is the most common casting material as it hardens upon contact with water. Nurses must carefully assess skin under casts for complications and educate patients on cast care.

1. BY:- JISS MARY JAMES
[NURSING TUTOR]

2. INTRODUCTION
• Plaster casts made from Plaster of Paris, the device encases the injured part in order to
protect and immobilize it during the healing process and it is used to correct the
deformity.
• A cast is a rigid external immobilizing device that is moulded to the part of the body to
which it is applied.
• Cast application is the process of applying Plaster of Paris to a body part for
immobilization or to align mal-positioned tissues such as club foot, congenital hip
dislocation, etc.

3. DEFINITION
• A cast is an immobilizing device, made of plaster bandages, fiber glass or a
thermolabile plastic material.
OR
• A cast application is a process of applying Plaster of Paris to a body part for
immobilization or to align mal-positioned tissues.

4. PURPOSE
• To immobilize a body part in a specific position
• To immobilize and hold the bone fragments
• To correct the deformity
• To prevent the deformity
• To apply uniform pressure on soft tissues
• To support and rest a part after surgical intervention until healing occurs

5. TYPES OF CAST
1) Short Arm Cast:-
It extends from below the elbow to the proximal palm crease.

6. 2) Gauntlet Cast:-
It extends from below the elbow to the proximal palm crease,
including the thumb (thumb spica).

7. 3) Long Arm Cast:-
It extends from the upper level of the axillary fold to the
palm crease. The elbow is usually immobilized.

8. 4) Short Leg Cast:-
It extends from below the knee to the base of toes.
5) Long Leg Cast:-
It extends from the junction of the upper and the middle third
the thigh to the base of the toes, the foot is at right angle in a neutral position.

9. 6) Walking Cast:-
It is a short or long leg cast with a walking device.

10. 7) Body Cast:-
It incorporates a position of the trunk and one or two

11. 8) Shoulder Spica Cast:-
It is a body jacket that encloses the trunk and the shoulder and
elbow.

12. CASTING MATERIAL [PLASTER OF
PARIS]
• Plaster of Paris (anhydrous calcium sulfate) is a chalky white powder.
• In the process of making Plaster of Paris, crystals of gypsum are broken up and reduced to
the powder form and heat is applied to remove water from crystals.
• A chemical process of rehydration occurs when Plaster of Paris is placed in water.
• The exothermic reaction that takes place during this recrystallization or setting period that
generates heat which can be felt in newly applied cast.
• Plaster of Paris bandages are available in varying widths from 2” to 8”.
• Plaster of Paris is available in various setting speeds, extra fast (2 to 4 min), fast (5 to 8 min)
and slow (10 to 18 min).
• The strength of a completed cast is determined by the number of layers of plaster used.
• Plaster of Paris splints of varying sizes are also available.

13. PROCEDURE OF CAST APPLICATION
Articles:-
• Rolls of plaster 3,4 or 6 inch rolls
• Gloves and apron
• Scissors with blunt end
• Bowls with water, cool at the time of application
• Positioning equipment e.g.:- fracture table or chair

14. Preparation Of The Patient & Environment:-
• Determine the reason for and type of cast being applied
• Examine skin for any kind of lesions
• Assess the affected part for circulatory and neuromuscular status: color, temperature
response to touch and ability to move
• Determine if currently has complications of immobilization
Procedure:-
• Explain the procedure to the client
• Prior to the application of the cast, the patient should be informed that he will feel warm
under the plaster, but the application of the plaster is not painful.
• The patient is draped to prevent the plaster from smearing on those parts that are not
cast.
• The part that has to be cast is cleaned with soap and water, and dried. Padding with cotton
placed over the area on the bony prominences.
• Orthopedics is used for padding. Then the cast is applied.

15. • Measure and cut the stockinette
• Roll the stockinette
• Hold the affected limb in a neutral position grasping the joints of uninjured parts while
the physician / technicians applies the stockinette
• Immerse the correct size cast roll in cold water squeeze to remove excess water
• Support the body part in anatomical position by grasping the distal position or
unaffected area
• Assist with moulding the shape of the cast
• Assist the physician in folding the stockinette at distal and proximal edges of the cast
Trimming The Cast:
 After the application, the plaster is cleaned from the patients skin with a towel.
 The cast is trimmed or cut with a cast knife or scissors.

16. Drying A Cast:
 A cast should be exposed to circulating air, so that it will dry.
 The patient should be kept under a fan. After a cast has cooled the arm or leg
applied with a cast should be elevated above the level of heart to reduce swelling.
 The cast should not be allowed to rest on hard surfaces or sharp edges as it may
cause pressure in the cast and can cause pressure sores.
Immediate Cast Care Following Application:
 Immediate care is needed to avoid complications
 Mainly 2 types of complications can occur they are constriction of circulation and
pressure on tissues and bony parts.
 So skin around the edges of the cast should be inspected for signs of irritation.
 Accessible skin should be massaged with an emollient.
 Pressure sores develop over bony prominences. So the exposed area should be
washed and massaged.
 The area of the cast around the perineum needs to be protected from excretions.
When cast is dried the perineum is covered with towel.

17. NURSING
CARE OF
PATIENT
WITH
PLASTER
CAST

18. NURSING CARE OF PATIENT WITH
PLASTER CAST
• Assess the edges of the cast and all skin areas where the cast edges may cause pressure.
• If there is any signs of edema or circulatory impairement then notify it to incharge nurse or
physician immediately.
• Move the skin gently in backward and forward manner to stimulate circulation.
• Assess for any bad odors to identify any tissue damage.
• Check the integrity of cast by looking for cracks, breaks and soft spots.
• The casted body part must be examined and assessed frequently in order to prevent
complications.
• Assess the presence of sensation in the affected limb by touching exposed areas of skin and
asking the patient regarding what he felt.

19. • Assess the motor ability of the affected limb by having the patient wiggle his fingers
or toes.
• Educate the patient regarding following:
o Avoid resting cast on hard surfaces or sharp edges that may cause pressure on
the cast and pressure sore can develop.
o Never use a pen or other foreign objects to scratch inside the cast. This may
cause skin damage and infection.
• Report any danger signs like pale, cold fingers or toes, tingling, numbness, increased
pain, pressure spots, bad odors or feeling that the cast has become too tight.
• Report if any damage to the cast such as cracks, breaks or soft spots.
• Never attempt to remove or alter the cast.
• After a leg cast is applied reduce the swelling by elevating the extremity above the
level of heart.
• If the patient has an arm cast then instruct the patient to tighten and release the fist.
• Encourage the patient to move his fingers and toes frequently.