The document discusses the application and removal of casts. It defines a cast as a rigid external device used to immobilize and support injured body parts. The objectives are to define casts, learn how to apply and remove them, and provide post-cast care. Key steps in application include preparing equipment, positioning the injured area, applying padding and casting material, and ensuring proper drying. Care involves monitoring for complications and ensuring the cast remains intact and dry. Removal requires checking for healing and using specialized tools to carefully cut and remove the cast.

1. Assisting with Cast application and
removal

2. Objectives: at the end of this lesson, the
learner will be able to:
– Define cast
– Assemble equipments for application and
removal of cast
– Identify the preventive and health teaching
needs of the patient with a cast
– Demonstrate the nursing care for a patient with
cast

3. Cast application
Definition:- A cast is a rigid external immobilizing
device that is molded to the contours of the
body.
Purpose:
• To immobilize a body part in a specific position
• To apply uniform pressure on encased soft tissue
• To immobilize a reduced fracture
• To correct a deformity
• To support and stabilize weakened joints

4. Contraindications (relative)
• Skin diseases
• Peripheral vascular disease
• Diabetes mellitus
• Open or draining wounds
• Susceptibility to skin irritations
•

5. • Equipment
– Drape for patient
– Knitted material (eg, stockinette)
– Nonwoven roll padding
– Casting material (POP)
– Water and basin
– Cast knife or cutter
– Trolly

6. Procedure
• Perform neurovascular assessment
• Explain the procedure
• Wash hands
• Assemble necessary equipments
• Support extremity or body part to be casted.
• Position and maintain part to be casted in
position indicated by physician during casting
procedure.
• Drape patient.
• Wash and dry part to be casted.
• Place at least three layers of knitted material
(eg, stockinette) over part to be casted.

7. • Apply plaster or fiberglass casting material
evenly on body part.
– Choose appropriate-width bandage.
– Overlap preceding turn by half the width of the
bandage.
– Use continuous motion, maintaining constant
contact with body part.
– Use additional casting material (splints) at joints
and at points of anticipated cast stress.

8. • Support cast during hardening.
• Handle hardening casts with palms of hands.
• Support cast on firm, smooth surface.
• Do not rest cast on hard surfaces or on sharp
edges.
• Avoid pressure on cast.
• Promote drying of cast.
– Leave cast uncovered and exposed to air.
– Turn patient every 2 hours, supporting major
joints.
– Fans may be used to increase air flow and speed
drying.

9. Care of patient with cast
• Wash hands.
• Check circulation, movement, and sensation
– Note color and temperature of skin.
– Pinch finger or toe and watch for capillary refill within
2 to 4 seconds.
– Ask client to twist fingers or toes.
– Ask client to tell you if s/he feels you touching the
extremity
• Assess skin.
– Tell client not to put objects under the cast.
– Use powders or creams only outside the cast.
• Assess pain or soreness.
– Reposition the extremity q2h.
– Elevate the extremity and apply ice.

10. • Assess cast for intact cotton padding. Pad or add
additional padding to areas of redness or
irritation
• Assess cast for intact edges.
• Assess safety
• Instruct client and caregiver about symptoms to
report to the physician or qualified nurse:
– An increase in swelling.
– A tingling or burning sensation.
– An inability to move muscles around the cast.
– A foul odor around the edges of the cast.
– Any drainage, which may show through the cast.
– Any cracks or breaks in the cast.

11. • Support the cast.
– Use pillows for arms and legs.
– Use a bed board under the mattress for a spica cast.
• Assess for infection.
– Check for foul odor under cast.
– Check for drainage on cast.
– Mark drainage and date on cast.
• Synthetic casts should be kept dry. If the physician
or qualified practitioner does permit bathing or
swimming, the wet cast should be dried quickly
and thoroughly.
• Dry the cast with a towel and then a hair dryer set
on low. Dry until the padding underneath does not
feel cold or damp to the skin.
• Wash hands

12. Cast Removal
Indication
 When a fracture heals
 If it requires further manipulation
Less common indications include:
• Cast damage
• Pressure ulcer under the cast
• Excessive drainage or bleeding
• Constrictive cast

13. Equipment
• Cast cutter
• cast splitter
• Bandage scissors
• Surgical or plaster knife
• Warm water
• Gloves
• Guaze