The document provides information on basic trauma management and casting in emergency settings. It discusses principles of casting including immobilization and maintaining function. It describes the two types of fracture healing and the three R's of casting - reduction, retention, and rehabilitation. Details are given on the history and uses of plaster of Paris as well as the chemical process that occurs when it is mixed with water. Guidelines are provided on the application of plaster casts and synthetic casts, potential complications, and instructions to give patients.
Cast and immobilization techniques in orthopaedics by Dr O.O. AfuyeAlade Olubunmi
Cast, similar in function to splints are used to immobilize broken bones. The principles of its application and cast care most be followed for effectiveness.
Please find the power point on Fracture of Talus with well diagrammatic explanation from very reliable sources. If you need such a power point on different topics related with MBBS then please write it on comment section. Thank you
Cast and immobilization techniques in orthopaedics by Dr O.O. AfuyeAlade Olubunmi
Cast, similar in function to splints are used to immobilize broken bones. The principles of its application and cast care most be followed for effectiveness.
Please find the power point on Fracture of Talus with well diagrammatic explanation from very reliable sources. If you need such a power point on different topics related with MBBS then please write it on comment section. Thank you
It shows methods of gingival retraction and its recent advances.
gingival retraction is done prion to tooth preparation or impression making to widen the gingival sulcus for easy access to the margin around tooth that is prepared.
Objectives, applications & mechanism of drying processAkankshaPatel55
the process of removing moisture from a material. It's a crucial process in various fields, from food preservation and agriculture to manufacturing and construction. Here's a breakdown of the different aspects:
Mechanisms of Drying:
There are several ways to remove moisture from a material:
Evaporation: This is the most common method, where heat is used to convert liquid water into vapor. This vapor is then removed from the material, typically by airflow. Examples include sun-drying clothes or using a clothes dryer.
Desiccation: This method uses a desiccant, a material that absorbs moisture from the air. This creates a dry environment around the material, promoting moisture removal. Silica gel packets are a common example of desiccants.
Freeze-drying: This technique involves freezing the material and then removing the ice directly through sublimation (solid to gas transition) under a vacuum. This preserves delicate materials like fruits and pharmaceuticals.
Factors affecting drying rate:
Surface area: More surface area allows for faster moisture escape. Imagine a wet sponge - the more you spread it out, the faster it dries.
Temperature: Higher temperatures increase the vapor pressure of water, making it easier to escape. Think about clothes drying faster on a hot day compared to a cool one.
Humidity: The amount of moisture already in the air (humidity) affects how readily new vapor can be absorbed. Higher humidity slows down drying.
Airflow: Moving air removes evaporated moisture from the material's surface, preventing it from building up and slowing down further drying. Good ventilation is crucial.
Material properties: Different materials have different properties affecting moisture release, like pore size and permeability.
Applications of drying:
Drying plays a vital role in numerous fields:
Food preservation: Dehydration removes moisture from fruits, vegetables, and other foods, extending shelf life and preventing spoilage.
Agriculture: Drying grains and other crops after harvest prevents mold growth and ensures safe storage.
Manufacturing: Drying various materials like textiles, paints, and pharmaceuticals is crucial for processing and finishing.
Construction: Drying newly built structures before finishing prevents moisture damage and ensures structural integrity.
Types of dryers:
There are many types of dryers, each suited to specific materials and applications:
Convection dryers: Use heated air to remove moisture. Examples include clothes dryers and tunnel dryers used in food processing.
Freeze dryers: Used for delicate materials, removing ice through sublimation under vacuum.
Spray dryers: Atomize liquids into droplets, drying them instantly with hot air. Used for milk powder production, for instance.
Fluidized bed dryers: Suspend particles in a stream of hot air for efficient drying. Used in chemical and pharmaceutical industries.
A STEP IN CASTING OF CAST PARTIAL DENTURE, a precious duplication process and proper wax up of refractory cast results in accurate fitting of the framework of the prosthesis.
THIS PRESENTATION INCLUDES THE MOST COMMON CONCRETE PROBLEMS CAUSES AND RESPECTIVE MEASURES TO AVOID IT.
THE COMMON CONCRETE PROBLEMS ARE
1)DISCOLORATION
2)SCALING
3)CRAZING
4)CRACKING
5)CURLING
6)BLISTERS
7)DELAMINATION
8)DUSTING
9)EFFLORESCENCE
10)SPALLING
11)POPOUTS
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
2. PRINCIPLES OF CASTING
• LUCAS CHAM- IMMOBILIZATION AND A LOT OF FUNCTIONAL THERAPY AND
MASSAGE LEAD TO FRACTURE HEALING.
• LORENZO BOHLER- IMMOBILIZING THE BONE FRAGMENT AND ADJACENT
JOINT IN A FUNCTIONAL POSITION.
SIR JOHN CHARNLEY
3. FRACTURE HEALING
TWO TYPES OF HEALING
DIRECT HEALING
• THE FRACTURE GAP IS VERY SMALL(LESS THAN 0.5) THIS HEALING OCCURS UNDER
CONDITION OF ABSOLUTE STABILITY(PLATE) WHERE REMODELLING OCCURS
WITHOUT CALLOUS FORMATION
INDIRECT HEALING
• THIS IS THE USUAL WAY OF HEALING IN NON- OPERATIVE FRACTURE CARE,
INVOLVES CALLOUS FORMATION
4. 3 R’S OF CASTING
• REDUCTION
• FRAGMENTS MUST REDUCED PROPERLY BEFORE CASTING AND PLACED IN A
FUNCTIONALLY ACCEPTABLE LIMB ALIGNMENT
• RETENTION
• FRAGMENTS MUST BE KEPT IN A REDUCED POSITION UNTIL HEALING OF BONE
OCCURS
• REHABILITATION
• FIRST THE FREE JOINTS HAS TO BE MOBILIZED DURING CAST IMMOBILIZATION
AND FOLLOWED BY MOBILIZATION OF ENTIRE LIMB POST CAST REMOVAL
5. 5,000 YEARS AGO EGYPTIANS BEGAN TO PRODUCE A POWDER BY
HEATING GYPSUM, WHEN MIXED WITH WATER IT FORMED A PASTE THAT
HARDENED AS IT DRIED, THEY USED THIS TO JOIN STONE BLOCKS FOR
BUILDING THE GREAT PYRAMID OF CHEOPS
PLASTER OF PARIS WAS ABUNDANT AND WIDELY USED BY PERSIANS FOR
BUILDING PURPOSE AND PARIS BECAME THE CAPITAL OF GYPSUM, HENCE
THE NAME PLASTER OF PARIS
6. FIRST USED BY A DUTCH MILITARY SURGEON ANTONIUS MATTHYSEN
IN 1952, HE DEVELOPED PLASTER BANDAGES DURING THE CRIMEAN WAR, BY
FILLING COTTON BANDAGES FILLED WITH POWERED POP.
THE MODERN POP BANDAGE CONSIST OF A ROLL OF MUSLIN STIFFENED BY
DEXTROSE/ STARCH WITH IMPREGNATED HEMIHYDRATE OF CALCIUM SULFATE
8. CHEMICAL AND PHYSICAL FEATURES
• GYPSUM IS A SEDIMENTARY CRYSTALLINE ROCK, IT IS CALCIUM SULFATE
DIHYDRATE(CASO4. 2H2O)
• WHEN IT IS HEATED IT CONVERTS INTO CALCIUM SULFATE HEMIHYDRATE
(CASO4.1/2H20)
• CASO4.2H2O + HEAT - CASO4.1/2H2O + 11/2H2O
• THIS PROCESS IS CALLED CALCINATION
• WHEN WATER IS ADDED TO THIS HEMI HYDRATE
2(CASO4.1/2H2O)+3H2O ----> 2(CASO4.2H2O)+HEAT
THIS EXOTHERMIC REACTION IS RESPONSIBLE FOR THE FEELING OF
WARMTH FOLLOWING APPLICATION OF A POP SLAB/ CAST
9. SETTING TIME : 3- 9 MIN(START OF REACTION TO FORMATION OF CRYSTALLINE FORM)
DRYING TIME : 24 – 72 MIN ( CRYSTALLINE FORM TO AMORPHOUS FORM)
LOAD BEARING : 48 HRS
THE SETTING TIME CAN BE
INCREASED DECREASED
COLD WATER HOT WATER
SUGAR SALT
POTSSIUM SULFATE SODIUM BORATE
10. VARIOUS FORMS
• SLAB/ SPLINT: ONLY A PART OF CIRCUMFERENCE OF LIMB IS
INCORPORATED
• CAST: ENCIRCLE WHOLE CIRCUMFERENCE
• SPICA : CROSS BANDAGE APPLIED TO THE ROOT OF A LIMB
• BRACE: A DEVICE FITTED TO INJURED PART OF THE BODY, TO GIVE
SUPPORT
11. • SPLINT/ SLAB
• IF COMPLETE IMMOBILIZATION IS NOT REQUIRED( IN ORDER TO DECREASE SWELLING OR TO
PROTECT AGAINST SOFT TISSUE DAMAGE) NON CIRCUMFERENTIAL SPLINT MADE OUT OF POP
OR SYNTHETIC MATERIAL CAN BE USED
• USED IN POST OPERATIVE STABILIZATION, SHIFTING OF PATIENTS, SUPPORT TO REDUCE THE
SWELLING
12. • CAST
• IT IS CIRCUMFERENTIAL APPLICATION OF POP, DONE WHEN HIGH DEGREE OF
IMMOBILIZATION IS REQUIRED
13. • SPLIT CAST
• WHEN A CIRCUMFERENTIAL CAST IS APPLIED TO A FRESH FRACTURE OR POST
OPERATIVELY IT HAS TO BE SPLIT OPENED LONGITUDINALLY TO ALLOW SWELLING TO
OCCUR WITHOUT INCREASE IN PRESSURE, THE SPLIT CAST IS THEN WRAPPED WITH AN
ELASTIC BANDAGE
15. BIOMECHANICS OF CAST
• IN # THERE MAY BE IMBALANCE BETWEEN THE FORCES ON THE
EXTREMITIES AND RESULTING IN DISPLACEMENT OF THE FRACTURE, THE
CAUSE OF THIS DISPLACEMENT COULD BE DUE TO DIRECT FORCE , OR
DUE TO THE LEVERAGE OF THE MUSCLE INSERTED
• A SUPPORT TO COUNTER THESE FORCES IS REQUIRED FOR STABILIZATION,
THIS DEPENDS ON THE AMOUNT OF FORCE ACTING ON THE # SITE( MORE
TENSION THE FOREARM # THAN CLAVICLE # HENCE THE FORMER
REQUIRES HIGH DEGREE OF IMMOBILIZATION)
16. • THREE POINT STABILIZATION OF THE # IS REQUIRED AS TWO POINT
STABILIZATION (PROXIMAL AND DISTAL) WILL NOT BE SUFFICIENT FOR
OF ANGULATIONS
• IN FOREARM # AE CAST/ SPLINT HAS TO BE GIVEN TO COUNTERACT THE
ACTING ON THE # SITE, BUT IN A ANKLE # WHICH IS FAR FROM THE
TIBIA ONLY AN BK CAST WILL SUFFICE TO COUNTERACT THE FORCE ACTING
THE # SITE
17. The three point principle, using the example of
a traction and reduction cast for the distal
radius using POP Point one dorsal moulded
rim
Point two palmar aspect, where the surgeons
palm is situated
Point three proximal shaft of the cast where
the four fingers are shown
18. IDEAL MATERIAL FOR CASTING
• DRIECT APPLICATION
• EASY TO MOULD
• NON – TOXIC
• UNAFFECTED BY FLUID
• TRANSPARENT TO XRAY
• EASY TO MODIFY
• EASY TO REMOVE
• CHEAP
19. • CONFORMABILITY AND PLASTICITY
• PLASTER SHOULD BE SUFFICIENTLY PLIABLE AND PLASTICALLY DEFORMABLE, TO CUT
THE CIRCUMFERENTIAL PLASTER ALONG A SINGLE LINE, THIS IS DONE IF THERE IS
SWELLING AND IMMEDIATE RELEASE OF POP IS REQUIRED, THIS PROCESS IS CALLED
UNIVALVING AS OPPOSED TO BIVALVING WHICH IS CUTTING ALONG TWO LINES
• POROSITY AND ABSORPTION
• IT MUST BE POURS TO ALLOW THE TRANSMISSION OF PERSPIRATION, WHICH ALLOW
SKIN MOISTURE TO DRY, POP ALSO ABSORBS WATER AND DISCHARGE FROM THE
WOUND AND LOOSES ITS RIGIDITY
20. • STRENGTH AND STABILITY
• DEPENDS ON THE CRYSTAL STRUCTURE AND IF THE CAST IS MANIPULATED WHILE IT
BECOMES HARDEN OR PREVENTED FROM DRYING OUT IT WILL BE WEAK BECAUSE OF
IMPAIRED CRYSTALLIZATION
• DEPENDS ON THE LAYER OF PLASTER AND THE SHAPE OF THE CAST CONTOURED
AROUND THE INJURED EXTREMITY
• THE WATER DEPTH SHOULD BE AT LEAST 20 – 30CM, THE IMMERSION TIME IS
APPROXIMATELY 3 SECONDS OR UNTIL AIR BUBBLES STOP APPEARING, THE PLASTER
MUST BE UNIFORMLY WET, DRY SPOTS FORMS PUFFY PASTRY PLASTER.
• IT IS IMPORTANT TO RUB THE MOIST PASTE INTO THE FABRIC IN ODER TO MAINTAIN A
SMOOTH, UNIFORM COMPOSITE
• LOW STRENGTH TO WEIGHT, 20% INCREASE IN THE WEIGHT OF POP WILL DOUBLE THE
STRENGTH
21. MATERIALS FOR CASTING
1)PLASTER OF PARIS:
MODERN POP ARE MADE BY GRINDING GYPSUM AND HEATING IT UNDER
PRESSURE IT IS MIXED WITH VARIOUS ADDITIES TO IMPROVE ITS HANDLING
CHARACTER, THE RESULTANT SLURRY IS ADDED TO LENO.
2)POP WITH MELAMINE RESIN: WATER RESISTANT CAST
3)MATERIALS WHICH UNDERGO POLYMERISATION
- WATER ACTIVATED
- NON WATER ACTIVATED
4) LOW TEMPERATURE THERMOPLASTICS
22. SYNTHETIC CAST MATERIAL
SYNTHETIC CAST MATERIALS TYPICALLY CONSIST OF ONE LAYER OF
POLYESTER KNIT OR POLYPROPYLENE KNIT WITH FIBERGLASS FABRIC OR
FIBERGLASS FREE POLYMER (THE LATTER ALSO CALLED THERMOPLASTIC).
THE IMPORTANT PART OF THE MATERIAL IS THE KNITTED FABRIC
IMPREGNATED WITH A POLYURETHANE RESIN, THE PREPOLYMER.
THE RESIN POLYMERIZES AND HARDENS AFTER BEING EXPOSED TO
HUMIDITY OR WATER.
GLOVES SHOULD BE USED DURING APPLICATION BECAUSE THE RESIN
ADHERES TO SKIN AND CAUSES IRRITATION
23. PROPERTIES
• MOLDABILITY IS LES THAN PLASTER
• RETAINS THE STRENGTH EVEN WHEN WET
• MODIFIYING THE RESIN POLYMER CAN FORM RIGID OR SEMIRIGID CAST
24. TYPES
• POLYSTER:
• POLYSTER FABRIC IS COATED WITH POLYURETHANE RESIN, STRENGTH
DEPENDS UPON THE NUMBER OF LAYERS, INTERFERES LESS WITH XRAY, THIS
PRODUCES LESS DUST DURING REMOVAL, IT CAN BE APPLIED AS A PRIMARY OR
SUBSEQUENT APPLICATION
• FIBERGLASS
• FIBERGLASS WITH POLYURETHANE RESIN PROVIDES RIGID DURABLE
IMMOBILIZATION, THE RIGIDITY DEPENDS UPON THE COMPOSITION OF RESIN
BASED ON THIS THEY CAN BE OF
• RIGID: IS APPLIED FOR PERFECT IMMOBILIZATION,
• SEMI RIGID: THEY ARE PLIABLE AND THEY ARE MEANT FOR MAINTAINING ALIGNMENT
DURING FUNCTIONAL USE,
• THE SETTING TIME IS 5 MINUTES AND WEIGHT BEARING AFTER 30 MINUTES
25. THERMOPLASTIC
• THIS CONSIST OF KNITTED POLYESTER WITH THERMOPLASTIC POLYESTER, THERE IS
NO RESIN HERE, THEY ARE REVERSIBLY MOLDABLE DEPENDING ON THE TEMPERATURE,
THE MATERIAL HARDEN ON COOLING AND CAN BE MOLDED ON HEATING
26. PLASTER OF PARIS VERSUS
SYNTHETIC CAST MATERIAL
• THESE INCLUDE:
• • GREATER MATERIAL COSTS OF SYNTHETIC
• • SHORTER WORKING TIME OR THE APPLICATION OF SYNTHETIC
• • LESS FREQUENT NEED OR RECASTING WITH SYNTHETIC
• • LESS ABRASIVE AND SMOOTHER EDGES IN SEMI RIGID SYNTHETIC
CASTING
• • HEAVIER WEIGHT OF POP
• • TIME REQUIRED OR COMPLETE SETTING WITH POP
• • THE AMOUNT OF HEAT THAT CAN BE PRODUCED IN POP, PARTICULARLY
WITH WARM DIPPING WATER OR A THICK PLASTER CAST.
27. RULES FOR CAST
• CAST SHOULD BE MOULDED WITH PALM
• ONE JOINT ABOVE AND BELOW
• CAST SHOULD NOT BE TOO TIGHT OR TOO LOOSE
• UNIFORM THICKNESS IS PREFERRED, APPLYING ROLLS
OVER EXTREMITIES PREVENTS EASY BREAKAGE
28. APPLICATION OF POP
• PADDING: PADDING IS DONE FROM DISTAL TO PROXIMAL WITH A 50% OVERLAP, MINIMUM 2
LAYERS, AND EXTRA PADDING AT BONY PROMINENCE(FIBULAR HEAD, PATELLA)
• LAYERS:
• 20 FOR ADULT LOWER LIMB
• 15 FOR ADULT UPPER LIMB
• 12 – 15 FOR CHILD UPPER LIMB
• 10 – 12 LAYER FOR CHILD UPPER LIMB
• SIZE:
8 INCH FOR THIGH
6 INCH FOR LEG
4 INCH FOR ARM AND FOREARM
29. APPLICATION OF SYNTHETIC CAST
• THERE ARE TWO DIFFERENT WAYS TO APPLY SYNTHETIC CAST MATERIAL.
• NORMALLY THE MATERIAL IS DIPPED INTO TEPID WATER (AROUND 18–20° C) AND
THEN APPLIED TO THE LIMB.
• THE WORKING TIME USING THIS TECHNIQUE IS ABOUT 2–4 MINUTES AND THE
INITIAL SETTING TIME TAKES ABOUT 6–8 MINUTES
• ANOTHER WAY O APPLYING SYNTHETIC CAST MATERIAL IS THE DRY APPLICATION
METHOD WHERE THE MATERIAL IS FIRST APPLIED TO THE LIMB AND THEN
MOISTENED BY SPRAYING WATER ON IT OR BY WRAPPING IT WITH A WET BANDAGE.
THIS TECHNIQUE GIVES MORE WORKING TIME
30. • UNPADDED PLASTER
• APPLYING WITHOUT ANY PADDING OR APPLIED OVER STOCKINETTE
• INTRODUCED BY BOHLER
• BANDAGE SHOULD ROLL ITSELF ROUND THE LIMB, NO TIGHTENINIG
31. • PADDED PLASTER
• COTTON WOOL IS APPLIED BETWEEN THE SKIN AND THE
PLASTER
• THE COTTON WOOL ENHANCES THE FIXATION DUE TO ITS
ELASTIC PROPERTY (TISSUE SHRINKAGE)
• ONE INCH THICKNESS OF COTTON ROLL IS APPLIED WHICH
GETS REDUCED TO 1/8TH ON APPLICATION PLASTER
32. TRIPLE SEQUENCE IN APPLICATION
• PHASE 1 : EXAMINATION AND REHEARSAL
• PHASE 2: PLASTERING
• PHASE 3: REDUCTION AND HOLDING
35. INSTRUCTIONS TO PATIENT ON PLASTER
• TO REPORT IMMEDIATELY
• INCREASED PAIN OR PINS AND NEEDLE
• FINGER OR TOES BECOME BLUE OR NUMB
• UNABLE TO MOVE YOUR FINGER
• YOUR UNABLE TO HOLD PENCIL OR COIN
• NOT TO REST THE CAST ON FIRM SURFACE
• NOT TO HANG THE LIMB
• TO DO MOVEMENTS OF THE IMMOBILISED JOINT
• TO KEEP THE PLASTER DRY
36. COMPLICATIONS
• DUE TO TIGHT CAST
• PAIN
• PRESSURE SORE
• COMPARTMENT SYNDROME: IF PT IS HAVING PAIN ON FLEXING/ EXTENDING THE FINGERS
THE PLASTER HAS TO BE CUT FULLY TO EVALUATE FOR COMPARTMENT SYNDROME
• PERIPHERAL NERVE INJURIES: WHEN ADEQUATE PADDING IS NOT GIVEN, COMMON
PERONEAL NEVER PALSY WHEN PADDING IS NOT GIVEN OVER FIBULA HEAD
37. • DUE TO IMPROPER APPLICATION
• JOINT STIFFNESS
• PLASTER BLISTER AND SORES
• BREAKAGE
• SLIPPAGE OF REDUCTION
• DUE TO ALLERGY
• ALLERGIC DERMATITIS