Assisting with Cast application and removal.pptx

Assisting with Cast application and removal.pptx

• 1.
  Assisting with Castapplication and removal
• 2.
  Objectives: at theend 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:- Acast 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) • Skindiseases • Peripheral vascular disease • Diabetes mellitus • Open or draining wounds • Susceptibility to skin irritations •
• 5.
  • Equipment – Drapefor patient – Knitted material (eg, stockinette) – Nonwoven roll padding – Casting material (POP) – Water and basin – Cast knife or cutter – Trolly
• 6.
  Procedure • Perform neurovascularassessment • 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 plasteror 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 castduring 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 patientwith 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 castfor 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 thecast. – 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  Whena 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