CAST:

 -temporary immobilization device which is made up of gypsum sulfate anhydrous

calcinations when mixed with water swells and forms into a hard cement

 can be applied to the extremities, to the trunk and to extremity and trunk as in
spices

 -can be applied to encase the whole area where it should be applied or it can be
applied as a splint or mold

Functions:

 To immobilize

 To prevent or correct deformity

 To support, maintain and protect realigned bone

 To promote healing and early weight-bearing

Casting materials:

- Plaster of paris

- Synthetic materials

Principles OF CASTING:

1. Provide for maximal comfort and alleviation of complications

a. application of padding is the first step in the procedure. Padding materials are:

i. wadding sheet

ii. roll of cotton

iii. stockinette

iv. felt

2. Maintain desired position throughout cast application

3. use caution in handling of the cast until it has set or become hardened

a. it can be applied as a combination, like stockinette and sheet wadding

b. apply it to include the joint above and joint below the injured part
 c. apply it in circular motion and mould it as you do the procedure by the palmar
hypothenar

d. support it with the palm

Prepare the patient for the cast application by providing appropriate education

4. Provide the patient with privacy, before and during the cast application

COMPLICATION

1. NEUROVASCULAR COMPROMISE

a. Necrosis

b. Pressure sores

c. Nerve pulses

2. INCORRECT FRUCTURE ALIGNMENT

3. Cast syndrome

a. Multisystem problem

4. Compartment syndrome-increased pressure within a limited space,compromises

the circulation and function of the tissues

5. Circulatory impairment

6. Fracture blisters

Cast management:

1. Allow cast to dry

2. Handle a wet cast with a palm not the fingertips

3. Keep the casted extremity elevated using a pillow

4. Turn extremity for equal drying. Use low cool drier

5. Petal the edges of the cast to prevent crumbling of the edges

6. Monitor for the ff: pain, swelling, discoloration, coolness, tingling or lack of
sensation and diminished pulses
 7. Observe for s/s of cast syndrome such as: prolonged N/V, abd distention, vague
and abd pain, (-) bowel sound.

Care of the client with cast

1.carry the newly- casted body part with palms of the hand.

2.Elevate the body part with pillow

3.Expose the cast to dry. Dry cast appears white, shiny,hard and resonant.

4. Keep the cast clean and dry.

5. Observe hot spots and musty odor, or drainage from cast.

6.Maintain skin integrity.- by petalling ( applying adhesive tapes at the edges of the cast
to smoothen areas

7.Do neurovascular checks. The following findings distal to cast application indicate that
cast is too tight

Skin color-pallor

Skin temperature- cold skin

Sensation-numbness, tingling

Mobility-inability to move body part

Pulse-absence of pulse

8.Windowing- is done to facilitate observation under nthe cast. It is also done to assess
pulse and to prevent cast syndrome. Cast syndrome may occur if the client has body
casts. It is manifested by bloated feeling, prolonged nausea, repeated vomiting,
abdominal distention, SOB)

9 Bivalving- done for wound care or Xrays.It is also done when the cast is too tight or
when healing process has occurred. The procedure involves splitting of the cast.