GUIDELINES FOR APPLYING A CAST
PROCEDURE
1. Support extremity or body part to be casted.
2. Position and maintain part to be casted in position
indicated by physician during casting procedure.
3. Drape patient.
4. Wash and dry part to be casted.
5. Place knitted material* (eg, stockinette) over part
to be casted.
• Apply in smooth and nonconstrictive
manner.
• Allow additional material.
6. Wrap soft, nonwoven roll padding* smoothly and
evenly around part.
• Use additional padding around bony
prominences to protect superficial nerves (eg, head of
fibula, olecranon process).
7. Apply plaster or nonplaster 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. “Finish” cast:
• Smooth edges.
• Trim and reshape with cast knife or cutter.
9. Remove particles of casting materials from skin.
10. Support cast during hardening.
• Handle hardening casts with palms of hands. hardness of nonplaster cast occurs in minutes.
• Support cast on firm smooth surface.
• Do not rest cast on hard surfaces or on sharp (24 to 72 hours, depending on environment and
edges.
• Avoid pressure on cast.
11. 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.
RATIONALE
1. Minimizes movement; maintains reduction and
alignment; increases comfort.
2. Facilitates casting; reduces incidence of
complications (eg, malunion, nonunion, contracture).
3. Avoids undue exposure; protects other body parts
from contact with casting materials.
4. Reduces incidence of skin breakdown.
5. Protects skin from casting materials. Protects skin
from pressure. Folds over edges of cast when
finishing application; creates smooth, padded edge;
protects skin from abrasion.
6. Protects skin from pressure of cast.
Protects skin at bony prominences. Protects
superficial nerves.
7. Creates smooth, solid, well-contoured cast.
Facilitates smooth application. Creates smooth, solid,
immobilizing cast. Shapes cast properly for adequate
support.
Strengthens cast.
8. Protects skin from abrasion. Assures full range of
motion of adjacent joints.
9. Prevents particles from loosening and sliding
underneath cast.
10. Casting materials harden in minutes. Maximum
Maximum hardness of plaster cast occurs with drying
thickness of cast). Avoids denting of cast and
development of pressure areas.
11. Facilitates d rying