Cast Care

Chapter 55, Patient Education Lesson 2Pearson's Comprehensive Medical Assisting, 2nd ed.

Beaman, Fleming-McPhillips, Routh, Gohsman, and Reagan, Pearson 2011

MA100: Instructor Mayra Howells

Explain that casts are a form of inflexible bandage that are applied for the purpose of immobilizing a broken bone or muscle strain and sprain

A cast may be applied after a surgical procedure on a limb to immobilize the area until healing takes place

Preparing a Patient for a Cast Application

Cast material (bandage roll or tape) Container of warm water Stockinette Webril (sheer wadding) padding rolls Bandage scissors Rubber gloves Sponge rubber (for padding)

Instruments Used for Cast Application

It may be necessary to hold the limb at the joint areas as the cast is being applied

Remember to handle a damaged limb gently

Assisting the Physician with Cast Application

After the cast has been applied, it must be left uncovered during the drying process

The limb may need to be supported on a pillow at this time

The patient should be cautioned against moving around until the cast is dry

The cast may feel warm or even hot during the drying process – Reassure the patient that this is normal

Assisting the Physician with Cast Application

Circulation restricted by the cast Pain as a result of the cast pinching the skin Excessive itching under the cast Numbness or tingling of fingers or toes Discolored toes or fingers Swelling of the limb around the edge of the cast Discoloration soaking through the cast Loosely-fitting cast Foul odor coming from the cast

Observations that Patients Should Report

Short arm cast (SAC)– Extends from the finger to just below the

elbow – Used for a fracture or dislocation of the wrist or forearm

Long arm cast (LAC)– Extends from the fingers to the axilla, with a

bend at the elbow – Used for a fracture of the upper arm

Long and short leg casts– Extend from the thigh to the toes (LLC) or

from below the knee to the toes (SLC) – They usually include an embedded walking heel

Types of Casts

Clean the cast with a damp cloth Do not cut or trim the cast – If the edge seems sharp,

apply masking tape to the sharp edge or use a nail file to trim it down

Elevate the extremity with the cast on it to reduce swelling and pain

Observe the fingers and toes for color changes, temperature changes, pain, tingling, or decreased sensation

When decorating a cast, use only water-soluble paints or marking pens – Otherwise the cast will not be able to breathe

Patient Cast Care

Call the physician’s office if you smell a bad odor coming from the cast, lose sensation or blood flow beyond the cast, feel a burning sensation, or notice blood coming from the cast

After being sure that the patient understands the importance of cast care, the medical assistant must document the teaching in the patient chart

Patient Cast Care

Cast cutterCast spreaderBandage scissorsBag for disposing of cast materialsDrape

Equipment Needed for Cast Removal

After washing hands and draping the patient, explain the process to the patient

The cutter vibrates and does not spin The patient may feel some pressure and warmth The patient may be shocked to see that the skin

under the cast has become white and the muscle tone has decreased, and may need some reassurance that physical therapy will improve the function and appearance of the limb

Procedure for Cast Removal

The MA should stand near the physician and hand the necessary equipment as requested

After the cast is removed, the medical assistant shouldProvide written instructions for post cast careClean the equipmentWash handsDocument the procedure in the patient chart

Procedure for Cast Removal