How To Remove Fiberglass Cast Without Saw

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This is an excerpt from Athletic Taping, Bracing, and Casting, 4th Edition With HKPropel Access by David Perrin & Ian McLeod.

This department details the fundamental steps and of import considerations that pertain to applying and removing fiberglass casts and splints.

Application of a Fiberglass Cast

1. Based upon history, physical test, and imaging studies, determine what type of cast should be applied.
2. Inspect the involved extremity and document the presence or absence of pare lesions, open up wounds, and swelling.
   1. Presence of an open up wound in an area that volition be covered by the bandage is a contraindication to applying the cast.
   2. If post-traumatic swelling is all the same present and the injury occurred less than 48 hours ago, it is contraindicated to apply a cast. If the injury occurred more than 48 hours agone, swelling is gradually decreasing, and the patient is capable of elevating the involved extremity, a cast can exist applied. Manifestations of compartment syndrome must be reviewed.
3. Check and certificate distal neurovascular status for the involved and uninvolved extremity.
4. Embrace the patient's wear with a protective barrier.
5. To determine the amount of stockinette needed, measure about four inches (10 cm) across each end of the expanse that will exist casted.
6. Apply stockinette and place each joint that will be immobilized in a functional position. Specific positions are every bit follows:
   1. Elbow: 90º of flexion (run across figure vi.thirteena)
   2. Wrist: 30º of extension (run into figure 7.22a)
   3. Pollex: midway between maximal radial and palmar abduction (see effigy seven.22a)
   4. Manus: metacarpophalangeal joints in 70º of flexion and interphalangeal joints in full extension (come across effigy seven.19a)
   5. Knee joint: 15º to 30º of flexion
   6. Ankle: 0º of dorsiflexion (come across figure two.33a)
7. Smooth out whatsoever wrinkles in the stockinette. If needed, trim the stockinette over flexor surfaces.
8. Apply bandage padding by kickoff about 1 inch (ii-3 cm) beyond the distal end of the area that will be casted. Roll the cast padding circumferentially from distal to proximal, making sure to overlap the previous layer by l%. This will provide two layers of padding. Ideally you should have two to 3 layers of padding. The cast padding should extend about i inch (two-iii cm) beyond the proximal finish of the area that will be casted (see figure 2.33eastward).
   1. Extra padding can be applied to protect bony prominences (due east.m., ulnar styloid, olecranon process, medial malleoli, and lateral malleoli).
   2. Place extra padding at the proximal and distal edges of the surface area that will be casted.
   3. As well much padding on the flexor surface of a articulation volition increase the risk of skin irritation and peel breakup.
   4. Excessive padding can compromise the ability of the cast to immobilize the injured surface area.
9. Utilise fiberglass casting fabric by kickoff about 1 inch (2-iii cm) in from the distal cease of the cast padding. The fiberglass cloth should exist rolled circumferentially from distal to proximal, overlapping the previous layer by fifty%. Maintaining a small amount of compatible tension will reduce the take a chance of pare irritation, neurological injury, and vascular compromise (see figure 2.33h).
10. After applying two to iii layers of fiberglass, confirm that functional positioning of the joints has been maintained. Using the palm and heel of the hand, mold the casting textile as needed. Never apply the fingertips when molding because they may create focal pressure points that increase the hazard of skin irritation and pressure sores.
11. Prior to applying the final layer of fiberglass, fold the stockinette dorsum over the previously applied fiberglass. The final layer of fiberglass should exist applied in a distal to proximal management. If necessary, mold the final layers of casting fabric.
12. Post-obit cast application. recheck and certificate distal neurovascular status for the involved and uninvolved extremity.

Video one.1 demonstrates the preparation and application of a fiberglass bandage.

Cast removal is all-time accomplished with use of a cast saw (meet effigy one.23a) because it has an oscillating blade that is specially designed to cut hardened fiberglass and plaster. While the oscillating blade tin damage the underlying soft tissue, the risk of injury is significantly less in comparison to that of a rotating saw blade. As the oscillating blade cuts the difficult cast textile, a significant amount of heat is generated, which has the potential to burn the patient. Inserting a plastic cutting guard betwixt the stockinette and skin and using proper cut technique reduces the risk of soft-tissue injury. When cutting the fiberglass it is all-time to apply the "upward, over, and down" technique described hither:

1. While holding the saw blade perpendicular to the cast (come across figure 1.24a), employ gentle downward pressure until there is a sudden decrease in resistance, which indicates that the saw blade has cut through the cast.
2. Lift up to remove the saw bract. One time the saw bract is clear of the cast, move it over to the next portion of the cast.
3. Once once again, apply gentle downward pressure until the bract cuts through the cast.
4. Repeat this technique along the entire length of the cast.
5. Resist the temptation to "elevate" or "push" the saw blade forth the length of the bandage because doing so significantly increases the risk of soft-tissue injury.

Effigy ane.23 (a) Bandage saw, (b) cast spreader, and (c) bandage scissors that are necessary for cast removal.

Figure 1.24 (a) Agree the cast saw blade perpendicular to the cast. (b) Bandage spreaderis used to dissever the opposing edges of the bandage. (c) Bandage scissors are used to cut the underlying bandage padding and stockinette.

Cast removal is accomplished by making a longitudinal cut along the entire length of the cast followed past a like cut on the opposing side of the bandage. In one case both cuts have been completed, a bandage spreader (see figures one.23b and i.24b) tin can exist used to separate the opposing halves of the cast, making it much easier to utilize bandage scissors (see figures 1.23c and i.24c) to cut along the length of the underlying cast padding and stockinette.

Video ane.3 demonstrates bandage removal.

Splint removal is accomplished by first removing the rubberband wrap that secures the splint in place. Side by side, the rigid splint is removed. When doing so information technology is extremely important to support the injured extremity to minimize any type of motion or stress that could compromise the healing that has taken place. Bandage scissors are used to cut along the entire length of the cast padding and stockinette, which is then removed.

We've included this general competency checklist to help instructors and students alike evaluate the cognition, skills, and techniques necessary for constructive injury assessment and casting or splinting.

The principles we take presented in this chapter will set up you for the specific treatments that nosotros hash out in the remaining chapters. Adept luck every bit y'all brainstorm your training in these gratifying psychomotor skills!

Visit the spider web resource for checklists and video clips related to topics discussed in this affiliate.

Casting and Splinting Competency Checklist

1. Determines mechanism of injury
2. Ensures a clean body part that is free from open up wounds
3. Checks distal neurovascular condition
4. Selects advisable splint or cast
5. Properly positions patient and trunk part
6. Correctly applies appropriate splinting or casting or combination procedure
7. Checks distal neurovascular status
8. Educates patient on signs and symptoms that would warrant removal of the splint or cast
9. Correctly instructs patient on how to remove splint or how to seek assistance with removing a bandage

Learn more about Able-bodied Taping, Bracing, and Casting, Fourth Edition .

Source: https://canada.humankinetics.com/blogs/excerpt/applying-and-removing-casts-and-splints

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