OCC OCC Cast Removal & Bivalving 2 — Questions and Answers
Question 1: Before cast removal, what should the technician tell the patient to reduce anxiety about the saw?
- The saw vibrates but will not cut skin if used correctly (Correct answer)
- The saw is completely painless and silent
- The process takes only a few seconds
- The patient should not look at the saw at any time
Correct answer: The saw vibrates but will not cut skin if used correctly
Explaining how the oscillating saw works reassures patients and encourages cooperation, which improves safety during removal.
Question 2: During cast removal, the skin under a long-standing plaster cast is commonly found to be:
- Dry, flaky, and possibly malodorous (Correct answer)
- Infected in most cases
- Deeply pigmented
- Thickened from pressure
Correct answer: Dry, flaky, and possibly malodorous
Weeks of immobilization causes skin dryness, desquamation (scaling), and sometimes odor due to trapped dead skin cells and moisture.
Question 3: Which protective technique is used over bony prominences when running the cast saw?
- Slide a cast spreader or tongue depressor between the blade and the skin (Correct answer)
- Apply extra stockinette over the prominence
- Mark the area and skip it with the saw
- Slow the saw speed to minimum
Correct answer: Slide a cast spreader or tongue depressor between the blade and the skin
Inserting a flat instrument between the blade and skin over bony areas protects against saw burns and lacerations.
Question 4: After both medial and lateral cuts are made during bivalving, which instrument is used to separate the cast halves?
- Cast spreader (Correct answer)
- Bandage scissors
- Hemostat
- Kelly forceps
Correct answer: Cast spreader
A cast spreader (or cast bender) is inserted into the saw cuts to gently pry the two halves apart without stressing the extremity.
Question 5: Heat generated by the oscillating saw can cause skin burns. This risk is BEST reduced by:
- Using a plunging motion and limiting contact time at each point (Correct answer)
- Cooling the blade with water during cutting
- Pressing firmly to cut faster
- Using a lower-frequency saw setting
Correct answer: Using a plunging motion and limiting contact time at each point
Repeated brief contacts with the oscillating saw prevent heat accumulation; prolonged contact causes thermal burns even without laceration.
Question 6: Which cast material requires the MOST caution during saw removal due to increased heat generation?
- Fiberglass (Correct answer)
- Plaster of Paris
- Thermoplastic
- Cotton-based splint material
Correct answer: Fiberglass
Fiberglass generates more heat during sawing than plaster, increasing burn risk if the saw lingers in one position.
OCC OCC Cast Removal & Bivalving 2
Before cast removal, what should the technician tell the patient to reduce anxiety about the saw?