Mixed Deck — All OCC Topics Flashcards

Which sign is most concerning for compartment syndrome in a casted limb?

Answer: Severe pain unrelieved by analgesics

Severe pain that is disproportionate to the injury and unrelieved by standard analgesics is the most concerning sign for compartment syndrome in a casted limb. This condition occurs when increased pressure within a confined muscle compartment compromises circulation and nerve function. It is a medical emergency requiring immediate intervention to prevent permanent tissue damage.

Which information is REQUIRED to be included on every cast application record?

Answer: Date, time, type of cast, materials used, neurovascular status, and technician name

A complete cast record includes procedure details, materials, neurovascular findings, and technician identification to ensure accountability and continuity of care.

Which structure connects muscles to bones?

Answer: Tendons

Tendons are strong, fibrous connective tissues that serve to connect muscles to bones. They are essential for transmitting the force generated by muscle contractions to the skeletal system, thereby facilitating movement. In contrast, ligaments connect bones to other bones, providing stability to joints.

After cast removal, which skin finding requires the clinician's evaluation before the patient is discharged?

Answer: Open pressure sore or wound

Any open wound or pressure injury discovered post-removal must be assessed by the clinician for infection and wound care planning.

Which color-coded system is used to guide padding at vulnerable areas in pediatric casts?

Answer: There is no color system; anatomy landmarks guide extra padding placement

Padding placement in pediatric casts is guided by anatomical landmarks rather than a color-coded system; extra padding is placed over identified bony prominences.

A casting record that is incomplete or falsified could result in:

Answer: Professional discipline, civil liability, and potential criminal charges

Falsifying or omitting medical records constitutes fraud and negligence, with serious legal and professional consequences.

Which standard precaution applies to all patient interactions?

Answer: Treat all body fluids as potentially infectious

Standard precautions are a set of infection control practices where all human blood, body fluids, secretions, excretions (except sweat), non-intact skin, and mucous membranes are treated as potentially infectious. This universal approach applies to all patient interactions, regardless of their diagnosis, to prevent the transmission of infectious agents and protect both patients and healthcare workers.

Which Salter-Harris fracture type passes completely through the physis and is associated with the highest risk of growth disturbance?

Answer: Type V (crush injury to the physis)

Salter-Harris Type V is a compression (crush) injury of the growth plate that may appear normal on initial X-ray but carries the greatest risk of growth arrest.

Which of the following is a critical first step in cast application?

Answer: Applying padding over bony prominences

A critical first step in cast application is to apply adequate padding, especially over bony prominences. This padding protects the patient's skin and underlying tissues from pressure sores, skin breakdown, and nerve compression that can result from the rigid casting material. Proper padding ensures patient comfort and prevents complications throughout the immobilization period.

What should be done if a cast technician experiences a needle-stick injury?

Answer: Report it and follow post-exposure protocol

Any needle-stick injury is a serious occupational exposure that carries the risk of transmitting bloodborne pathogens. The immediate and correct action is to report the incident to a supervisor and follow the established post-exposure protocol. This protocol typically includes wound care, medical evaluation, and potential prophylactic treatment to ensure the healthcare worker's safety and health.

A Colles fracture is a distal radius fracture with which characteristic displacement?

Answer: Dorsal displacement and angulation of the distal fragment (dinner fork deformity)

The classic Colles fracture produces dorsal tilt of the distal fragment, creating the dinner fork silhouette on lateral X-ray.

What is the primary advantage of fiberglass casting material over plaster?

Answer: It is lighter and water-resistant

Fiberglass casting material offers several advantages over plaster, most notably being significantly lighter and water-resistant. Its lighter weight enhances patient comfort and mobility, while its water-resistant property allows patients to shower or bathe with proper precautions, improving hygiene and quality of life during immobilization. These features contribute to better patient compliance and overall experience.

Which instrument is the standard tool for cast removal?

Answer: Oscillating cast saw

The oscillating cast saw vibrates rather than rotates, cutting hard cast material while minimizing risk of skin laceration.

Which scenario represents a reportable incident in a healthcare setting?

Answer: A cast saw laceration of the patient's skin during removal

Any unintended patient injury — such as a saw laceration — is an adverse event that must be documented in the medical record and reported per facility policy.

What is the function of the periosteum?

Answer: Protects and nourishes bone

The periosteum is a dense, vascular connective tissue membrane that covers the outer surface of most bones. Its primary functions include protecting the bone, providing a surface for muscle and ligament attachment, and containing cells vital for bone growth, repair, and nourishment. It also houses nerve endings, contributing to bone sensitivity.

The OCC certification is maintained through:

Answer: Continuing education credits and periodic recertification requirements

Certification maintenance requires ongoing continuing education and recertification to ensure competency remains current.

A capillary refill time greater than how many seconds is considered abnormal in a casted extremity?

Answer: 2 seconds

Capillary refill greater than 2 seconds indicates impaired peripheral perfusion and requires prompt evaluation.

A patient refuses a cast recommended by the physician. The casting technician's role is to:

Answer: Document the refusal and notify the supervising clinician

Competent patients have the right to refuse treatment; the technician must document the refusal and inform the clinician so appropriate follow-up can be arranged.

Which assessment finding in a casted lower extremity requires IMMEDIATE notification of the supervising provider?

Answer: Absence of the dorsalis pedis pulse

Absence of a pedal pulse indicates potential vascular occlusion and is an emergency requiring immediate physician notification.

After both medial and lateral cuts are made during bivalving, which instrument is used to separate the cast halves?

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.