OCC Cast Removal & Bivalving Flashcards

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.

How does an oscillating cast saw avoid cutting the patient's skin?

Answer: It vibrates rapidly but does not rotate, cutting rigid material but bouncing off soft tissue

The oscillating motion cuts through hard fiberglass or plaster but does not slice soft, pliable skin when proper technique is used.

When removing a cast, the saw should be moved in which pattern?

Answer: In and out (plunging motion) along the cast surface, not dragged

A plunging in-and-out motion prevents overheating and reduces the risk of skin burns and lacerations.

What is the purpose of bivalving a cast?

Answer: To split the cast into two halves to relieve pressure or allow for swelling

Bivalving cuts both sides of the cast and releases the underlying padding, reducing circumferential pressure while maintaining some immobilization.

After bivalving, what is the NEXT step to fully relieve circumferential pressure?

Answer: Cut and spread the underlying cast padding

The inner padding layer also contributes to circumferential pressure and must be cut along the same bivalve lines to fully decompress.

Which complication is most directly prevented by prompt bivalving of a tight cast?

Answer: Acute compartment syndrome

Bivalving relieves circumferential pressure that, if left unaddressed, can progress to compartment syndrome and ischemia.