Orthopaedic Technologist Certified Cast Complications and Removal Flashcards

A patient with a short arm cast reports burning pain that started 30 minutes after application. The most appropriate immediate action is:

Answer: Bivalve the cast immediately

Burning pain shortly after cast application suggests pressure or thermal injury, requiring immediate bivalving to relieve pressure and inspect the skin.

Which of the following is the MOST common site for a pressure ulcer in a patient wearing a long leg cast?

Answer: Fibular head

The fibular head is a prominent bony prominence and a high-risk site for pressure ulcer development beneath a long leg cast.

When using a cast saw to remove a fiberglass cast, the blade should be moved in which motion to avoid skin injury?

Answer: Up-and-down oscillating plunge cuts

The oscillating saw blade should be used with up-and-down plunge cuts rather than dragging, which reduces heat buildup and risk of laceration.

A patient's cast has developed a foul odor and the patient reports fever. These findings most likely indicate:

Answer: Infection beneath the cast

Foul odor combined with fever are classic signs of infection under a cast, requiring urgent cast removal and wound assessment.

After bivalving a cast, the two halves should be secured with:

Answer: Elastic bandage (ACE wrap)

After bivalving, an elastic bandage is wrapped around the cast halves to hold them in place while still allowing circumferential decompression.

Which sign indicates venous congestion rather than arterial compromise in a casted extremity?

Answer: Cyanosis and swelling of digits

Cyanosis (bluish discoloration) combined with swelling suggests venous outflow obstruction rather than arterial insufficiency.

When removing a cast from a child, the preferred technique to reduce anxiety includes:

Answer: Demonstrating the saw on the parent's hand first

Demonstrating the cast saw on the parent's hand shows the child the saw does not cut skin, effectively reducing fear and improving cooperation.