Orthopaedic Technologist Certified Cast Complications and Removal Flashcards

A patient reports inserting a pencil inside their cast to scratch an itch and now has increased pain at that site. The FIRST priority is:

Answer: Remove the cast and inspect for skin injury

Foreign objects inside a cast can cause pressure sores or lacerations, so removing the cast to inspect the skin is the first priority.

Thermal injury during cast removal is most commonly caused by:

Answer: Heat generated by the oscillating saw blade

The oscillating saw blade generates friction heat, which can burn the skin if held too long in one spot, especially over bony prominences.

Which patient population requires the MOST vigilance for pressure complications during cast immobilization?

Answer: Patients with diabetes or peripheral neuropathy

Patients with diabetes or peripheral neuropathy have impaired sensation and cannot reliably detect pressure-related pain under a cast.

After cast removal, the skin commonly appears:

Answer: Pale, scaly, and with accumulated dead skin cells

Following cast removal, the skin typically appears pale, scaly, and covered with accumulated dead cells due to lack of exposure and normal desquamation under the cast.

A cast that becomes wet and begins to soften should be:

Answer: Replaced with a new cast after skin care

A wet, softened cast loses its structural integrity and must be removed, the skin assessed and cared for, and a new cast applied.

Which technique helps prevent skin maceration when padding a cast?

Answer: Ensuring padding is smooth without wrinkles or ridges

Smooth, wrinkle-free padding distributes pressure evenly and prevents focal pressure points that cause skin breakdown and maceration.

The cast spreader tool used during bivalving is inserted into the cut to:

Answer: Pry the two halves apart to decompress the limb

The cast spreader is inserted into the bivalve cuts to gently pry the halves apart, widening the cast to relieve constrictive pressure.