e. Long arm cast--extends from axilla to palm, with the elbow normally
immobilized at a right angle.
f. Walking cast--a short or long leg cast with a rubber or metal walking device
attached to the foot.
g. Body cast--encases the trunk.
h. Shoulder spica cast--a body cast that encases the trunk, shoulder, and elbow.
i. Hip spica cast--a body cast that encases the trunk and one or both lower
1-17. CARE OF THE PATIENT WITH A NEWLY APPLIED CAST
a. Expose a newly applied cast to air circulation. It should never be covered,
because the cover will restrict the escape of moisture and heat. This is essential, as a
drying cast generates heat within the plaster as the moisture evaporates and the cast
b. Handle a wet cast carefully. A newly applied cast is set and firm when the
patient leaves the cast room, but it is still damp and easily damaged. It takes 24-48
hours for a cast to become dry and hard. Handle the cast by lifting and supporting it on
a pillow or with the palms of the hands. Never use fingers as they will leave
c. Provide plastic-covered pillows to support the cast along its entire length.
Never permit the wet cast to rest directly on a flat or firm surface as this will flatten the
contours of the cast and cause pressure within the cast.
d. Review the patient's clinical record for the type of cast and the reason the
cast has been applied. Interview the patient to determine his knowledge of the cast
purpose and whether he has had a cast before. Instruct the patient on care of the cast
that is wet and after it is dry.
e. After a cast has cooled and begins to harden, elevate the casted extremity to
reduce swelling which often occurs after application of a cast. When a newly applied
cast is elevated, it should be supported along its entire length, on an inclined plane, with
the distal joints higher than the proximal joints. For example, hand higher than elbow,
elbow higher than shoulder.
f. Observe all edges of the cast for any areas that cut or put pressure on the