ASSISTING WITH APPLICATION OF PLASTER OF PARIS (POP)

S. Procedure Yes No
no
1. Assess patients health status, including conditions affecting wound healing (e.g.
diabetes, malnutrition)
2. Explain to patient about the purpose and procedure of cast application,
according to his/ her level of understanding.
3. Assess condition of tissues to be in the cast including circulation to extremities.
note presence of skin breakdown, bruising, rash and irritation. Skin of babies,
children and older persons may contain less subcutaneous fat.
4. Determine patients pain status.
5. Protect patient cloths with protective sheet.
6. Administer analgesics 20-30 minutes before cast application.
7. Wash hands and done gloves.
8. Position patient as desired. patient may be lying; sitting or standing depending
on type and body part to be casted.
9. Prepare skin for cast if necessary; may involve cleansing with soap and water,
changing dressing and trimming or shaving long hair. Use gentle strokes to
maintain skin integrity.
10. Place stockinette over the skin where casting material will be applied.
11. Wrap the site with cast padding
12. Depending on type of cast material being applied, do one of the following:
a. hold plaster roll under water in a casting bucket or plastic basin until
bubble stop, then squeeze slightly and hand over to person applying
cast.
b. Submerge synthetic cast roll in leukwarm water for 10-15 seconds,
squeeze to remove excess water.
c. Hold body part or parts to be put in cast in position requested, for
applying cast.
13. Continue to apply dampened rolls of plaster to hold parts as necessary until cast
is finished.
14. Assist with “finishing” the cast by folding stockinette or other padding down
the outer edge of cast to provide smooth edge to cast. Damp plaster is then
rolled over padding to hold it securely outside cast.
15. Using scissors trim plaster roll around thumb, finger or toes as necessary.
16. Depending on tissues casted, do one of the following
a. Place damp cast on cloth-covered pillow to prevent deformation or
pressure points as its sets.
b. Handle the damp plaster cast with only the palm of the hand and not the
fingers
 17. Remove and dispose off gloves. Assist with transfer of patient to stretcher or
wheelchair for return to nursing unit.
18. Clean equipment used, return to usual place; discard used materials and wash
hands.
19. Explain purposes of exposure for faster drying. Use elevation if pertinent, apply
icebags if ordered, or use fans or hairdryer and set to cool settings to facilitate
drying.
20. Have patient turn every 2-3 hours.
21. Observe patients for signs of pain or anxiety; hyperventilation, swallowing air,
tachycardia or BP increase.
22. Assess neurovascular status by performing neurovascular checks:
a. observe color of tissues distal to cast.
b. observe for edema distal to cast.
c. feel temperature of tissues above and below the cast.
d. palpate the distal pulses of the casted extremity. note presence and
strength of pulse.
e. ask patient to move parts distal to cast in ROM if possible if patient
cannot do active ROM, perform passive ROM on these joints noting
responses or complaints of increased pain.
f. ask patient to describe sensations or feelings of tissue in cast; listen for
descriptions such as pins and needled, asleep, numb, burning or
throbbing.
23. Record application of cast and condition of skin and circulation status.
24. Record patients ability or inability to perform ADL and specific requirements
for care.

BOOK REFERENCE:

Annamma Jacob (2011), textbook of clinical nursing procedures: the art of nursing practice,
second edition , jaypee publication. Page no: 339.