Cast carts-how do you do it?

Hi all,

I'm a PA in Orthopaedic surgery and found your site while searching on casting cart brands. Hope you all don't mind my input on this topic.

As far as mobile carts, there is a good picture of one at http://www.lab-gear.biz/1461.html. But you dont need to spend that kind of money on a stainless steel one. You can duplicate it with a good Black & Decker tool cart for much less.

As far as material, a lot of Ortho Surgeons do still like to use plaster, especially in the OR for splints...it's much more moldable than fiberglass.

Materials should include regular and fast drying types of plaster 2" to 6", of course have some fiberglass as well...webril both synthetic and regular in similar size ranges. Ace bandage both single and double length in various sizes.

We keep stockinette available but rarely if ever use it post-op.

Also the pre cut plaster sheets in various widths and lengths.

Some docs like to use a Robert Jones Splint in the lower extremity after an IM nail of the tibia..which is some webril on the skin covered with rolled cotton (split in half for easier application), covered by Kurlix for some compression then a posterior or stirrup splint of plaster. Some say to put the stirrup on before the cotton...user preference on that. The OR nurses where I work make a couple of bags of materials for the Jones dressing so they dont have to search around for the additional materials.

We keep a non-vacuum type cast cutter on the cart...it's more portable an easier to handle. We usually do any cast cutting in the pre-op area so there's no dust flying around the OR if we wind up doing an open procedure....and a vacuum won't cut down enough of it. But, that's user preference.

As far as plaster vs. fiberglass I would poll the surgeons you work with and find out their preferences. There's pro and con to both, The newer fiberglass is becoming more moldable and easier to manipulate.

Hope this was helpful

JC

We havent ever really had a cast cart on our ortho floor. Probly because most of our patients are hip pinnings, arthroplasties, and fractures that come from OR with cast/splints already in place. However, after last week and the problems we had just getting supplies to apply a cast i may suggest we organize one to be kept on the unit.

The hassle we went through just finding a stupid bucket believe it or not.

In our OR we have a cast cart that normally sits in the back hall near our normal ortho room, but is mobile.

What we did is take a wheeled linen cart. It is stainless steel, about 5 foot tall, 2-3 foot wide, and has about 4 shelves. Sorry, don't know the name or manufacturer, I bet your housekeeping dept has 'em or books with them in it.

We keep what ever we need on that.

In a couple of large heavy bins on the bottom we keep traction bows, weights, finger traps, cast cutter saw and other tools.

The next is basicly Ortho Glass. Fiberglass splinting material, all ready to go on rolls. We keep 2,3,4 and 5 inch. There is also a pair of scissors chained to the box the OrthoGlass boxes are in.

Top shelf is rolls of stockenette, of various widths, also a small supply of fiberglass casting tape rolls, and a smaller amout of plaster rolls and splints.

Most of the time, we use the OrthoGlass for immediate post op splints, then the doc casts them, if needed, in the office in a couple of days when the swelling goes down.

We also keep a small assortment of SoftRoll, Webril, and Ace bandages of various sizes on the cart.

By the way we still keep a bucket for dunking fiberglass or plaster, but rarely use it anymore. The OrthoGlass had these neat little squirt bottles with them to wet it down, but those "walked off" some time ago. I just wet them down in the scrub sinks now, just before applying them.

Hope that helps.

Mike

Have some bandage scissors, and some cast splitting tools handy as well.

Our docs almost all use plaster; it's strange how different preferences can be.

In our OR, we've got a nice Armstrong (I think?) rolling cart with:

2,3,4,6" Ace wraps and Webril

2,3,4,5" Plaster and Fiberglass rolls

3x15, 4x15, and 5x30 Pre-cut Plaster strips

2x15, 3x35, 4x(35?) and 5x(35?) Pre-made Fiberglass splints (packaged separately)

We keep universal and elevating Arm slings on there, as well. Some of our docs have taping rituals (they like 1/2" or 1" silk tape that they criss-cross over the ace when they're done), so we keep that on there, as well.

And, for water, we use the yellow plastic hospital basins with a plastic bag lining them.