Extremity Fracture Clinical Pathway — Emergency Department

ED Tech Casting Responsibilities

Casts Techs Can Apply	Short/long arm casts Short/long arm thumb spica casts Short/long arm ulnar gutter casts Short/long arm open mitten casts Short/long leg casts KOPH Only Long/short arms Long/short leg
Casts Techs Cannot Apply	Walking casts Short/long arm radial gutter casts Short/long arm closed mitten casts Hanging casts Cylinder casts
ED Techs Can Remove Casts with Cast Saw Except	Casts with external hardware Casts applied in the OR Closed reduction ≤ 10 days

Casts Techs Can Apply

Short/long arm casts
Short/long arm thumb spica casts
Short/long arm ulnar gutter casts
Short/long arm open mitten casts
Short/long leg casts

KOPH Only
- Long/short arms
- Long/short leg

Casts Techs Cannot Apply

Walking casts
Short/long arm radial gutter casts
Short/long arm closed mitten casts
Hanging casts
Cylinder casts

ED Techs Can Remove Casts with Cast Saw Except

Casts with external hardware
Casts applied in the OR
Closed reduction ≤ 10 days

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.