EVENTS

2007 Events
4th - 6th May 2007
Castaways UK Eleventh Spring Conference

15th - 17th June 2007
Association of Orthopaedic Technicians Conference

9th & 10th November 2007

Benefoot Conference

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2006 Events
12th – 14th May 2006
Castaways UK Tenth Spring Conference

14th – 15th September 2006
SOTN Conference

2007 Events

Castaways UK Eleventh Spring Conference

Bronwyn Delbridge RGN ONC RCNT RNT BEd MEd
TEACH Director

The Mummy Returns!

Aim: To provide an overview of bandaging techniques.

Objectives: At the end of this session, the participants will be able to:

Bandaging is a a skill which is as old as time. Some of the earliest examples are the wrappings around Egyptian Mummies. The embalming of bodies of Pharoahs, their families and other dignitaries and the encasement of the cadaver in linen strips required great skill and dexterity.

Today, the same skill and dexterity is still required when applying a bandage. A bandage may be needed for keeping a dressing in place; supporting an injured joint; assisting venous return; reduction of swelling; control of bleeding; to restrict movement and to secure traction.

There are various types of materials used for bandages: cotton elasticated thread in cotton, tubular bandage, strong elasticated bandage, domette, crepe, plaster of paris and synthetic casting tapes. Practitioners need to be aware that each of the above has different properties and careful selction of the type of bandage is required in relation to the reason for its use and/or its method of application.

Bandages are applied in three main configurations: spiral, ascending spica (figure of eight) and divergent/diverging spica. Divergent spicas are best used when bandaging a joint as this method does not restrict joint movement. Spiral bandages and ascending spicas are the most common methods of application.

However with all bandaging techniques there are rules that govern their application. For example, sit or stand in front of the patient, hold the barrel of the bandage uppermost, bandage from the inside to the outside of the limb and observe the colour, warmth, movement and sensation of extremities. One can see therefore that great skill and practice is required in order to enable the bandage to fulfill its purpose, provide patient comfort and prevent neurovascular compromise.

Further Reading List
Love, C (2000) Bandaging Skills for Orthoapedic Nurses Journal of Orthopaedic Nursing 4: 84-91
Nelson, EA (1995) Improvements in Bandaging Techniques Following Training Journal of Wound Care 4(4): 181-184
Thomas, S (1990) Bandaging and Bandages: The Science Behind The Art Case Science and Practice 8(2): 56-60


As part of the Castaways UK Eleventh Spring Conference, the TEACH Directors also gave a number of Main Hall Presentations and smaller workshops on behalf of Castaways UK. These included:

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AOT Conference
Chris Wardman PG Cert BSc Hons Dip He RGN P.Tech Cert
Matron of Orthopaedics & Trauma
TEACH Director

Focussed Rigidity Casting - Helping You Make The Difference

The session will firstly describe the process by which FRC was first introduced into UK practice, outlining briefly the research process undertaken and the outcome of that research. It will then introduce the theory of FRC and discuss the benefits of its application from both a patient and provider perspective.

Chris delivered an excellent Main Hall Presentation to the delegates and exhibitors at the AOT Annual Conference in York. Covering the initial implementation of Focussed Rigidity Casting Techniques to the UK nearly ten years ago by Chris and co-Director Anne Petty, the Presentation discussed the advantages of the technique, advances since it's initial introduction and gave a demonstration of a cast for the treatment of fractures at the base of the fifth metatarsel. Chris' presentation produced a lively Question & Answer Session where Chris was able to give advice and further information on implementing FRC Techniques in Plaster Rooms across the UK. TEACH were pleased by the large numbers of delegates that approached Chris afterwards to say how much they had enjoyed her presentation.

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2006 Events

Castaways UK Tenth Spring Conference

Sarah Petty BA (Hons) MBA
Managing Director Prego Events Ltd
TEACH Director

12th – 14th May 2006


Effective Team Working: A Taster!
Aim: A short introduction to means for the individual to become an Effective Team Player.
Informal Workshop – bring your Blue Peter Badges!

No Health Care Practitioner can work effectively in isolation. Effective Team Working empowers the individual to become an integral part of any team through creativity and confidence. A practical “challenge” will be introduced to highlight the need for pragmatic thinking, welcoming change and recognising individual contributions. As ever, Effective Team Working will be delivered in the professional and approachable style associated with all TEACH courses.

Intended Learning Outcomes:
At the end of the session, the participant should:
• Recognise how to apply simple rationale to all practical tasks to achieve the best outcomes
• How to use limited resources to best advantage
• Better understanding of the internal workings of an elephant!

References:
Boss, RW (1991) Team Building in Health Care Journal of Management Development Vol.10 Issue 4
Pech, R & Slade, B (2006) Employee Disengagement: Is there evidence of a growing problem? Handbook of Business Strategy. Vol.7 Issue 1
Staniforth, D (1996) Teamwork, or Individuals Working in a Team? Team Performance Management Vol. 2 Issue 3
Thacker, RA (1997) Team Leader Style: Enhancing the Creativity of Employees in Teams Training for Quality Vol. 5 Issue 4

TEACH was delighted to present a Taster Workshop and an Exhibition Stand at the Castaways UK Tenth Spring Conference. Slightly different from previous TEACH Workshops, this Taster emphasised an important but often forgotten string to every HCPs bow: the ability to be a strong Team Player.
	After a short introduction defining the need for Strong Communication, the Dangers of Disengagement and the Need for Creativity, TEACH involved all delegates with a practical exercise: How to Build An Elephant! A light-hearted and certainly fun exercise on the outside, this task reminded participants that in order to achieve a personal or patient outcome, team working and communication is preferable to working in isolation. It emphasised the need for seeing all exercises through to completion regardless of personal bias and introduced the increasing responsibility of the individual in initiating change through creative thinking in order to improve.
The TEACH Handout, How to Build An Elephant gave participants an effective step-by-step approach to introduce a new product or service to their department including the need to think objectively and creatively around the need (or outcome) and to be able evaluate and fine tune to changing needs. Feedback from the Taster Workshop: Castaways UK ask delegates to score all Workshops on how Interesting, Informative, Enjoyable and Useful they find them, based on 5 as Excellent and 0 as Poor. This Taster Workshop scored the majority of 5s with a few 4s.

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Focussed Rigidity Casting (FRC)

Anne Petty MBE. JP. RGN. RM. FETC. Orth Tech Cert
TEACH Director

Aim: To show that using evidence can change practice

Throughout history casting techniques have changed little and over the last three decades despite the introduction of new generations of materials, no radical shift in application methods has emerged.

Fractures and soft tissue injuries and conditions are frequently managed in a rigid cast until healing. The cast may be changed during this period due to soft tissue reactions which include the reduction of swelling. External immobilisation in a cast is known to have several other disadvantages, muscle and other soft tissue suffer from disuse atrophy. Patients may require physiotherapy following cast removal to regain function. Synthetic casts made from polyester or fibre glass bandages impregnated with polyurethane resin have been widely used to replace Plaster of Paris casts. Moisture curing polyurethane resin on a bandage substrate emerged as dominant technology. In Europe the use of non fibre glass substrates polyester and polypropylene is growing with the use of fibre glass products declining.

The technique of Focussed Rigidity Casting was first developed in Germany. Further development took place in Holland, Belgium and by the authors in the UK. The technique allows a single cast to be used throughout the treatment. It is adjustable to accommodate swelling or atrophy and focuses maximum rigidity over the fracture site whilst increasing flexibility proximally and distally to minimise muscle wasting. Where possible the casts are minimal in extent.

Unlike much casting practice the use of FRC is supported by research. Traditional methods of casting have taken little account of the patients needs in terms of ability and function within the cast. A different perspective on the assessment of the individual’s need is an imperative for the success of this technique and calls for a major change in attitude and culture in order to adopt this method of cast application.

The authors conducted a randomised control group trial examining the efficacy and safety of the technique and designed a specific assessment tool (Bradford Criteria) in order to carry out the trial.

The authors having introduced FRC techniques to the UK have further developed the technique in practice and have taught the technique widely to casting professionals and to Medical Staff. They are pleased to have given the practitioner further skills to own and a wider range of responses to the problems presented by patients in need of casting.

Intended Learning Outcomes:
At the end of the session, the participant should:
• Be aware of research papers which allow practice changes to occur
• See modern casting techniques demonstrated

References:
Petty, A Wardman, C (1998) A Randomised, Controlled Comparison of Adjustable Focussed rigidity Casting Techniques with Standard Plaster of Paris/Synthetic Casting Techniques in the Management of Fractures and Other Injuries Journal of Orthopaedic Nursing (3): 111-114
Schleikis, A (1994) Fracture Fixation with Polyester: Primary Care with Polyester in Selected Forms of Fractures Pflege Zeitschrift 47 (12): 664-665
Wierzimok, A Houben, F Wilmen, HR (1995) Mokcast for Fractures of the Big Toe Klinik Magazin 2: 16-17 (German)
Wierzimok, A Houben, F Wilmen, HR (1996) Definitive Care of Fractures Dialog 1: 26-28 (German)

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