Ankle Air Casts 

Purpose: 

• To maintain the ankle in a stable position for increased functional use and functional alignment. 

• To control or treat the instability for certain residents. 

Procedure: 

1. Preparation: 

• Obtain a specific physician order for the application of an air cast. Only licensed nurses or licensed therapy personnel may apply the air casts. 

• Explain the procedure to the resident to ensure their understanding and cooperation. 

2. Application: 

• Place a cotton sock on the resident's foot for hygiene reasons. 

• Position the air cast on the ankle with the air bladders running along the malleoli. 

• Fasten the Velcro straps to secure the air cast in place. 

3. Monitoring: 

• Check the position of the air cast every 2 hours and reapply as necessary. 

• Nursing/therapy staff must monitor and document the status, noting any changes in: 

• Edema 

• Skin integrity 

• Color 

• Temperature 

• Pedal pulse 

• Pain related to the application of the air cast 

4. Hygiene: 

• The air cast may be removed daily for hygiene purposes. 

• Maintain a neutral ankle position while cleansing the foot. 

• Reapply the air cast after hygiene procedures. 

Compliance and Documentation: 

• Adhere to CMS guidelines and Requirements of Participation for Long-Term Care Facilities. 

• Document the application, monitoring, and any observations or changes in the resident’s care plan. 

• Regularly review and update techniques and protocols for the use of air casts according to the latest clinical best practices and regulatory standards. 

• Provide training to staff on the correct application and monitoring of ankle air casts to ensure resident safety and comfort. 

• Conduct regular audits to ensure compliance with this policy and address any gaps in practice or documentation. 

References: 

• Centers for Medicare & Medicaid Services (CMS). State Operations Manual (SOM), Appendix PP - Guidance to Surveyors for Long-Term Care Facilities. 

• CMS Requirements of Participation for Nursing Homes.