Ankle Air Casts 

Purpose: 

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

Equipment: 

• Air cast 

• Cotton sock 

Procedure: 

1. Preparation: 

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

• Place a cotton sock under the air cast for hygiene reasons. 

2. Application: 

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

• Fasten the Velcro straps to keep 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 any changes in edema, skin integrity, color, temperature, pedal pulse, and pain related to the application of the air cast. 

4. Hygiene: 

• The air cast may be removed daily for hygiene reasons. Maintain a neutral ankle position while cleansing the foot and reapply the air cast afterward. 

Compliance and Documentation: 

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

• Document the application of the air cast, including the resident’s response and any observations of changes in edema, skin integrity, color, temperature, pedal pulse, and pain, in the medical record. 

• Regularly review and update techniques for air cast application according to the latest clinical best practices and regulatory standards. 

• Provide training to staff on proper air cast application and monitoring procedures 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.