Founded in 1972, the Canadian Society Of Orthopaedic
Technologists, (C.S.O.T.), recognized the importance
of identifying and credentialling competent
Orthopaedic Technologists.

What Is An Orthopaedic Technologist? Orthopaedic Technologists are medically trained individuals who work under the direction of physicians and in collaboration with other members of the health care team of professionals. They are experts in plaster and synthetic cast application and are responsible for instructing patients on this form of treatment. They provide care to clients with orthopaedic problems through the application, adjustment and removal of a variety of casts, splints and traction fittings. Orthopaedic technologists perform casting services primarily in hospital fracture rooms. Some medical clinics now offer limited orthopaedic services as well. The duties of orthopaedic technologists vary from one place of employment to another and may include, but are not necessarily limited to, the following:

• dressing removal - assess the condition of wounds prior to
  cast applications. Consult with physicians for further orders
  when problems are identified. Debride wounds as directed
• cast application - (including specialized casts, fracture braces,
  body casts, Halo body casts) using plaster or synthetic materials.
  This involves adjusting, removing, repairing, bivalving,
  wedging and windowing of casts
• measure and fit patients for orthopaedic devices and
  ambulatory aids. Instruct patients regarding care and proper
  use. Assist in the application, maintenance and adjustment of
  traction (skin, skeletal and manual). This includes patient education
  of traction therapy.
• remove sutures, K Wire, staples,pins and external fixators
  using sterile technique
• fabricate and apply splints and bandages (ie., finger splints,
  wrist splints, velpeau bandages, pressure dressings,
  humeral splints, knee splints, etc.)
• instruct patient/family in the care of the cast, slab or brace
  as well as skin care. Reinforce the teaching of the medical
  information given by the physician regarding the specific injury,
  treatment plan procedure and expected outcomes
• order and maintain equipment. Manage orthopaedic supplies
• collaborate with other health care professionals such as
  physicians, nurses, physiotherapists and occupational therapists,
  as required
• interact with other departments (medical records, radiology,
  service coordination) to obtain the resources needed to
  assist in patient care
• establish effective helping relationships with patient and family
• patient visit assessment maintaining patient dignity and
  confidentiality
• provide on the job instruction and demonstration of casting
  techniques to other health professionals (medical students,
  interns, residents) as requested
• charting and documentation and maintain accurate notes
  and records
• participate in ongoing education and development
• Is certified in the Added Nursing Skills and Sanctioned
  Delegated Medical Acts defined for the orthopaedic clinic area
  

KNOWLEDGE
The Registered Orthopaedic Technologist and the Orthopaedic
Technician base practice on orthopaedic science and on content
relevant to orthopaedic technology. The Registered Orthopaedic
Technologist continues to learn throughout his/her professional
career.

EDUCATION

High School graduate or equivalent
and/or
Apprenticeship programme and sponsorship by an Orthopaedic
Physician.

Nursing and Medical background an asset.

There are no orthopaedic technician/technologist courses available that are recognized by the CSOT. The majority of our members are trained in hospital
via their orthopaedic surgeon and/or registered orthopaedic
technologist. Once a person is hired as a 'trainee/apprentice' - Student membership should be taken with the CSOT.

What is the difference between a technician, registered
orthopaedic technologist and an advanced registered
orthopaedic technologist?

The Orthopaedic Technologists are under the controlled medical act
delegated by a Physician (Regulated Health Professions Act).
The Registered Orthopaedic Technologist is able to practice
independently in collaboration with the physician.

Skills required of an Orthopaedic Technician:

• Basic understanding of anatomical structures and their
  relationship with one another; able to accurately describe
  orthopaedic conditions
• Ability to apply and remove all types of casts, splints and
  orthopaedic devices under the direct supervision of a
  Registered Orthopaedic Technologist and/or Physician
• Understanding of theory and application of skin and
  skeletal traction
• Understanding of the proper application of aseptic
  technique in dressing change, pin and suture removal,
  setting up surgical fields

Orthopaedic Technicians should be striving to gain
certification by completing the written, oral and practical exam
of the CSOT. Individuals joining the CSOT should do so with
certification in mind, knowing that this is the highest standard
one may achieve within their field as a Registered
orthopaedic technologist in Canada.

Registered Orthopaedic Technologists

• Wider body of knowledge of anatomical structures
  and their relationship with one another
• able to articulately describe orthopaedic conditions
• Ability to apply, adjust and remove all common orthopaedic
  devices
• Increased knowledge of theory and application of skin, skeletal
  and manual traction
• Increased knowledge of the proper application of aseptic
  technique in dressing change, removal of sutures,
  staples, pins and wires and setting up surgical fields
• Ability to interpret common fractures and dislocations on X-ray film
• Ability to perform in an operating room environment
• Ability to supervise and train students and orthopaedic
  technicians
• Are able to work unsupervised
• Ability to apply specialty casts, ie., hinge casts and assist in
  special procedures such as advanced wound care and
  fracture reductions
• Can take verbal orders
• Can preceptor students
• Has a proven knowledge base, skills and expertise that
  will benefit the patient and the hospital they serve
• has successfully completed the written, oral and practical
  examinations of the governing body,The Canadian Society
  of Orthopaedic Technologists (CSOT)
• must continue their education to maintain their certification
  with the CSOT. This is mandatory to keep certification
  up to date. Continuing education units must be accumulated
  on an annual basis

ADVANCED REGISTERED ORTHOPAEDIC TECHNOLOGIST

Performs all of the above and has

• Advanced body of knowledge of anatomical structures and their
  relationship with one another, able to articulately describe
  orthopaedic conditions
• Ability to apply, adjust and remove all common and
  difficult orthopaedic devices
• Advanced knowledge of theory and application of skin,
  skeletal and manual traction
• Advanced knowledge of the proper application of aseptic
  technique in dressing change, removal of sutures,
  staples, pins and wires and setting up surgical fields
• Ability to interpret most fractures and dislocations on X-ray
  film
• Expert ability to apply specialty casts, ie., hinge casts,
  fracture braces, body casts and Halo body casts and assist
  in special procedures such as advanced wound care and
  fracture reductions

Advanced Clinical and Practical Knowledge

• Serves as a technical expert to hospitals, physicians, students,
  orthopaedic technicians and other registered orthopaedic
  technologists in matters pertaining to orthopaedic devices
  and techniques
• Sets up and teaches patients and their families for home
  treatments
• Instructs others in the practice of orthopaedic technology
• Educates the public in the role of an orthopaedic technician and
  registered orthopaedic technologist

The Registered Orthopaedic Technologist and the Orthopaedic
Technician both provide care to clients with orthopaedic problems,
and the clients' family members in some situations. All Technologists
and Technicians are accountable individually for their decisions and
actions, whether they act independently or in consultation and
collaboration with other members of the health care team.

EXAMINATION FOR REGISTRATION
Candidates for the examination must be FULL MEMBERS of the
C.S.O.T.

A Full member is one who is gainfully employed and actively
working full time (a minimum of 850 hours per year),
applying casts and traction assemblies in an
orthopaedic setting in a Canadian Institution and has
been sponsored by an Orthopaedic Surgeon.

The written exam takes place in October each year.

Members joining after JULY 1st will not be eligible to take part in
the October written exam. The written exam must be successfully
completed before you may proceed on to the oral and practical exams.
Membership must be paid in full before exams can commence.

There are three parts to this Registration exam; Written, Oral
and Practical. The passing mark is 70 per cent.
Once the examination process has been
started it must be completed in a specific time period.

Upon successfully completing all parts of the examination
you are entitled to be known as a

"Registered Orthopaedic Technologist". (R.T. Orthopaed).

DEFINITIONS

Registered:

A Registered Orthopaedic Technologist (R.T. Orthopaed)
is a person who has successfully completed the written, oral and
practical examinations of the CSOT, has current membership in
the Society and maintains certification through the continuing education programme.

Advanced Registered Orthopaedic Technologist:

A person who has current membership in the Society and
maintains certification through the continuing education with at
least eight (8) years full time work experience working directly
in the care of orthopaedic patients and registered with the CSOT
for not less than three years.

Full Member (Orthopaedic Technician):

A Full member is one who is gainfully employed and actively
working full time (a minimum of 850 hours per year), applying casts
and traction assemblies in an orthopaedic setting in a
Canadian Institution and has been sponsored by an
Orthopaedic Surgeon.

Associate:

A person working in fields related to orthopaedic technology or who
reside and practice outside Canada. Is not working 850 hours per
year in the orthopaedic fracture and/or cast room.
Ineligible to write the exams.

Industrial: A person engaged in the manufacture or sale of
orthopaedic equipment or supplies.
Ineligible to write the exams.

Student: Is available to students in the process of being
trained "in hospital".
Ineligible to write the exams.

JOB DESCRIPTION FOR ORTHOPAEDIC TECHNOLOGISTS - JUNE 2008 REVISED

The following job description refers to male and female but for
easier reading the male pronoun is used.

Summary of Duties: The Orthopaedic Technologist is a
paramedically trained individual who performs his duties under the
direction of a Physician. The Orthopaedic Technologist collaborates
with other members of the health care team, primarily in the orthopaedic department, and occasionally in other areas such as the Plastic Surgery
and Emergency Departments. Casting services are provided to both
inpatients and outpatients, usually in the orthopaedic clinic, but also
as needed in the inpatient areas and operating rooms.

The Orthopaedic Technologist organizes the workload and
fulfills the responsibilities of the position with a high degree of
autonomy, within established guidelines and procedures.
Clinical direction and support are provided by the attending
physicians or house staff for unexpected or unusual clinical problems.

The Orthopaedic Technician/Technologist works in compliance
with the provisions of the Occupational Health and Safety Act
and adheres to all Health and Safety policies, procedures and
provisions established by management. Responsible for recognizing
unsafe work practices and other potential hazards in the work area
and for reporting these situations to the supervisor.

This job description indicates the conditions under which he
performs his duties, but his duties are not set forth for
limiting the assignment of work.

To perform his duties the Orthopaedic Technologist must
have basic knowledge of:

1. Anatomy and physiology related to orthopaedics
2. Orthopaedic diseases and related principles of patient care
3. Orthopaedic injuries and related principles of patient care
4. Basic nursing functions
5. Aseptic techniques
6. His responsibilities as related to legal and medical ethics
7. Office, departmental and hospital procedures.

MAIN DUTIES

Under the direction of a Physician

l. The Orthopaedic Technologist:
1.1 Is responsible for cast application, adjustment and removal.
The repairing of casts, application of walking devices, bi-valving,
wedging and windowing of casts.
1.2 applies and removes dressings, assesses condition of the wound
prior to further treatment. Consults with the physician for further
orders when problems are identified.
1.3 Measuring and fitting patients for orthopaedic devices and
ambulatory aids. Instruct patients regarding care and proper use.
Assist in the application, maintenance and adjustment of traction
(skin, skeletal and manual). This includes patient education of
traction therapy
1.4 removes sutures, K-wires, pins and external fixators
using sterile technique
1.5 is responsible for maintenance of orthopaedic equipment
and the use of such, and the management of orthopaedic supplies.
1.6 fabricates and applies required splints and bandages using
various materials, e.g., finger splints, wrist splints, velpeau bandages,
pressure dressings, humeral splints, knee splints, etc.
1.7 applies specialized casts, i.e., fracture brace, body cast,
1.8 Assists physician with procedures, ie., closed reductions,
minor surgical treatment with or without anaesthetic using
sterile technique. This includes the preparation of surgical trays
and medications required for the procedure
1.9 is responsible for patient visit assessment,
maintaining patient dignity and confidentiality
1.10 is responsible for charting and documentation and
maintaining accurate notes and records
1.11 Is certified in the Added Nursing Skills and Sanctioned
Delegated Medical Acts defined for the Orthopaedic Clinic Area.

EXPANDED DUTIES - these duties and responsibilities may not
necessarily be practised in all health care facilities
by the orthopaedic technologist
• Custom knee bracing (should include a certified fitter's course)
• Basic Cardiac Life Support (BCLS)
• application, maintenance and removal of Halo body vest

2. The Orthopaedic Technologist provides patient/family teaching:
2.1 independently teaches patient/family care of cast, slab or brace,
and care of skin, based on knowledge of potential problems and
follow up assessment of the patient/family learning needs.
2.2 reinforces the teaching or medical information conveyed by
the physician to the patient/family regarding the specific injury,
treatment plan, procedures and expected outcomes. Establishes
effective helping relationships with patients and families.
2.3 responds to telephone enquiries from patients/families by
providing information or referring the problem to the appropriate
member of the health care team.

3. The Orthopaedic Technologist functions collaboratively with other
members of the health care team:
3.1 utilizes interpersonal and communication skills to establish
effective helping relationships with patients/families.
3.2 effectively organizes workload and sets priorities to provide timely
care to patients on the high volume, rapid turnover orthopaedic
service.
3.3 collaborates with health professionals such as physicians, nurses, physiotherapists, and occupational therapists as required, to
provide optimum patient care.
3.4 interacts regularly with support service departments such as
medical records, radiology, and service coordination to
obtain needed resources and to facilitate the flow of patient care.

4. The Orthopaedic Technologist participates in ongoing education
and development:
4.1 participates in the C.S.O.T. Biennial Convention, chapter meetings,
continuing education programme and the journal BodyCast.
4.2 completes self-appraisal and identifies performance objectives
annually.
4.3 identifies and seeks opportunities to meet own learning needs
4.4 keeps informed of changes in casting equipment and materials,
and new procedures in accordance with the orthopaedic surgeons'
practices.
4.5 Registered Orthopaedic Technologists maintain annual
re-certification as mandated by the C.S.O.T.
4.6 provides on-the-job instruction and demonstration of casting
techniques to other health professionals, such as medical students,
interns or residents, on request.

SPECIFICATIONS
1. Full Membership is available to all persons who are gainfully
employed and actively working in the orthopaedic fracture
and/or cast room of a Canadian Hospital and have done so for
at least ONE FULL YEAR (minimum of 850 hours per year).

They should be able to carry out these procedures with a minimum
amount of direct supervision.

This is the only category of membership eligible to complete
the written, oral and practical exams.

Sponsorship of an Orthopaedic Surgeon must accompany application
for membership in this category. Members of this classification should
be striving for reclassification as a REGISTERED ORTHOPAEDIC
TECHNOLOGIST.

2. Definitions:

Registered: A Registered Orthopaedic Technologist (R.T. Orthopaed)
is a person who has successfully completed the written, oral and
practical examinations of the CSOT, has current membership in the
Society and maintains certification through the continuing
education programme.

Advanced Registered Orthopaedic Technologist: A person who
has current membership in the Society and maintains certification
through the continuing education with at least eight (8) years full
time work experience working directly in the care of orthopaedic patients
and registered with the CSOT for not less than three years.

Full Member (Orthopaedic Technician): A person gainfully employed
and actively working in the orthopaedic fracture and/or cast room
of a Canadian Hospital and have done so for at least ONE FULL YEAR
(minimum of 850 hours per year)and has not completed
the examination process.

Associate: A person working in fields related to orthopaedic
technology or who reside and practice outside Canada.
Is not working 850 hours per year in the orthopaedic fracture
and/or cast room.
Ineligible to write the exams.

Industrial: A person engaged in the manufacture or sale
of orthopaedic equipment or supplies.
Ineligible to write the exams.

Student: Is available to persons in the process of being
trained "in hospital" via an orthopaedic surgeon
and/or registered orthopaedic technologist.
Ineligible to write the exams.

3. The CSOT recommends that a Delegated Medical Acts form
certifying that the member has been taught, examined
and is competent to perform certain procedures as authorized
by the hospital be issued annually.

The Orthopaedic Technologist is an extension of the
Orthopaedic Surgeon and/or Physician and assists him in the
care of the sick and disabled persons.
The Technologist must relate well to other people and be tolerant
and considerate of their condition. He is able to communicate
with patients in understanding their anxieties and allaying their fears.

This job description is a composite of the task which the
Orthopaedic Technologist is trained to undertake. There need not,
however, be complete agreement among Orthopaedic Surgeons
on the tasks they feel should be delegated. Nor does this description
prohibit the Orthopaedic Surgeon from delegating responsibilities
not covered if such delegation meets the approval of the medical
profession and if the technologist has the required skills and ability.

THE DIFFERENCE BETWEEN A TECHNICIAN,
REGISTERED ORTHOPAEDIC TECHNOLOGIST
AND AN ADVANCED REGISTERED ORTHOPAEDIC
TECHNOLOGIST

Registered Orthopaedic Technologists have been assuming
responsibility each year for a number of health services classified
as delegated medical acts. They integrate these services into their
scope of daily practice in the Fracture Clinic, Operating Room,
Emergency Room and private practice and have developed a
unique body of knowledge and practical skills pertaining to
these services/delegated medical functions.

ORTHOPAEDIC TECHNICIAN
• Basic understanding of anatomical structures and their
relationship with one another; able to accurately
describe orthopaedic conditions.
• Ability to apply and remove all types of casts, splints
and orthopaedic devices under the direct supervision of a
Registered Orthopaedic Technologist and/or Physician
• Understanding of theory and application of skin and skeletal traction.
• Understanding of the proper application of aseptic technique
in dressing change, pin and suture removal, setting up surgical fields.

REGISTERED ORTHOPAEDIC TECHNOLOGIST
• Wider body of knowledge of anatomical structures and their
relationship with one another, able to articulately describe
orthopaedic conditions
• Ability to apply, adjust and remove all common orthopaedic devices
• Increased knowledge of theory and application of skin,
skeletal and manual traction.
• Increased knowledge of the proper application of aseptic
technique in dressing change, removal of sutures, staples,
pins and wires and setting up surgical fields
• Ability to interpret common fractures and dislocations on X-ray film.
• Ability to perform in an operating room environment.
• Ability to supervise and train students and orthopaedic technicians.
• Ability to apply specialty casts, ie., hinge casts and assist
in special procedures such as advanced wound care and fracture
reductions
• Are able to work unsupervised
• Can take verbal orders
• Can preceptor students
• Has a proven knowledge base, skills and expertise that will
benefit the patient and the hospital they serve
• has successfully completed the written, oral and practical
examinations of the governing body, The Canadian Society of
Orthopaedic Technologists (CSOT)
• must continue their education to maintain their certification
with the CSOT. This is mandatory to keep certification up to date.
Continuing education units must be accumulated on an annual basis

ADVANCED REGISTERED ORTHOPAEDIC TECHNOLOGIST
Performs all of the above and has
• Advanced body of knowledge of anatomical structures and
their relationship with one another, able to articulately describe
orthopaedic conditions
• Ability to apply, adjust and remove all common and
difficult orthopaedic devices
• Advanced knowledge of theory and application of skin,
skeletal and manual traction
• Advanced knowledge of the proper application of
aseptic technique in dressing change, removal of sutures,
staples, pins and wires and setting up surgical fields
• Ability to interpret most fractures and dislocations on X-ray film
• Expert ability to apply specialty casts, ie., hinge casts, total contact casts
and assist in special procedures such as advanced wound care
and fracture reductions

Advanced Clinical and Practical Knowledge
• Serves as a technical expert to hospitals, physicians,
students, orthopaedic technicians and other registered orthopaedic
technologists in matters pertaining to orthopaedic devices and
techniques.
• Sets up and teaches patients and their families for home treatments
• Instructs others in the practice of orthopaedic technology
• Educates the public in the role of an orthopaedic technician
and registered orthopaedic technologist

Refer to Guidelines for Orthopaedic Technology for further
information.

---

e-mail csot@look.ca