Plaster cast or backslab care instructions for patients and their carers

Elevate

During the first 24 hours try to keep your child’s limb elevated above the level of their heart and encourage them to move their fingers or toes as much as possible. This will help reduce any swelling.

Check for any of the following:

• excessive swelling of the fingers or toes.
• blueness or whiteness of the fingers or toes (compare this to the unaffected hand or foot).
• pins and needles, tingling or burning.
• numbness or loss of feeling.
• inability to move fingers or toes.
• severe or increasing pain under the plaster.
• a grizzly child that cannot be settled.
• pain that is unrelieved by pain relief medication.

If any of the above occurs, elevate the limb for at least 15 minutes and encourage finger/toe movement.  If the symptoms are not relieved, take your child to the closest hospital emergency department immediately.

Ensure your child does not scratch under the cast with any objects e.g. knitting needles, chopsticks or pens as it may damage the skin and can lead to infection.  Children may push objects under the plaster and this can cause a pressure ulcer on the skin. 

If you think that an object has been trapped inside the cast, take your child to the closest hospital emergency department immediately.

• liquid staining the plaster, i.e. yellow or green liquid oozing through.
• foul or rotten smelling plaster.

• Do not wet, cut, heat or otherwise attempt to modify the cast at home. It takes about 48 hours for a Plaster of Paris cast to dry properly. 
• Avoid resting the plaster on hard surfaces during this time. 
• Allow the cast to dry naturally in circulating air. 
• Keep it away from direct heat such as heaters, electric blankets, hot water bottles and hair dryers. 
• Do not allow your child to walk on a leg cast.
• Younger children should bath in shallow water under supervision with the limb covered in a plastic bag and sealed with adhesive tape. 
• Older children may be able to shower with a handheld shower hose with the limb covered in a plastic bag and sealed. 
• Do not put your child’s limb in the shower or immerse in the bath even if covered by a plastic bag
• If the cast becomes loose, cracked, and soft or is no longer keeping the affected body part immobilised, take your child to the closest hospital emergency department.