Plaster cast or backslab care instructions for patients and their carers

• This fact sheet explains how to care for your child in a cast at home. Please read the following instructions carefully.
  If you have any questions or problems, please see your GP or go to the Emergency Department of your nearest hospital.

Care of the affected arm or leg

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.

FOR ARMS

• Use a sling to support your child’s arm and elevate it on pillows when sitting or lying down.
• Ensure your child is wearing the sling as instructed by their doctor or physiotherapist.

FOR LEGS

• Elevate your child’s leg on pillows when resting and use crutches or walking aids as instructed by the physiotherapist.
• 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 analgesia.

If any of the above occurs, elevate the limb for at least 15minutes and encourage finger / toe movement.  If the symptoms are not relieved, go straight to the Emergency Department of your nearest hospital.

Skin care

• 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, go straight to the Emergency Department of your nearest hospital.

Signs that there is a problem under the plaster:

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

Cast care

• 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, please go to your nearest Emergency Department. 

Remember:

• Keep the cast dry. Cover the cast with a plastic bag taped securely at the top during bath and shower time. Avoid placing the cast in water.
• Ensure no objects are placed inside the cast.
• Check the circulation of fingers or toes. If you are worried, elevate the limb and wriggle fingers or toes.
• Follow the specific instructions of your child’s doctor and/or the physiotherapist or occupational therapist.
• Your child should not take part in any active play or sport.
• If you have any concerns please go to your nearest Accident & Emergency Department.