Do not cut, heat or try to change the cast at home unless instructed by your child’s treatment team.

Take your child to the emergency department if you notice the cast:

• is loose, cracked or soft
• no longer supports the injury properly

It is important to wet your child’s waterproof cast every 1-2 days to lower the risk of skin irritation.

Your child can use soap, body wash and shampoo as normal. Rinse the cast with clean water after using these products to make sure there is nothing on the skin.

Swimming in a pool is okay. After swimming, rinse pool water off under running water. Try to avoid beaches or lakes as sand and dirt may get trapped in the cast.

After wetting the cast: 

• allow water to drain from cast
• let it air dry
• place it on a towel to allow the absorption of extra water

Do not use fans or blow-dryers to dry the cast. This can cause damage and put your child at risk of burns. 

Wait until the cast is fully dry before: 

• covering with long sleeves or pants
• tucking under bed sheets or blankets

Casts can become itchy.  Do not let your child scratch under the cast with objects like:

• knitting needles
• chopsticks
• sticks
• pens or pencils

These can harm the skin and cause infection, as well as shift the padding and damage the cast.

To help soothe an itch:

• tap firmly on the outside of the cast over the itchy spot
• scratch the same spot on the other side of the body
• distract your child with games or toys

Check regularly to make sure your child has not pushed anything under the cast. Trapped objects can lead to skin pressure injuries.

Take your child to the nearest emergency department if you think: 

• something is trapped inside the cast
• your child has pain or a blister under the cast

In the first 24 hours, keep your child’s limb raised above heart level to help reduce swelling. Encourage them to gently move their fingers or toes as often as possible.

If your child complains of sensations like tingling or numbness after 24 hours, elevate the limb as above for 20 minutes and encourage them to wiggle their fingers or toes

If the sensation does not go away, go to your nearest emergency department.

You can test your child’s capillary refill time at home to check their circulation. Capillary refill time is how long it takes for colour to return to a body part after pressure is applied to it.

To check capillary refill time:

1. press down on their fingertip or toe for three seconds and release
2. watch the colour change from pale or white to your child’s normal skin tone.

If normal skin colour returns within 3-4 seconds, your child has good circulation to the limb.

Contact a GP or Sydney Children’s Hospital Network if your cast is: 

• loose, cracked or soft
• no longer supports the injury properly
• is showing signs of injury or infection:
  • yellow or green liquid oozing through
  • unpleasant smell
  • fever

Check your child regularly for:

• swelling, burning or tingling in the fingers or toes
• numbness, loss of feeling or trouble moving fingers or toes
• fingers or toes turning blue or white compared to the other limb
• if capillary refill return is greater than 4 seconds
• new, severe or increasing pain under the cast
• pain that does not improve with over-the-counter pain relief
• being unusually upset or hard to comfort

If you notice any of these signs, try raising the limb above the heart and encourage gentle finger or toe movement. If symptoms do not improve after 20 minutes, go to your nearest emergency department.