Discharge Instructions: Caring for Your Child’s Plaster Cast
Your child will be going home from the hospital with a plaster cast in place. A cast helps your child’s body heal. A damaged cast can prevent the injury from healing well. Take good care of your child’s cast. If the cast becomes damaged, it may need to be replaced.
Your child has a broken ___________________ bone. This bone is located in the ____________.
Keep the cast dry
A wet cast can crumble and fall apart. Take these steps to keep the cast dry:
Don't let your child do any activities that could the cast wet.
Take special care to keep the cast dry when your child bathes or showers. Wrap the cast in plastic bags. Use heavy tape or rubber bands to secure the plastic so that water won’t leak in.
Don’t soak the cast in water, even if it’s wrapped in plastic.
If your child must go out in rain or snow, cover the cast with waterproof clothing or plastic.
Use a hair dryer turned to the “cool” setting to dry a cast that has become wet. Call your child’s healthcare provider if the cast has not dried within 24 hours.
Other cast care
Do's and don'ts:
Don’t let your child stick things in the cast, even to scratch his or her skin. Objects put in the cast may get stuck or your child’s skin may be cut and become infected. If your child’s skin itches, try blowing air into the cast with a hair dryer turned to the “cool” setting.
Don’t let your child pick at the padding of the cast. Padding protects your child’s skin and must be kept intact.
Don’t cut or tear the cast.
Cover any rough edges of the cast with cloth tape or moleskin. (You can buy this at a pharmacy.)
Never try to remove the cast yourself.
Here is what your child can do:
Help your child to exercise all the nearby joints not kept still (immobilized) by the cast. If your child has a long leg cast, exercise the hip joint and the toes. Don't walk until getting your healthcare provider's approval. If your child has an arm cast or splint, exercise the shoulder, elbow, thumb, and fingers.
Raise the part of your child’s body that is in the cast above heart level. This helps reduce swelling.
Take acetaminophen or ibuprofen as directed to control pain.
Return to school, but activities such as sports should be cleared by your child's healthcare provider first.
Make a follow-up appointment as directed by your child's healthcare provider.
When to call your child's healthcare provider
Call the healthcare provider right away if your child has any of the following:
Fever (see “Fever and children” below)
Tingling, numbness, or swelling in the injured body part
Severe pain that can't be relieved
Cast that feels too tight or too loose
Decreased ability to move arm or leg in the cast.
Swelling, coldness, or blue-gray color in the fingers or toes
Cast that is damaged, cracked, or has rough edges that hurt
Cast that gets wet or soggy
Any drainage comes through or out of the end of the cast
A bad odor comes from underneath the cast
Fever and children
Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.
For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.
Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.
Infant under 3 months old:
Ask your child’s healthcare provider how you should take the temperature.
Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider
Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider
Child age 3 to 36 months:
Rectal, forehead, or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider
Armpit (axillary) temperature of 101°F (38.3°C) or higher, or as directed by the provider
Child of any age:
Repeated temperature of 104°F (40°C) or higher, or as directed by the provider
Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.
April 26, 2018
Bass, Pat F. III, MD, MPH,Joseph, Thomas N., MD,Turley, Raymond Kent, BSN, MSN, RN