Daily Checks
Check the skin at the edges of the cast for signs of:
- Redness, broken skin or blisters
- Cracking or damage to the plaster
- Staining or soakage through the cast
- Swollen or blue discolouration of the toes
- Pain or sore areas
- A nasty smell from under the cast
- An unusually irritable child
If you are worried about any of the above, please contact the hospital.
Toileting
- If toilet trained, use a bedpan or urinal and protect the cast with tissues. After passing urine/moving bowels, ensure all skin areas are clean and dry.
- If not toilet trained, tuck a small nappy inside the cast; this nappy will need to be changed every 2-3 hours during the day, and one to two nappy changes during the night. A larger nappy will be worn around the cast to keep the internal nappy in place; this will be changed daily or if soiled.
- It is helpful to leave the nappy area exposed for a short time daily to allow air to the cast and skin.
Washing and Hygiene
- Wash and dry all showing skin as normal and apply a moisturising cream.
- Do not use talc, sprays or creams under the cast.
- Tuck a towel around the cast edges to keep it dry.
- It is easiest to wash hair lying down.
Eating and Drinking
- Position the child as they find comfortable.
- Your child may eat less but more often because of the plaster.
- A healthy diet including fresh fruit, vegetables, and plenty of drinks is important to avoid constipation.
- Bendy straws make drinking easier.
- Cover the top of the cast with a t-shirt/bib to avoid food going down the cast.
Clothing
- Flexible clothing to cover nappies or pads can be worn.
- Loose natural fibre clothing such as t-shirts, jogging bottoms, and elasticated skirts are best.
- Alter pants by cutting the side seams and using Velcro.
- Wear socks to stop their feet from getting cold.
Mobility/Seating
- It is important that your child continues to move as advised by the doctor and physiotherapist.
- Your child’s occupational therapist may see you in the hospital to advise you about seating.
- The floor may be the safest place to play.
- Use pillows, blankets or beanbags for support.
- Change your child’s position every 1-2 hours, from back to tummy and sides, checking that the toes are not being squashed.
- Do not lift your child under the arms without supporting the weight of the plaster, as the plaster may move.
Play
Your child may feel very bored and frustrated while in the cast. To avoid this, spend time playing games, drawing, watching TV, or doing schoolwork. Friends should be encouraged to visit.
Sleeping
You will need to change your child’s position every 2-3 hours during the night as they will become uncomfortable.
Other Important Points
Avoid poking any objects under the cast which could cause skin sores. Itches under the plaster can be a problem. Distraction with toys and games can help. If the itch is severe, discuss this with your doctor who may prescribe some medicine to help.
Further Information & Contact Telephone Numbers
We hope that this leaflet has been useful, but if you have any questions, please ask one of the staff. Once home, if you have any worries or questions about your child in the cast, please contact your:
- General Practitioner
- Community Nurse
- Orthopaedic Cast Technician: Mon – Fri 9 am to 4 pm
Telephone: 0131 536 1000 - Ward that your child was in
- Accident & Emergency Department
Telephone: 0131 312 0007
