Discharge Instructions: Caring for Plaster Cast (Child)

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 get 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 their 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.

Activity

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 approval from your child's healthcare provider. 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. 

Follow-up

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)

• Chills

• 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

• Blisters

• Any drainage that comes through or out of the end of the cast

• A bad odor that comes from underneath the cast 

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

• Rectal, forehead, or ear: 102°F (38.9°C) or higher

• Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

• Repeated temperature of 104°F (40°C) or higher in a child of any age

• Fever of 100.4° F (38° C) or higher in a baby younger than 3 months

• Fever that lasts more than 24 hours in a child under age 2

• Fever that lasts for 3 days in a child age 2 or older