Instructions for CAST CARE in Children

KEEP A CAST DRY: those casts should not get wet, wet casts can cause skin irritation and increase the risk of the infection.

HOW WOULD MY CHILD TAKE A SHOWER IN THE CAST: Then cover the cast with a towel, place a transparent plastic bag over the cast and tie it on secured with tape or a rubber band.

The cast should not be directly submerged or exposed to any kind of water.

However for younger children especially those aged less than three should be bathed with a sponge.

Parents should have a plastic bag ready in the car, their purses or their child’s backpack for proper cast care, just in case it rains or snows.

Cast Care to PREVENT SWELLING 

Exsanguinate the child’s cast to minimise swelling of fingers and toes. For the upper extremities– Position the hand relative to the elbow and the elbow relative to the shoulder. One may use a sling to lift high while the child is standing.
In case of lower limbs: In case the cast involves the foot, it should be kept raised above the level of knee; if the cast involves the area above knee joint, it should be kept above the level of shoulder.
As said earlier Elevation is crucial in the first 24- 48 hours but sometimes the Elevation may be required for longer periods depending on the injury. The heel must be kept clear and raised at all times by placing a pillow or cushion under the calf.

WHAT TO DO IF THERE IS ITCHING IN THE CAST

It is observed that casts get itchy sometimes, it is therefore very important to provide proper cast care and keep them dry at any cost. 

1. resist the temptation and avoid placing anything down or inside the cast.
2. Refrain from applying any lotion or powder inside the cast, do not remove any cotton padding from inside the cast as it would just increase the irritation and make the cast loose affecting the fracture.
3. To help with itching, encourage the child to decrease their activity levels, sweating causes the skin under the cast to become hot and itchy.
4. Blow cold air down the cast by a fan or hair dryer on cool settings or an air conditioner.
5. A cloth-covered bag of ice can also be kept over the cast, Ice may be kept for a short duration like 5 minutes every hour but never keep ice directly over the cast 
6. Tap gently on the cast with a wooden spoon or round object.

If your child does not or cannot move on their own, it is important to change his position every 2 hours to avoid skin breakdown in the cast, the position change can be alternated to every 4 hours at night 

WHEN TO SEEK HELP IN A CHILD WITH CAST

The following red flags should alert the parents to seek professional medical advice for immediate cast care:

1. Your child’s finger or toes have turned blue, pale or discoloured
2. Has decreased feeling in the fingers and toes.
3. Has increased swelling over the fingers and toes.
4. Have decreased or no movement of digits.
5. Has tingling or pins and needles-like feeling 
6. Have increased pain.
7. Something gets stuck in the cast.
8. Cast breakdown, becomes wet or falls down.
9. Foul odour coming from the cast.
10. The child is irritable or has a fever for no other obvious reasons.
11. Having pain that is not relieved by medicines.