There are several types of casts. There are regular fiberglass casts, fiberglass casts with a Gortex liner or a plaster cast/splint.
When the cast or splint is placed, your doctor or emergency room physician should give you a handout with the type and care required for your child’s cast.
It is important not to put ANYTHING in your child’s cast. No perfumes or powders. They will not help the smell, could cause serious irritation and, in the end, make the odor worse. If your child complains of itching, you can use a blow dryer on a cool setting to blow air down and on the skin above and below the cast. NEVER allow your child or anyone else to stick any type of object in the cast. This is very important as you could break the cast, or scratch the skin under the cast, causing an infection. Your doctor may allow use of over-the-counter Benadryl® to relieve itching.
The most common cast is the regular fiberglass cast. It usually takes up to one hour to completely dry. While it dries, do not let your child put any weight on it. The inside liner of this cast is generally made of cotton. It is there to protect your child’s skin from the rough plaster as well as absorb water and perspiration, all of which can cause an odor under your child’s cast. It is very important that this type of cast DOES NOT GET WET! When bathing is needed, you can use a waterproof sleeve from a medical supply store or wrap the cast in a towel, then cover each end of the cast with plastic wrap. Next, wrap the cast with a large plastic bag, sealing the entire covering with wide tape. Your child should then hang the arm or leg outside the bath or shower. If the cast covers the entire leg, sponge baths would be best. If this type of cast gets wet, blot dry with a towel. If it becomes saturated, have it reevaluated by your physician.
Fiberglass Cast with a Gortex Liner
The fiberglass cast with a Gortex liner is made for the child to bathe, shower and swim with the cast on. This cast can also be washed or rinsed, which may reduce odor and skin irritation. There are no special drying procedures necessary after getting this cast wet.
A plaster cast or splint takes several hours to harden, and it is very important not to get the cast wet at any time! Follow the fiberglass cast instructions above about how to keep the cast dry when bathing. If it becomes wet, have it reevaluated by your physician.
Contact your child’s physician if any of the following occur:
- fingers/toes appear pale, white, blue or purplish
- swelling is causing the cast/splint to rub or feel too tight
- arm or leg with the cast is colder than the non-casted arm or leg
- complaints of numbness, tingling or a pins-and-needles sensation
- cast/splint becomes too loose and the arm/leg is able to move inside it
- a strong odor coming from inside the cast
- drainage or discoloration seen on the cast
- cast/splint becomes broken or very wet
- an object is stuck inside the cast/splint
- fever higher than 101 degrees
- severe pain, even after medication is given and especially if worse with movement of the child’s arm/toes
Remember that the length of time your child is to be in the cast may seem unbearably long, but the effects of it not being worn and used properly could cause lifelong complications.
This article was written by Lisa Teasley, RN, a nurse on the Children’s Direct Physician Access Line at St. Louis Children’s Hospital.