Discharge Instructions: Removable Cast Care (Child)

Your child has a broken ___________________ bone. This bone is in the ____________.

General care

• Make sure your child wears the removable cast according to the healthcare provider's instructions.

• Give your child acetaminophen or ibuprofen as directed to control pain.

• Always keep the removable cast dry. Have your child bathe with the cast out of the water. They can hold the body part with the cast outside the tub or shower. Protect it with a large plastic bag. Close the bag with tape or rubber bands. Use 2 layers of plastic to help keep the cast dry. Or you can buy a waterproof shield.

• If the cast gets wet, dry it with a hair dryer on the “cool” setting. Don’t use the warm or hot setting. Those settings can burn your child’s skin.

• Have your child keep the cast clean and away from dirt.

• Don’t cut or tear the cast.

• Keep the cast away from open flames.

• Don’t let your child expose the cast to heat, space heaters, or a lot of sunlight. Too much heat will cause the cast to change shape.

Cleaning the cast

• Clean the removable cast with soap and lukewarm water. Scrub it with a small brush.

• Use alcohol wipes to rub the inside of the cast. This is to reduce odor and bacteria.

• Wash the Velcro straps and inner cloth sleeve (stockinet) with soapy water. Then let it air dry.

Activity

• Have your child exercise all the nearby joints that are not limited in movement by the cast. If your child has a long leg cast, help them exercise the hip joint and toes. If your child has an arm cast, help them exercise the shoulder, elbow, thumb, and fingers.

• Raise the part of the body that is in the cast. Have your child do this as often as possible during the day. This helps reduce swelling.

• Your child may return to school, but activities such as sports should be cleared by your child's healthcare provider first.

Follow-up care

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) or chills

• Tingling, numbness, or swelling in the affected area

• Severe pain that is not relieved with medicine

• 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

• Pressure sores or red marks that don’t go away within 1 hour after removing the cast

• Blisters

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 a 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 is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.

When to call a healthcare provider about your child’s fever

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

• A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

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

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

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

• A fever of ___________ as advised by the provider