2885 YLH Caring for patients with a cast - a guide for staff

If you are caring for someone with a cast, there are some important checks that you need to undertake to ensure that there aren’t any problems developing, especially pressure sores. What should you be looking out for? A cast that is rubbing or leaving red marks. A patient complaining of a persistent blister-like pain, tenderness or area of local heat A discharge, wetness or smell under the cast or staining on the outside of the cast A patient whose fingers or toes become very cold, blue or white and do not recover when elevated or exercised.  You can also reduce the risk of a pressure ulcer developing and help to accelerate recovery by encouraging your patients to adopt these simple practices where appropriate: Rest and elevation. For first 48 hours after the cast is fitted, patients should rest and raise their injured limb as much as possible.  A damaged leg needs to be raised above the hip. Reduce the pressure. When a patient with a leg cast is lying or sitting with their leg raised, place a pillow lengthways under the their calf, not under their heel.  And when they are lying on their side, place a pillow between their knees to prevent the cast rubbing on the other leg, or between their arm and their chest if their arm is in a cast. Keep the plaster dry. Don’t get the cast wet as it will weaken it and the damp padding will cause skin problems.  Keep them moving. Ensure that they change position at least every two hours to avoid pressure on any one area of their limb. Keep them hydrated. Make sure that they drink plenty of fluids throughout the day. Remember that they are at greater risk of a pressure ulcer because they are wearing a cast Keep them exercising. They should exercise all joints that are not in a cast as much as possible. This should include fingers, elbows, shoulders, knees and toes.  Exercising will improve their circulation and reduce stiffness. If they are allowed to walk in their plaster, make sure they always wear a cast shoes.