Cast Supplies, Long Arm Cast, Pediatric (0-10 years), Plaster (Q4007)

Name of the Procedure:

Common Name(s): Long Arm Cast, Pediatric

Technical/Medical Term: Pediatric Long Arm Cast using Plaster

Summary

A pediatric long arm cast using plaster is a medical procedure used to immobilize the arm of a child aged 0-10 years, typically to allow healing of fractures or other injuries. The plaster cast extends from the upper arm to the fingers, keeping the arm in a fixed position.

Purpose

This procedure is used to treat fractures, dislocations, and other injuries of the arm and elbow. The goal is to immobilize the area to allow for proper healing, prevent further injury, and alleviate pain.

Indications

• Suspected or confirmed fracture in the arm, elbow, or wrist.
• Severe sprains or ligament injuries.
• Post-surgical immobilization.
• Bone infections or conditions requiring immobilization.

Preparation

• The patient may need an X-ray or other imaging tests to assess the injury.
• Ensure the patient does not eat or drink if sedatives or anesthesia is anticipated.
• Adjust any medications as advised by the healthcare provider.

Procedure Description

1. Initial Assessment: The healthcare provider assesses the injury and decides on the need for a long arm cast.
2. Anesthesia/Sedation (if applicable): Administered based on the child's comfort and nature of injury.
3. Application of Stockinette and Padding: A tube of soft material (stockinette) is applied to the arm, followed by padding to protect the skin.
4. Plaster Application: Wet plaster rolls are wrapped around the arm, starting from a bit above the elbow and extending down to the hand.
5. Molding and Setting: The plaster is molded to ensure it fits snugly and offers the required support. It hardens within a few minutes.

Tools/Equipment Used:

• Stockinette
• Padding material
• Plaster rolls
• Scissors

Anesthesia Details (if applicable): Local anesthesia, sedatives, or general anesthesia may be used based on the child's age and condition.

Duration

The procedure typically takes about 20 to 30 minutes.

Setting

This procedure is generally performed in:

• Emergency rooms
• Hospitals
• Outpatient clinics

Personnel

• Orthopedic surgeon or emergency physician
• Nurses
• Radiologic technologist (for imaging before and after placement)

Risks and Complications

Common Risks:

• Skin irritation or rash
• Swelling
• Limited movement

Rare Risks:

• Compartment syndrome
• Infection
• Poor bone healing

Benefits

• Stabilizes the broken bone for proper healing
• Reduces pain and discomfort
• Prevents further injury
• Healing typically begins immediately, with most improvements seen within a few weeks.

Recovery

• Keep the cast dry and clean.
• Elevate the arm to reduce swelling.
• Follow specific instructions on activity restrictions.
• Regular follow-up visits to monitor healing.
• Typical recovery time varies, with most pediatric fractures healing in about 4-8 weeks.

Alternatives

• Removable splints or braces
• Orthopedic surgery for more complex injuries

Pros and Cons:

• Splints/Braces: Easier to manage day-to-day but may offer less rigid immobilization.
• Surgery: More invasive with longer recovery, but necessary for complex fractures.

Patient Experience

During the procedure, the child might feel some initial discomfort while the cast is being applied, especially when manipulating the injured arm. Post-procedure, monitored pain management with pain relievers may be necessary. The child might experience itching under the cast, which is common. Comfort measures like elevation and the use of cold packs can aid in reducing swelling and pain.