It happens and it hurts. My 8-year-old son fell off the monkey bars on the playground at school. His teacher called me immediately to say it really hurt and he couldn’t move it. Fast forward and a few hours in the emergency department later along with repeated sets of x-rays, we confirmed a distal lateral humeral fracture and my son got his first cast. He was a trooper throughout the process at the hospital while I played mom and nurse. It was when we got home that he had a huge adrenaline release from pain, built up nerves, and admitting he was scared. I wanted to share our experience here and offer some parenting tips for cast care and helping a child with a broken bone.
Here is a recap of our emergency room experience along with 3 easy comfort care interventions for a child with a suspected broken bone:
While kids react to unexpected situations differently, we all know our own kids. As a mom and a nurse, I’m all about encouraging someone to be their own advocate. In the case of kids, it’s about making a responsible decision as a parent on behalf of our kids and deciding what you feel is best. In this case, the emergency room physician told me she would get my son Lortab for pain at a time that he wasn’t crying and was sitting uncomfortably but managing the pain. I explained we could try Motrin before jumping to Lortab (which is a combo of acetaminophen and hydrocodone). She questioned my decision by reminding me he was in pain – which I fully recognized, but I trust my mommy gut and didn’t feel like Lortab was necessary at that point (it ended up not being needed at all). I wish the emergency physician had handled this differently. She had no other recommendations aside from narcotics. Thankfully, the nurse was proactive and polite and we worked together to provide some comfort interventions.
Here are 3 easy comfort care interventions when a child has a suspected broken bone:
- Apply Ice
- Elevate and stabilize
- Use distraction
Due to the location of the fracture and the swelling, the orthopedist made a bivalve cast. He split the cast (cut it in half) to allow for swelling. My 8-year-old told everyone that “getting his arm sawed in half was cool” but this can be very scary for a little kid.
Here are 4 comfort measures you can take if/when your child needs their cast cut:
- Cover their ears – The saw is VERY loud and the sound can be startling.
- Ask the clinical person to let the child touch the saw – It can help reduce the fear if they understand how it will work.
- Close your eyes and count together – This can be especially helpful for a child with sensory issues. Using this type of distraction to get them through the few minutes it will take to use the saw to cut/open the cast.
- Provide reassurance – The combo of pain and fear can put anyone over the edge. Not knowing what to expect can be particularly tough for some kids. Be reassuring with kind words and soft touch and try to explain what is happening so they can understand and know what to expect.
Here are 3 parenting tips to help with cast care for a child:
- Use Umbrella Bags for baths – Don’t get the cast wet. Easier said than done, so here is my #1 tip. You know the long umbrella bags that are sometimes in the lobby at the emergency room or in stores? Grab a handful of them. They are the perfect size to cover a full arm cast and can be reused for bathing so the cast stays dry.
- Be Flexible – Everything takes longer. Getting dressed, moving around, and handling regular situations. My son gets frustrated more easily and has been cranky and uncomfortable, but distraction has worked wonders. Ease up a little and modify chores and tasks as needed.
- Let them decorate/sign and take care of their cast – It’s a big deal, so empowering the child to care for their cast themselves and understand how important it is that their bone heals properly can help them accept why it has to stay on for weeks. If possible, let them choose whichever color cast they’d like (the emergency room only had white, but he had to get it changed 2 more times and was thrilled to have green, and then blue). My son also received “get better” cards from his entire class at school and it truly raised his spirits. Some special attention can really help.
Of course, every situation is different, but I hope these tips help if your child ever ends up needing a cast.