Taking off a cast

Fibreglass casts can only be taken off with plaster saw

Take off Plaster of Paris (POP) casts with

Plaster saw (best)
OR Plaster cutters (harder)
OR Soak cast for 10–20 minutes, tear it apart bit by bit, soaking as you go (much harder)

If using saw — always steady (brace) hand holding saw against plaster cast and/or work surface
Saw blade can cut person or give a burning sensation on skin, so go carefully
Avoid areas where bones protrude (stick out) such as ankle and wrist joints
Do outside or in well-ventilated area — makes a lot of noise, dust, mess

For plaster make 1 cut down back of limb
For fibreglass make 2 cuts, one down either side of limb (eg radial and ulna borders)

Using plaster saw

Brace saw by resting knuckles on cast — Figure 10.68
Cut plaster in short movements going down then up, then forward
Do not push or drag blade — increases friction and heats saw blade more
Saw blade gets very hot, can burn person. Stop every few minutes, cool blade with cold, wet towel
Monitor cutting process by asking person if they feel any heat at cutting site
Stop when you feel a slight give in plaster and plaster wool can be seen
Split whole length of cast with saw

Figure 10.68

Start cutting from hand/foot end of cast, take care not to bruise skin and bone underneath

When cast split

Open up cast using plaster spreaders — or a lot of wrist strength. You can also soak plaster to loosen it
Cut through plaster wool with blunt-ended scissors and gently take off cast
Check limb for bruises, lesions
Wash with soap and water to remove dead skin or dirt

Saw down 1 side, open cast with spreaders but leave in place around limb
Cut plaster wool with blunt-ended scissors
Pad between cut edges of plaster with cork, wads of gauze etc to stop it closing again, bandage
Send for replastering and review