Educating and Preparing Families and Distracting Patients for Cast/Splint Applications

Abstract

The casting process can produce anxiety and sometimes discomfort for both patients and caregivers. Proper preparation and education are essential for a successful casting experience. The teaching process should begin as early as possible before cast placement. Strategies to enhance the patient experience include pain management, environmental controls, and distraction techniques. Tailoring the experience to the child's developmental stage is crucial. By implementing these strategies, healthcare professionals can enhance the experience for patients and caregivers, making the process more efficient and less traumatic for everyone involved. The purpose of this chapter is to detail evidence-based strategies, along with insights and challenges from pediatric orthopaedic experts, in preparing patients and caregivers for cast and splint immobilization.

Key concepts: (1)Successful pediatric orthopaedic cast and splint application relies on clear, compassionate communication and education for patients and caregivers.(2)When preparing patients and families for the casting and splinting process, the approach should be customized to the child's age and developmental stage.(3)Adequate pain management, environmental controls, and distraction techniques can be helpful in alleviating discomfort and anxiety during the placement and removal of casts and splints.(4)The placement of the cast marks the beginning of a typically much longer process, making proper preparation and education vital for a successful casting or splinting outcome.

Keywords: Cast; Immobilization; Pediatric fracture; Splint.

Figure 1

Flowchart detailing anesthetic considerations in pediatric fracture and casting management.

Figure 2

Decorations and available toys/games/books can help to make the pediatric orthopaedic clinic a more welcoming and less intimidating environment for children.

Figure 3

Performing unfamiliar tasks (to the patient) or lengthy activities prior to casting, such as preparing materials, can be done in advance to both speed up the casting process and reduce anxiety leading up to it.

Figure 4

A towel or blanket can be held up to shield the child from the process of working on a cast (A). Likewise, toys can serve as a good distraction during the casting process (B).

Figure 5

VR can serve as a distraction-based technique for reducing anxiety in the setting of pediatric casting and splinting. VR, virtual reality.

Figure 6

A “pediatric bone remodeling” clinic wall of example fractures and their subsequent long-term remodeling can be a valuable visual aid to reassure skeptical or nervous patients and parents.

Figure 7

QR Code for OrthoKids patient guide for casts and splints. https://orthokids.org/i-broke-my/casts-and-splints/. QR, Quick Response.

Fig. S1