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)

Attention

  • 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

What you need

  • Plaster saw or plaster cutters
  • Cold wet towel — soak in bowl of ice cubes
  • Plaster spreaders or very strong wrists
  • PPE for you and person
    • Hearing protection (ear muffs or plugs)
    • Goggles and masks — to protect eyes and lungs from dust particles

What you do

  • 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  

Using plaster cutters

  • 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

Tight cast

  • If cast too tight but new one can't be put on in your clinic 
    • 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