PEM pearls

Cast related harm

You have just seen Amelia, a 3year old girl who has represented after being seen in the department 3days ago when she was diagnosed with a toddler’s fracture. She was placed in a below knee backslab and discharged with fracture clinic follow up.

​Her parents report that over the last 48hours she has started to complain of pain to her heel on that side and is becoming increasingly distressed by this. 

​After discussion with the senior doctor, you remove the cast and find that Amelia has a pressure injury to her heel.
 
This publication by the Queensland Paediatric Quality Council reminds us that plaster casts can cause pressure injuries in children and discusses red flags plus tips and tricks to reduce this complication.

Dr Danielle Scarfe