Plaster application

Disclaimer These guidelines have been produced to guide clinical decision making for the medical, nursing and allied health staff of Perth Children’s Hospital. They are not strict protocols, and they do not replace the judgement of a senior clinician. Clinical common-sense should be applied at all times. These clinical guidelines should never be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of each patient. Clinicians should also consider the local skill level available and their local area policies before following any guideline.  Read the full PCH Emergency Department disclaimer.

Aim 

To guide PCH ED staff in the application of plaster backslabs in the Emergency Department.

General principles of plaster backslab application

Prepare equipment

• Protective sheet over patient
• Water bowl with plastic lining
• Plaster slab
• Crepe bandage x 2
• Tape to fasten x 2
• Stockinet and padding
• Sling/collar and cuff/crutches

Measure and cut stockinet (Tubinet or Tubon)

• Never use Tubigrip due to excessive compression
• Prevents rubbing and conducts perspiration
• Allow extra length for rolling over end of slab

Apply padding (Webril)

• Commence distally and roll evenly in a proximal direction overlapping by 1/3
• Avoid bunching up of padding by tearing around joints
• Apply extra layers over prominent points

Measure and Trim Plaster Slab

• Basic slab is 10 layers of plaster (i.e. 5 sheets measured to length and doubled over)

Below Elbow Slab/Above Elbow Slab

• use 20cm plaster for BIG arms
• use 15 cm plaster for SMALL arms

Below Knee Slab/Above Knee Slab

• back slab plus 5 layers for stirrups x 2
• use 20cm plaster for back slab and 10cm plaster for stirrups for big leg
• use 15cm plaster for back slab and 10cm for stirrups for small leg
• use 15cm plaster for back slab and 5cm for stirrups for baby

Gutter Splint

• use 15cm plaster for big arm
• use 10 cm plaster for small arms

Endorsed by:	Emergency Department Guidelines team	Date:	May 2018
		Review date:	May 2021

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