Paediatric Acute care Guidelines PMH 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 is10 layers of plaster (ie 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

Video Guides

Upper Limb

Below Elbow Cast:

Above Elbow Cast:

Thumb Spica:

Lower Limb

Below Knee Cast:

Above Knee Cast:


Provide parents with Patients with Plasters Health Facts sheet.

Thanks to Simon Green and Neil Long for creating the videos. Very special thanks to Ethan, Charli and Luke for being model patients.

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