Spica cast for older child...

daycaremom2002 · May 9, 2011

One of my daycare kiddos broke his femur yesterday. He had surgery today, and will be discharged tomorrow. I haven't seen him yet, but mom says he is sort of semi-reclined in a spica cast. My local coalition is helping with a harness for him to go home in. I will be able to get pictures of his cast soon. I'm sure that will help.

I will more than likely have him back in my care next week. I don't think laying down will work in my van. Is there a way to try to make a Regent work for him? He is 6.5yo and is approx 47 pounds. I am positive his butt will not be back in the seat all the way. Does this mean that he has to lay flat?

Help!??

ketchupqueen · May 9, 2011

One option that was mentioned by one of my instructors was a SafeGuard Go (now Safety 1st Go.) If you have access to one and he fits, you can put it in a captains' chair, and then recline it as necessary to achieve the correct angle. No, it's not using according to the instructions (they say not to recline more than 30 degrees from vertical-- though in some cases, depending on how he's casted, that might be enough) but it is something to consider in this case if you can't have a full bench available for him to use a modified vest. It's low profile, so you would then support the cast, coming right off the edge, with something soft and supportive (an underinflated large exercise ball, a large beanbag chair, or a platform made of a jumbo package of paper towels, with some rolled towels added as needed for support and positioning, are some ideas.)

You could try it with the Regent and some rolled towels under him to support him as needed (another "off-label use"-- but again, in special needs situations sometimes you do what you need to) both at his back and under his leg where it comes off the seat, but my concern with that is that it might cause discomfort. No matter what you use you'll need room for his leg to fully extend. How much do you need to drive him?

daycaremom2002 · May 9, 2011

I will need to drive him daily. I don't have access to a go, but will have to see if anyone else does. Would a plain harness (an ez on or similar) accomplish the same thing? I have never seen one, so I am clueless. Is that what they may be getting for laying down?

I guess a lot of this is depending on how he is casted. I have until at least next Monday to figure this out. I appreciate the ideas and the ability to brainstorm ideas. The ball idea is awesome! I will see if I can get a picture from his mom.

ketchupqueen · May 9, 2011

An 86-Y might work? As might an RSTV, though not as easily... But a modified vest is what they usually use-- that's one that's used lying down. If you need to transport him every day, gosh, I'd be uncomfortable with that. What vehicle are we working with here? Do you have LATCH? (If not, skip the Go... Also it needs vehicle support to ear level, a seated vest will too.)

Here's an example of what we did for Bridey when her leg had to be elevated for 2 weeks and we had to drive home, we used paper towels, a body pillow, towels, and duct tape (I didn't want to buy anything we wouldn't use again, lol.) She was in a Radian (nice and low-profile, she didn't have to lean back, just had a cast to above the knee), but picture the Regent, with him leaning back as needed and towels behind the gap at the back for comfort, if desired:

flipper68 · May 9, 2011

Most will depend on how he is casted. Some kids with a spica cast fit in a Regent or a Radian.

I'd be really uncomfortable transporting this kiddo daily:

1st - He's likely to be uncomfortable or in pain. (I remember a couple of trips when I first broke my ankle - and that was just an ankle.)

2nd - You'll need to be able to lift him in/out of the vehicle and THAT may be very challenging. 50 lbs for the kid + another 20+ (guess-t-mate) for the cast, no weight bearing. . .

3rd - Once you get to your destination, you will need something to transport him in/with as well as some positioning options.

daycaremom2002 · May 9, 2011

The more I get into this, the more I'm thinking this just might not work. I have to go pick up my school kids every day. His mom seems to think that they will send him to school in a wheel chair. Not so sure about that.

I can put him in the front bucket seat in my van. The regent would go in the first bench so his leg will fit between the front two seats. I have no latch. I do have top tethers including the front bucket.

So, if I do this at all, IF he fits in the regent, it would be ok to put towels or something behind him for support?

I know none of this is ideal, but they really can't afford to miss that much work, and the state pays me to watch him. It takes at least a month to transfer that benefit to someone to stay at her house with him.

Judi · May 9, 2011

I would try it. THe actually spica seat has a wedge that basically takes the bight out of the seat, if that makes sense.

daycaremom2002 · May 9, 2011

That makes sense. I guess I will just keep gathering information until I see him in person. I lift him daily anyhow, so that really won't be a problem. (said with every optimistic fiber I can muster...lol)

emtb79 · May 10, 2011

Assuming that you have a 12 or 15 passenger maybe you could do what KQ did for her daughter and do that in the first row bench seat with the leg extending through the fron seats.

daycaremom2002 · May 10, 2011

Yes, I have a 15 passenger. I think I am going to try him in either the Regent or the Apex. I haven't been using it because it is missing the right side arm rest but now that seems like it is a good thing..

I am slightly worried that the little extra recline on the Regent might cause a problem. It might make it easier too though, LOL. I really don't have a clue. I am just grasping for answers. I hate not having a plan.

He is being release today, so I will hopefully have more information soon.

daycaremom2002 · May 10, 2011

Well, good news, I think.

I just got off the phone with my instructor who went to see them this morning. He was able to use a hippo seat for him. He said that he thinks that the Apex that he usually uses will work fine, if they take off the arm rests. He said that he was able to get him all the way back into the seat, so no extra padding was necessary. I am going to see how it works with their Apex and then decide what to do in my van.

ketchupqueen · May 10, 2011

Bridget was told she could return to school in 1 week, in a wheelchair with elevated leg support. But she doesn't go to school, lol, so it wasn't an issue for her. Also, we used a wagon instead of wheelchair because they didn't have a wheelchair her size... If they get him a wheelchair I could totally see him going to school and needing transport to and from.

daycaremom2002 · May 10, 2011

That's good to know. I hope he does better than I am anticipating. I think the main factor(that I haven't mentioned here yet..) is that he has Autism. He is non verbal and usually very bouncy. I am afraid that it will cause sensory issues, especially in the car, that I am not prepared to deal with. If I can get him into his own seat, then that will be 1 thing that is the same for him.

ketchupqueen · May 10, 2011

Completely get that! I'd try the Regent in a spot where he can have his leg elevated in front of him, then, since they were able to get him into a Hippo it should work pretty well, I'd think. And yes, you may use support behind him as needed.

daycaremom2002 · May 10, 2011

So, what do you think about taking the recline bar off the Regent. It is post advisory, but I can only get it installed in my van with a pretty good recline. If it works with the recline, then I'm good. Otherwise, I might need to make that judgment.

ketchupqueen · May 10, 2011

No, I would not use it without the recline bar if it's post-advisory. I'd use the Apex instead. But I think the recline will probably work in your favor, not against you.

daycaremom2002 · May 11, 2011

You may be right.

Thanks for the help. I will post pictures of what we end up with (as long as mom give the ok.)

ketchupqueen · May 13, 2011

Have you had him yet? How is he casted? Is something working out?

daycaremom2002 · May 13, 2011

I will likely have him after his doctors appointment next Tuesday. I went and saw him and I really think he will fit just fine in the Regent. He fit great in the hippo.(he was just over the top slots though) his leg should be supported to almost the knee so I don't even need to worry about a foot rest.

ketchupqueen · May 14, 2011

Supported to almost his knee-- you probably will need something under his feet. You want to take the weight of gravity off the leg so he's not uncomfortable, by propping it up.

Spica cast for older child...

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