Anxiety reaction in children during removal of their plaster cast with a saw

K. Katz, R. Fogelman, J. Attias, E. Baron, M. Soudry

Research output: Contribution to journalArticlepeer-review


We have had experience of an 18-month-old boy with a cardiomyopathy who died a few minutes after removal of his cast with a saw, apparently from a malignant cardiac arrhythmia triggered by anxiety. We therefore examined the anxiety reaction to this method of removal of a plaster cast in 20 healthy children; ten were provided with hearing protectors and ten were not. The level of anxiety was assessed by measuring the heart rate, a known physiological indicator of anxiety, before, during and five minutes after removal of the cast. The noise level was also measured. The results showed a mean increase in heart rate during the procedure of 27.9 beats per minute (bmp) (26.9%) in the children with no hearing protectors and 10.4 bmp (11.1%) in children who used hearing protectors (p<0.001). Five minutes after the procedure the heart rate had returned to the baseline rate in all patients. We recommend that hearing protectors should be used in children undergoing removal of a plaster cast to decrease the anxiety reaction. If possible, clinicians should avoid the use of a saw for this purpose in children with a cardiomyopathy.

Original languageEnglish
Pages (from-to)388-390
Number of pages3
JournalJournal of Bone and Joint Surgery - Series B
Issue number3
StatePublished - 2001
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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