Tenaj Posted November 29, 2011 Share Posted November 29, 2011 We sat in the ER last night for four hours waiting for the Dr. who was able to twist my dd's elbow/arm back into place in 15 seconds! Surely there has to be a better system for injuries like this. All of the urgent cares in our area were closed and I honestly don't know if they would have touched it. My dh was walking from one room to the other, holding our youngest's hand. She decided she didn't want to go and let her legs go out from under her. Immediate high pitched crying and arm plastered to her side. I knew right away what it was and did a quick google to confirm and we were off to the brand-new hospital in town. For four hours we waited with her not moving her arm at all or whimpering everytime it accidently shifted. Then miracle Dr. walks in, does a quick twist, takes her down the hall for a popsicle and my dd comes back waving the treat in the arm she hadn't moved for five hours. So thankful that it was an easy fix! It is ironic that it happened the way it did because my daughter loves to be swung around by her arms so that's over for a while! Quote Link to comment Share on other sites More sharing options...
hmvaughan4 Posted November 29, 2011 Share Posted November 29, 2011 My son has done this twice. I had no idea what it was the first time and was certain they'd call CPS on me! Both times, our doctor popped it back in place. He showed DH how to do it, but thankfully it hasn't happened again. Quote Link to comment Share on other sites More sharing options...
jplain Posted November 29, 2011 Share Posted November 29, 2011 (edited) When I was a kid, our ped would give instructions to the parent by phone, and the parent would do the manipulation. It looked pretty simple to me, and required no office visit. If it happened to one of my kids, I'd call the ped's office first. But if they wouldn't give me instructions over the phone, Google would be my next stop. :D Edited November 29, 2011 by jplain Quote Link to comment Share on other sites More sharing options...
Tenaj Posted November 29, 2011 Author Share Posted November 29, 2011 When I was a kid, our ped would give instructions to the parent by phone, and the parent would do the manipulation. It looked pretty simple to me, and required no office visit. If one of my kids dislocated an elbow, I'd call the office first. But if they wouldn't give me instructions over the phone, Google would be my next stop. :D It was after hours for our ped or I know he would have done it in a minute. Probably the next time I'll be brave enough to try the google approach but as it was the first time I was a bit squeamish to try. Actually, I'm hoping that the ped will just show me the next time I'm in the office. I just thought it was strange that the triage nurse diagnosed it (after the three hour wait to get to that point - don't get me started) but then they did x-rays and then another hour until the dr. pops it back in. Maybe I'm unrealistic but for something so relatively simple that everyone had already identified it seems like the dr. or a nurse could have popped it back in in the waiting room and sent us on our way in two minutes! While I'm on the subject - any idea why they did x-rays when they knew what it was? I'm guessing it's a liability issue but it seems like it would have been more efficient to examine, pop the arm back and see if that was the fix before the x-rays. Quote Link to comment Share on other sites More sharing options...
milovany Posted November 29, 2011 Share Posted November 29, 2011 Google it. When this happened to our 2yo, it was 3 hours before we could see the doctor. I called a nurse friend and these were her exact words to me ("Google it."). I did it and it worked. Then you can make a FB post like I did: "I did a radial head subluxation today." :001_smile: I'm sorry for your daughter! Hopefully she feels all better. Quote Link to comment Share on other sites More sharing options...
4kiddies Posted November 29, 2011 Share Posted November 29, 2011 My daughter did this too and my pediatrician told me to come to the golf course where he was playing and he would pop it back in place in the parking lot. I inadvertently popped it back in though when I was putting her in the car seat so we didn't need to bother seeing the doctor. Quote Link to comment Share on other sites More sharing options...
Tenaj Posted November 29, 2011 Author Share Posted November 29, 2011 You should definitely learn to pop it back in if they can show you how. Ghastly to sit in an ER with an unhappy kid for that long. I think the waiting was harder for me than it was for her :) She was really fine unless that elbow moved and I got pretty good and keeping it still for her after the first hour. She was actually eating up all the attention. All of the other "waitees" were helping to entertain her - of course, just sitting in an ER can be an entertainment in and of itself :) Quote Link to comment Share on other sites More sharing options...
jplain Posted November 29, 2011 Share Posted November 29, 2011 While I'm on the subject - any idea why they did x-rays when they knew what it was? I'm guessing it's a liability issue but it seems like it would have been more efficient to examine, pop the arm back and see if that was the fix before the x-rays. If the injury involved a fall, they're supposed to x-ray before reducing the nursemaid's elbow, to make sure there aren't any fractures. Maybe this ER has a policy of always x-raying, instead of trusting the parent to know whether or not there'd been a fall. Quote Link to comment Share on other sites More sharing options...
fhjmom Posted November 29, 2011 Share Posted November 29, 2011 Standard of care for any dislocation (which Nursemaid's elbow is) is generally to shoot post reduction x-rays to ensure there are no complications including any fractures. There is also possibility of impingment of soft tissues. I am genuinely surprised at the number of recommendations to reduce it yourself at home. DS has had nursemaid's elbow (was pulling away from my dad and trying to get into something that was off limits). The urgent care doc was able to reduce it easliy and did shoot pics afterwards. Quote Link to comment Share on other sites More sharing options...
jplain Posted November 29, 2011 Share Posted November 29, 2011 Standard of care for any dislocation (which Nursemaid's elbow is) is generally to shoot post reduction x-rays to ensure there are no complications including any fractures. There must be some disagreement regarding standard of care then, as I've read otherwise. If the injury didn't involve a fall (meaning risk of fracture is very low), and the child his holding his arm in the characteristic attitude of nursemaid's elbow, I'd be comfortable attempting to reduce it myself. HOWEVER, if the child didn't immediately recover normal functioning of the joint, or had persistent pain, then yes, I'd take him in for x-rays. Quote Link to comment Share on other sites More sharing options...
justasque Posted November 29, 2011 Share Posted November 29, 2011 My dd was prone to this and she did it a bazillion times. It's unbelievably easy to fix - takes seconds. Google it now so you are prepared next time. Quote Link to comment Share on other sites More sharing options...
bbkaren Posted November 29, 2011 Share Posted November 29, 2011 We had a similar experience with my son; we couldn't see the doctor, though, until their "observation" of our interaction was complete, so they could determine if there was abuse involved. I guess they can tell if I'm abusive by watching us together when he's in pain? We had to sit in a little waiting room together and "play with toys" for almost an hour before they cleared us to see the doctor. Why that couldn't happen after the doc had helped him is beyond me. It was great fun... Afterward, we were told that the "1,2,3, swing!" (little one walking between the two parents, holding hands) game shouldn't be played until at least age 5 when the joints are mature. Quote Link to comment Share on other sites More sharing options...
Alice Posted November 29, 2011 Share Posted November 29, 2011 I've done it many times as a pediatrician and twice to my own daughter. I've never done X-rays and it's not the standard of care to do them unless the diagnosis is in question. Depending on the ER they are often staffed with people not as comfortable with pediatrics and who do more testing because of that. It is easy to do and I'm sure your pediatrician can show you how to do it or talk you through it on the phone. Both of which I've done for patients. It is more likely to happen again if it's happened once. Quote Link to comment Share on other sites More sharing options...
MotherMayI Posted November 29, 2011 Share Posted November 29, 2011 My dd was prone to this and she did it a bazillion times. It's unbelievably easy to fix - takes seconds. Google it now so you are prepared next time. :iagree: I did 2 visits to Urgent Care before googling it. I am so glad I did! Quote Link to comment Share on other sites More sharing options...
joannqn Posted November 29, 2011 Share Posted November 29, 2011 :grouphug: Please be very gentle/careful with that arm for a long time. My daughter had nursemaid's elbow, and it took about a year to heal. She kept aggravating it accidentally every so often. Quote Link to comment Share on other sites More sharing options...
Jean in Newcastle Posted November 30, 2011 Share Posted November 30, 2011 If you do the google it method, be aware that it doesn't always go back in the standard way. My ds had nursemaid's elbow and the ped. could not get it to go back in. We had to go to the children's hospital and they tried and could not get it in. It was only when they called an older doctor that he did it "backwards" and it went right in. He said that sometimes it spins out the opposite way. (Layman's language but that basically was how he explained it). Quote Link to comment Share on other sites More sharing options...
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