An injured limb: Should I stay or should I go now?

broken armThe classic punk rock song lyric “Should I stay or should I go now?” will run through your head many times during parenthood as you wonder when your kid should go to the doctor’s office. Today we turn to pediatric orthopedic surgeon and author Dr. Gleeson Rebello for advice on whether an injured limb needs immediate medical attention – Drs. Lai and Kardos. 


You drive home after a tiring day at work and think about all you will do with your family in the next few hours before calling it a day. A visit to the local emergency department or your child’s doctor is definitely not on that list. 

 
Upon arriving home, you find out your six-year-old daughter just fell from the swing in the backyard and complains of a painful elbow.
 
Do you hug, kiss, comfort her, stop to pour yourself a glass of wine and take it easy on the patio? Or, do you take her to a doctor?
 
Take her to a doctor as soon as possible if:

She has a deformed arm 
She cannot move her arm
She has an open injury with bone visible or with uncontrollable bleeding
She is screaming with pain that does not seem to get better with rest, comfort and ice packs
She cannot move the joint (shoulder, elbow, wrist and finger joints) without significant pain

DON’T GIVE HER ANYTHING TO EAT OR DRINK while you assess what is going on…. just in case she needs to undergo surgery once she gets to the hospital.

If she is in some pain with moving the elbow, immobilize her in a home-made sling using a towel and some safety pins. Apply an icepack and give her an anti-inflammatory/pain relief medication like ibuprofen (brand names Motrin, Advil).

Think strongly about going to the doctor if she shows signs of persistent discomfort and you wonder if you will be staying up with her the whole night.

If she appears comfortable, give her a light meal and elevate the elbow on a couple of pillows. Arrange her hand above the elbow, and the elbow above her heart in order for gravity to reduce the swelling.

Call your child’s doctor to set up an appointment if she is still in pain in the morning or has not improved overnight.

Hopefully you will never need to use the knowledge gained from this article!

Gleeson Rebello, MD
©2013 Two Peds in a Pod®

Dr. Gleeson Rebello serves as a pediatric orthopedic surgeon at MassGeneral Hospital for Children, and is on the faculty of Harvard Medical School. His new children’s book coauthored with Jamie Harisiades,  DareBone’s Big Break , helps children navigate the potentially frightening experience of fixing a broken elbow. Dr. Rebello is dedicated to making everyday medical practice accessible to children in a fun and sophisticated manner through books and media. Applaud his efforts and like his Facebook page at https://www.facebook.com/Darebone
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