How to prepare for a video visit about Nursemaid’s Elbow (Radial Head Subluxation) - Triage

Audience: pediatric

Nursemaid’s Elbow, also called radial head subluxation, is a common injury in young children where the elbow joint partially slips out of place. It often happens when a child's arm is pulled suddenly. This injury can cause pain and make the child avoid using that arm. A video visit with a healthcare provider can help assess the situation and guide you on what to do next. During the visit, the provider will ask about how the injury happened and watch the child's arm movement. They may suggest treatments or advise if an in-person visit is needed. Preparing for the video visit by having your child's medical history and a quiet space ready can make the appointment smoother. Remember, if your child has severe pain, swelling, or other serious symptoms, seek emergency care immediately. This guide helps you understand what to expect and how to get ready for a telemedicine visit about Nursemaid’s Elbow.

Red flags — go in person / ER

• Child cannot move the arm at all or shows extreme pain
• Swelling, bruising, or deformity around the elbow
• Child has fever, numbness, or weakness in the arm — seek emergency care immediately

What telemedicine can do

• Initial assessment of symptoms and injury history
• Visual observation of arm movement
• Providing guidance on home care and pain relief
• Determining if urgent in-person care is needed

What telemedicine cannot do

• Performing physical manipulation or reduction of the elbow
• Ordering or interpreting imaging tests like X-rays
• Treating fractures or other serious injuries
• Providing emergency care for severe symptoms

What is Nursemaid’s Elbow?

Nursemaid’s Elbow, or radial head subluxation, happens when the small bone in the elbow slips out of its normal position. It usually occurs in children under 5 years old. This injury often happens when a child's arm is pulled or lifted suddenly. It can cause pain and make the child hold their arm still and avoid moving it.

Signs and Symptoms to Watch For

Common signs include:

If you see swelling, bruising, or if the child has a fever, these may be signs of a more serious injury.

How a Video Visit Can Help

During a video visit, a healthcare provider can:

They cannot perform a physical exam or imaging tests remotely, but can help decide the next steps.

Preparing for Your Video Visit

To get ready for the visit:

This preparation helps the provider assess your child better.

What to Expect After the Visit

After the video visit, you may be advised to:

Follow the provider’s advice carefully to help your child recover.

How to prepare for your tele-visit

• Choose a quiet, well-lit room with a stable internet connection
• Have your child nearby and calm before the visit
• Prepare to describe how and when the injury happened
• Gather any relevant medical history or previous injuries
• Have a device with a camera ready to show the child's arm
• Be ready to follow instructions to move or show the arm during the visit

After your tele-visit

• Follow any care instructions given by the provider
• Use gentle arm movements as advised
• Apply cold packs if recommended to reduce pain
• Monitor your child’s symptoms closely
• Seek in-person care if symptoms worsen or do not improve

FAQs

What causes Nursemaid’s Elbow?

It often happens when a child's arm is pulled suddenly, such as when lifting or swinging them by the hands. This can cause the small bone in the elbow to slip out of place.

Can Nursemaid’s Elbow heal on its own?

Sometimes it may improve on its own, but often a healthcare provider needs to gently move the bone back into place. Prompt care can reduce pain and help your child use their arm again quickly.

When should I go to the emergency room?

Go to the emergency room if your child cannot move the arm at all, has severe pain, swelling, bruising, deformity, numbness, weakness, or a fever. These may be signs of a more serious injury.

Is it safe to treat Nursemaid’s Elbow at home?

You should not try to fix the injury yourself. Follow the healthcare provider’s advice from the video visit. They may guide you on safe care or recommend an in-person visit.

Will my child need an X-ray?

An X-ray is not usually needed for Nursemaid’s Elbow unless the provider suspects a fracture or more serious injury based on symptoms or physical exam.

Sources

1. Nursemaid's Elbow — MedlinePlus, U.S. National Library of Medicine.
2. Radial Head Subluxation (Nursemaid's Elbow) — American Academy of Pediatrics.
3. Nursemaid's Elbow (Radial Head Subluxation) — Mayo Clinic.
4. Radial Head Subluxation (Nursemaid's Elbow) — National Library of Medicine.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has severe symptoms or you are concerned about their health, seek immediate medical attention.