What happens after a telemedicine visit for 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. After a telemedicine visit, a healthcare provider may guide you through simple steps to help your child’s arm feel better. Often, the provider can suggest gentle maneuvers to help the elbow return to its normal position or advise when to seek in-person care. You may be asked to watch for signs of pain, swelling, or limited movement. Follow-up care usually includes rest, avoiding pulling on the arm, and monitoring your child’s comfort. If symptoms do not improve or worsen, a healthcare provider may recommend an in-person exam or X-rays. Telemedicine can provide quick advice and support but cannot replace hands-on treatment or emergency care. Always seek immediate medical help if your child shows signs of serious injury or distress.

Red flags — go in person / ER

• Child cannot move the arm or hand at all — seek emergency care immediately.
• Arm appears swollen, deformed, or bruised — visit a healthcare facility promptly.
• Child develops numbness, tingling, or loss of feeling in the arm or hand — get urgent medical attention.

What telemedicine can do

• Initial assessment of symptoms and injury description.
• Guidance on gentle maneuvers to reduce the subluxation if appropriate.
• Advice on home care, pain management, and activity restrictions.
• Determining if in-person evaluation or imaging is needed.
• Answering questions about injury and recovery.

What telemedicine cannot do

• Performing physical reduction maneuvers hands-on.
• Conducting imaging tests such as X-rays.
• Managing severe pain or complications requiring emergency care.
• Diagnosing fractures or other injuries without in-person exam.
• Providing casts, splints, or other physical treatments.

Understanding Nursemaid’s Elbow

Nursemaid’s Elbow happens when the ligament around the elbow slips out of place, usually after a sudden pull on the arm. It is common in children aged 1 to 4 years. The child may hold their arm still and refuse to use it because of pain. This injury is usually not serious but needs proper care to help the elbow move normally again.

What to Expect After Your Telemedicine Visit

During the telemedicine visit, the healthcare provider may ask you to describe your child’s symptoms and watch how they hold their arm. They might guide you through gentle movements to help the elbow slip back into place. After the visit, you will receive advice on how to care for your child at home, including rest and avoiding pulling on the arm. You may also get instructions on when to seek further care.

When to Seek In-Person Care

If your child’s pain continues, they cannot move the arm, or if the arm looks swollen or deformed, you should take them to a healthcare facility. Also, if your child develops fever, numbness, or weakness in the arm, seek emergency care immediately. Sometimes, an X-ray is needed to rule out a fracture or other injury.

Caring for Your Child at Home

After the telemedicine visit, keep your child comfortable by:

Follow-Up and Prevention

Most children recover quickly from Nursemaid’s Elbow. Follow any follow-up instructions from your healthcare provider. To prevent future injuries, avoid pulling or swinging your child by the arms. Teach caregivers about safe handling to protect your child’s elbows.

How to prepare for your tele-visit

• Have your child’s symptoms and recent injury details ready to describe.
• Be prepared to show your child’s arm and how they hold it during the video call.
• Ensure good lighting so the provider can see the arm clearly.
• Have a quiet space for the visit to hear and follow instructions.
• Keep a soft cloth or cold pack nearby in case advised for after the visit.

After your tele-visit

• Follow provider’s instructions on arm movement and rest.
• Avoid pulling or lifting your child by the affected arm.
• Use cold packs wrapped in cloth to reduce any swelling if recommended.
• Watch for any worsening symptoms or new signs like numbness or severe pain.
• Schedule or attend any recommended follow-up appointments or in-person exams.

FAQs

Can Nursemaid’s Elbow heal on its own without treatment?

Nursemaid’s Elbow often improves quickly once the elbow is gently moved back into place. Without treatment, the child may continue to avoid using the arm due to pain. It is best to seek care to help the elbow return to normal and reduce discomfort.

Is it safe to try to fix Nursemaid’s Elbow at home?

Some caregivers may be guided by a healthcare provider during a telemedicine visit to try gentle maneuvers. However, attempting to fix the elbow without guidance can cause more pain or injury. Always follow professional advice and seek in-person care if unsure.

How soon will my child feel better after treatment?

Many children start to use their arm normally within minutes to hours after the elbow is repositioned. Full comfort and normal movement usually return quickly, but some soreness may last a day or two.

Can Nursemaid’s Elbow happen again?

Yes, children who have had Nursemaid’s Elbow are more likely to have it again, especially if the arm is pulled or swung. Preventing sudden pulls on the arm can reduce the risk of recurrence.

When should I take my child to the emergency room?

Go to the emergency room if your child cannot move the arm or hand, if the arm looks deformed or swollen, or if your child shows numbness, tingling, or severe pain. These signs may indicate a more serious injury.

Sources

1. Nursemaid's Elbow — MedlinePlus, U.S. National Library of Medicine / NIH.
2. Radial Head Subluxation (Nursemaid's Elbow) in Children — American Academy of Pediatrics (AAP).
3. Nursemaid's Elbow: Treatment and Care — Mayo Clinic.
4. Radial Head Subluxation (Nursemaid's Elbow) — National Library of Medicine.

This telemedicine guidance is for educational and triage purposes only. It is not a substitute for in-person medical evaluation or emergency care. If your child shows signs of serious injury or distress, seek immediate medical attention.