Tuesday, August 05, 2014

How to treat a pulled elbow in Pediatic OPD practice ? Youtube to the rescue !

I reach the clinic at 9 AM in the morning, and I see this cute 3 year old girl whose parents complain that she has been not moving her left arm since last evening, when her grandfather accidentally picked her up by one arm. 
Clinical Diagnosis : Pulled Elbow
Problem: I do approximately 1 reduction every few months, so I need to review the technique before I do it again. During our student days, we used to send these kids routinely to the orthopedician, however, in practice I found that I could do the closed reduction successfully in about 75 % of the cases.
So I sent the kid outside with a couple of candies to keep her busy, and immediately googled the video from youtube !
2 minutes later, VOILA ... I have a set of happy baby, satisfied parents & a really happy & relieved pediatrician :)
Here is the video 
with detailed tips on how to do this reduction at your pediatric office practice.
Of course, if you are in doubt, not comfortable, I would suggest that you visit your orthopedician colleague once with the patient, and see how simple the procedure really is.
I just found an excellent parent focused study done in the US, published in April 2014, that talks about nurses doing the reduction in pediatric emergency departments as well.
You can read the article in Medscape here (requires free registration) 

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