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Warning-sign checks

Nursemaid's elbow: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Get emergency help if the hand becomes pale, blue, cold, numb, or unusually weak, or if the child cannot move their fingers.

    These signs may mean that blood flow or nerves are affected.

    Heavy bleeding or a major traumatic injury also needs emergency care.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Seek prompt, same-day medical assessment if a child suddenly stops using an arm after it was pulled, lifted, twisted, or caught.

    Assessment is also appropriate when the cause is unclear, because fractures and other injuries can cause similar behaviour.

    Seek urgent medical care if the child has:

    • Marked swelling, bruising, or a visibly bent or misshapen arm
    • Severe or worsening pain
    • A hot, red, swollen joint, especially with fever
    • An open wound near the injury
    • Symptoms after a major fall, collision, or direct blow
    • Continued refusal to move the arm after reduction
  3. 3

    Does any of this apply?

    Book an appointment

    After a successful reduction, routine follow-up is usually unnecessary unless the health professional recommends it.

    Arrange reassessment if the child still avoids using the arm later that day, has pain the following day, or develops new swelling or bruising.

Every sign above is quoted from the sofidex article on Nursemaid's elbow. If you are not sure, err upward — it is always reasonable to be checked.