Nurses effective at treating common arm injury in kids, but docs do it better

A clinical trial to determine if nurses in the emergency department could reduce "pulled elbows" in children at a rate similar to that of physicians found that althiough nurses were able to treat this common injury 85% of the time, physicians were more effective, with a 97% success rate. The trial is published Mar. 24 in CMAJ (Canadian Medical Association Journal).

Pulled elbow, or radial-head subluxation, is a common arm injury in young children, often resulting in a visit to the emergency department. The injury is easy to diagnose and quick to fix, but children usually wait hours in the emergency department.

Researchers performed an open, cluster-randomized controlled trial to determine whether triage nurses in the emergency department could fix the condition, thereby freeing up valuable resources. The trial involved 268 children at the Children's Hospital of Eastern Ontario in Ottawa, Canada. Children were assigned to be treated by either a physician or a nurse who was trained in treating this injury. On the basis of feedback from a survey of emergency , researchers set a target of 10%, meaning if nurses reduced the injury by rates within 10% of physician rates, the doctors would consider using the protocol at their hospitals.

Nurses had a success rate of 85% in reducing the injury compared with a rate of 97% by physicians, which was 12% below the physician rate.

"Nurses accurately identified and reduced radial-head subluxation in most cases," writes Dr. Andrew Dixon, Department of Pediatrics, University of Alberta, and Stollery Children's Hospital, Edmonton, Alberta, with coauthors. "Children in the nurse-treatment group had a shortened length of stay compared with in the physician-treatment group, spending an average of 55 minutes less in the ."

Although the nurses did not meet the target for reducing the injury, their success rate was still high, and there could be benefits for using trained to help reduce the injury.

The authors conclude "task-shifting in health care involves trade-offs. Our study provides an informed choice between an immediate treatment that works 7 times out of 10 and a delayed treatment that works 19 times out of 20."

More information: www.cmaj.ca/lookup/doi/10.1503/cmaj.131101

add to favorites email to friend print save as pdf

Related Stories

Observation in the ER can reduce CT scans in kids

Aug 06, 2013

The longer a child with minor blunt head trauma is observed in the emergency department, the less likely the child is to require computed tomography (CT) scan, according to the results of a study published online Friday in ...

Nurses can perform colonoscopies as well as docs

Mar 04, 2014

(HealthDay)—Colonoscopy quality and safety are comparable for nurse and physician endoscopy trainees, according to a study published in the March issue of Clinical Gastroenterology and Hepatology.

Nurse-initiated steroids improve pediatric asthma care

Mar 20, 2012

(HealthDay) -- Nurse initiation of oral corticosteroids before physician assessment of pediatric patients with asthma improves quality and efficiency of care provided in the pediatric emergency department, ...

Recommended for you

Study reveals state of crisis in Canadian foster care system

19 hours ago

A new study of foster care in Canada led by a researcher at Western University reveals a shrinking number of foster care providers are available across the country to care for a growing number of children with increasingly ...

Researchers prove the benefits of persimmons for diet

20 hours ago

Alba Mir and Ana Domingo, researchers from the Department of Analytical Chemistry of the University of Valencia, under the supervision of professors Miguel de la Guardia and Maria Luisa Cervera, from the same department, ...

Hand blenders used for cooking can emit persistent chemicals

20 hours ago

Eight out of twelve tested models of hand blenders are leaking chlorinated paraffins when used according to the suppliers' instructions. This is revealed in a report from Stockholm University where researchers analyzed a ...

User comments