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

March 24, 2014, Canadian Medical Association Journal

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."

Explore further: Observation in the ER can reduce CT scans in kids

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

Related Stories

Observation in the ER can reduce CT scans in kids

August 6, 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 ...

Use of simple rule in children's ankle injuries reduces use of radiography by 22 percent

August 12, 2013
Radiography is widely used in diagnosing ankle injuries, with 85%–95% in pediatric injuries, although only 12% of these show fractures.

Nurses can perform colonoscopies as well as docs

March 4, 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

March 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, according to a ...

New study assesses injuries seen in the emergency department to children of teenage parents

November 7, 2013
Although the number of children born to teenage parents has decreased since the 1990s, these children continue to be at an increased risk for injury, both accidental and intentional. This may be because many of these teenage ...

Recommended for you

Women run faster after taking newly developed supplement, study finds

January 19, 2018
A new study found that women who took a specially prepared blend of minerals and nutrients for a month saw their 3-mile run times drop by almost a minute.

Americans are getting more sleep

January 19, 2018
Although more than one in three Americans still don't get enough sleep, a new analysis shows first signs of success in the fight for more shut eye. According to data from 181,335 respondents aged 15 and older who participated ...

Wine is good for you—to a point

January 18, 2018
The Mediterranean diet has become synonymous with healthy eating, but there's one thing in it that stands out: It's cool to drink wine.

Sleep better, lose weight?

January 17, 2018
(HealthDay)—Sleeplessness could cost you when it's time to stand on your bathroom scale, a new British study suggests.

Who uses phone apps to track sleep habits? Mostly the healthy and wealthy in US

January 16, 2018
The profile of most Americans who use popular mobile phone apps that track sleep habits is that they are relatively affluent, claim to eat well, and say they are in good health, even if some of them tend to smoke.

Improvements in mortality rates are slowed by rise in obesity in the United States

January 15, 2018
With countless medical advances and efforts to curb smoking, one might expect that life expectancy in the United States would improve. Yet according to recent studies, there's been a reduction in the rate of improvement in ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.