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Radial head subluxation: how long do children wait in the emergency department before reduction?

Philippe Toupin1, Martin H Osmond, Rhonda Correll

  • 1School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.

CJEM
|October 16, 2007
PubMed

Insights

Children with radial head subluxation (RHS) often experience long emergency department (ED) waits for treatment. Most RHS injuries are successfully reduced on the first attempt, indicating effective ED interventions.

Area of Science:

  • Pediatric Emergency Medicine
  • Orthopedic Surgery
  • Musculoskeletal Injuries

Background:

  • Radial head subluxation (RHS), also known as nursemaid's elbow, is a common elbow injury in children.
  • Understanding ED wait times and treatment patterns for RHS is crucial for optimizing pediatric care.

Purpose of the Study:

  • To characterize emergency department (ED) wait times for children diagnosed with radial head subluxation (RHS).
  • To describe the treatment characteristics and outcomes for pediatric RHS cases within the ED.

Main Methods:

  • A retrospective review of medical records was conducted over a 2-year period.
  • The study included all pediatric patients presenting to a tertiary care pediatric ED with a diagnosis of RHS or related elbow injuries.
  • Data collected included demographics, injury mechanism, triage-to-physician assessment time, and triage-to-discharge time.

Main Results:

  • 501 cases of RHS in 427 children were identified, with the majority caused by a pull (62.8%).
  • Median time to physician assessment was 1.3 hours, with over 23% waiting more than 2 hours.
  • Median time to ED discharge was 1.7 hours, with over 41% of patients staying longer than 2 hours. 99.2% of injuries were reduced in the ED, most on the first attempt.

Conclusions:

  • Children with RHS frequently encounter prolonged waiting periods in the ED before reduction and discharge.
  • The majority of pediatric RHS cases are successfully treated with a single reduction attempt in the ED.
  • Findings will inform prospective studies aimed at reducing ED visit durations for pediatric RHS patients.
Abstract

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