March is Child Life month, and I wanted to feature some amazing organizations that are doing so much to support children and families in crisis. A few weeks back, I had the opportunity to interview an expert in the field of Child Life about the impact of disasters on children and families. Child Life Disaster Relief is an organization that empowers and supports children and families in crisis by integrating Child Life professional services into disaster-impacted communities. Learn more at www.cldisasterrelief.org.

Today I’m talking with Paige, who shares her daughter’s experience with Nursemaid’s Elbow. On this podcast, sometimes we talk about really intense diagnoses that last years and have a significant medical impact. Other times we talk about acute issues that are not severe but require medical attention – and today is one of those days. Check out this episode to hear about what Nursemaid’s Elbow is and how to fix it.

In this episode, we talk about…

[3:05] Paige’s background and family

Paige is our first Alaska representative on the podcast. She lives in Anchorage, Alaska, with her husband and her daughter. They have been there for almost 8 years, and they love living there. Paige is a nurse, and she works at a local hospital in Anchorage. Her background is primarily in surgery, she has worked in education for staff, and now she works in supply chain. 

Having a child and being on the patient side of things has been really eye-opening for Paige. It can be easy to look at everything from a clinical perspective and forget that every encounter is potentially life-changing for patients.

[4:55] Finding out about Nursemaid’s Elbow

Paige did not know anything about Nursemaid’s Elbow until they saw an orthopedic PA at a clinic. When her daughter was a toddler, she was on the smaller side. They would sometimes pick her up by one arm or swing her around – things that their friends could not do with larger toddlers because of their weight difference. 

When her daughter was 18 months old, they were waiting for Paige’s car to get an oil change and getting her tires changed over for the Alaska winter. She and her daughter went for a walk outside, and as they were going back inside Paige picked her up by her arm. She kept saying, “Owie, owie, owie.” Paige couldn’t quite figure out what was going on, because her daughter couldn’t tell her. She noticed her daughter was favoring her right arm, but she thought she would recover quickly like she did from other minor ailments.

They got home, had dinner, and did bath time. Paige was looking for bruises or anything else that seemed out of place, but she didn’t see anything that looked wrong or broken. Her daughter hadn’t used her right arm to eat or pick up toys, so she gave her some Tylenol and put her to bed. She slept through the night, but Paige was planning to take her to an orthopedic clinic in town if it was still a problem in the morning. She figured that would be a better option than the emergency room or urgent care, because it seemed specific to her arm.

The next morning, her daughter ate breakfast with her right arm straight down by her side. Eating with her left hand only was not her norm, so Paige tested her by putting a couple preferred items by her right side. She wouldn’t grab them with her right hand, so she decided to take her to the clinic when they opened. Her husband was out of town on a duck hunting trip, so she had to call and tell him that something was wrong with their daughter. He was supposed to return that morning, so she was letting him know in case he needed to meet them somewhere.

They arrived at the clinic, and Paige’s daughter was acting like nothing was bothering her. The PA watched her for a couple minutes, and recognized that she was experiencing something that is super common in young children, called Nursemaid’s Elbow. Paige was baffled, because she had never heard of it before. She was surprised that the PA could figure it out so quickly. He had Paige try a few different things to get her daughter to use the affected arm, but she still wasn’t using it. At that point he walked over to Paige’s daughter and nonchalantly took her arm, placed it in a straight position, and pulled it back into place. Her daughter cried a bit, said, “Owie, owie,” and sat in her lap for a couple minutes. After that, she was very quickly acting completely normal.

[12:57] Treating Nursemaid’s Elbow

The PA had not explained what he was doing beforehand, but it turns out that was the treatment for Nursemaid’s Elbow. Paige was glad that he had not given a lot of lead time beforehand, because she didn’t have the opportunity to get worked up and neither did her daughter. He told Paige that he felt her daughter’s elbow pop back into place. They tried handing her some things and she was already bending her elbow more to use her right arm again. He wanted to give her some time to see how she was doing and how much movement she would engage in. They did some x-rays to be sure everything else looked ok. By the time they were taking the x-rays, she was climbing on everything in the little office room and feeling just fine.

The PA explained that Nursemaid’s Elbow is essentially a dislocation of the elbow. It happens in little kids because their joints are more loose and flexible, which is why you aren’t supposed to pick kids up by their wrists or swing them around by their arms. 

This was an ideal medical situation in terms of the immediate treatment and recovery. Of all the things that could happen with a small child, especially with an arm issue, this was the best outcome you could hope for.

[17:09] What to do if you suspect Nursemaid’s Elbow

Paige explained that they had access to a local orthopedic clinic with walk-in hours, but certainly a children’s emergency room would have known what it was and would have been able to fix it. It just might not have been quite as quick as walking into the orthopedic clinic. Paige also shares that she has been a nurse for 14 years, and she can still come across things that she is not familiar with. There are more mysteries out there, so never hesitate to bring your child in for medical care if you suspect something is not right.

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