Simply stated... you won't.
Tonight at the park outside of our home, a little boy fell off of the monkey bars and broke his arm. I flew into "Nurse Andrea" mode, because this is just what I do. Being a nurse is as much my identity as any other part of me. I can't separate it, and I have no desire to do so. I don't care for kids in the ER anymore, but I love that I am still surrounded by kids, and opportunities to do something that is so close to my heart.
I wanted to mention a few things about arm injuries while it was fresh on my mind. Are there things to watch for after an arm injury? Yes. There are clear signs and symptoms to watch for. But the best part about the events of tonight for me were what the parents said. Who cares what I said... I clearly don't have x-ray vision, and it wasn't a critical injury. The dad said, "I know my son, and he does not act like this." Dad knew that something was wrong that required attention. From an outside perspective, he looked fine. Kids fall and cry, and get up and get over it. Even without my opinion, mom and dad knew that there was something wrong; they were just hoping that their instincts were wrong. I love this. You know your child. You know everything about them; always trust yourself.
Some pointers for an arm injury:
If the bone "looks" broken, then think no more and head to the ER. If there is any bone that has broken through the skin, then calling an ambulance is the best choice. There is now an increased risk of infection, as well as some other potential problems. If the injury is obvious by sight, (it is deformed or bowing, but no bone is exposed) then isolate the arm by wrapping an ace bandage, or even a t-shirt around the body with the arm at a 90 degree angle against the abdomen. This will keep them most comfortable. Apply ice to the injured area, but avoid ice directly on the skin. Having a light barrier between the ice and the skin is ideal. This injury requires an immediate trip to the ER. The immediate need of care for "deformed" arm injuries will be more obvious to a parent, but what about the injuries that appear fine? You know... the child is complaining of pain, but has only mild swelling, or none at all and can move their arm OK. Their fingers are nice and pink, indicating good blood flow, and their pain is controlled with ice and Ibuprofen. Are they bad parents for not rushing their child into the ER? I say, definitely not. But this is a judgement call for the parents. If they opt to keep them home, ice the injured area off and on, and keep it elevated to control pain and minimize swelling. If the pain continues, then go to the doctor. Your pediatrician can evaluate the injury and refer you for an x-ray. I have seen kids continue to play almost normally with a minor break, and the parents are shocked when they find out that there was an injury that needed attention. Kids will always keep us guessing, but when it comes to injuries, better safe than sorry. These little people have a lot of growing to do, and even a minor injury in the wrong place can mean trouble. Just do your best to watch for the signs and trust your gut.
RECAP FOR A MINOR ARM INJURY:
-Medicate it (Ibuprofen)
-Keep checking on it (unwrap it frequently, at least every hour to see if anything has changed)
-If child continues to complain, then get in for an x-ray
Andrea worked as a Registered Nurse in a Pediatric Emergency Department for 10 years before leaving to be a full-time/homeschooling Mommy to her three beautiful and crazy children.