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Nurses Can Treat Common Arm Injury in Kids, But Docs are More Effective

Update Date: Mar 24, 2014 01:37 PM EDT

In many health situations, trained nurses can effectively treat patients. By using nurses, patients' waiting time and doctors' workloads are both cut down. In a new study, researchers examined the effects of having nurses treat children with common arm injuries. They found that even though nurses can be effective in treating "pulled elbows," doctors have a higher success rate.

A pulled elbow, medically known as a radial-head subluxation, is very common in young children. Even though the condition can be easily fixed with a trip to the emergency department, waiting for a doctor at the ED can take hours. Due to these long waiting hours, the research team set out to see if trained nurses could help shorten them by treating the children.

The researchers created a small clinical trial involving 268 children from the Children's Hospital of Eastern Ontario located in Ottawa, Canada. The children who came to the hospital were randomly assigned either a nurse or a physician. Both medical professionals were trained in fixing pulled elbows. The researchers found that nurses had a success rate of 85 percent.

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

Even though the nurses' effectiveness rate was high, the researchers found that physicians had a success rate of almost 100 percent. The researchers concluded that even though the nurses' success rate was 12 percent below the doctors' rate, using nurses trained in treating pulled elbows could still be effective.

"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," the authors concluded.

The study, "Reduction of radial-head subluxation in children by triage nurses in the emergency department: a cluster-randomized controlled trial," was published in the Canadian Medical Association Journal.

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