How/why/when do you make the decision to go to A&E (DS has hurt his arm)

[NorbertDentressangle]

DS (aged 5) hurt his arm at the end of the school day. He fell on it but no adult witnesses to describe the fall.

He was very upset and distressed for quite a while afterwards, said he couldn't move it or that it hurt a lot to move it.

Since then he hasn't 'accidently' used that arm (ie. forgetting that hes hurt it IYSWIM), he has hardly moved it at all in fact. If he knocks it he gets really upset and says it very painful. There are no obvious lumps or bumps but possibly some swelling (but I'm not sure if I'm imagining it because I'm looking for it)

What is clouding my judgement is that hes coming down with a horrible cold too which is making him teary and emotional, and he says he feels really ill.

I'm not sure if hes over-reacting about the arm because hes feeling grotty or if he might have done something that needs an X-ray/treatment.

He was tired and wanted to go to bed so I've given him Calpol and just put him to bed but now I'm starting to doubt my judgement. Obviously if he wakes in pain I will re-think/act but he seems to have gone off to sleep, lying on the good arm.

I'm not someone who whisks the DC off to the hospital or GP with every slightest thing but equally I do worry about things in case I miss something (don't we all?!)

Have I done the right thing? What signs should I look for as an indication of an injury that needs an A&E visit (either when he wakes in a bit or tomorrow)?

think that sounds fine. if he has gone to sleep then good. if he wakes, do a&e but otherwise reassess tomorrow

My rule is that if calpol, nurofen and ice aren't relieving the pain then it is something that needs to be seen by a&e.
Hope he is ok

If there is persistant pain in the arm I would see someone. Go with you gut feeling.

I think you did the right thing, he was tired

see how his arm is in the morning

Thanks everyone.

I think I've made the right decision but was just having a crisis of confidence.

I'll see how he is in the morning (unless of course he wakes before then).

DP is back now too so it can become a joint decision process

I would actually say go to A&E,
when ds was a toddler he fell off a trike,
he cried everytime we lifted him at a certain angle but apart from that he was fine, although I really thought he just wasn't right but dh thought I was being overprotective,
He fell off his trike on a Sunday evening,
Monday he was grouchy when lifted out of high chair
Tuesday he cried lifting out of cot, so I just decided to go with my gut, I was so embarrassed telling the doctor I had left it a day and abit, especially when they came back and said he had a crack on his collarbone
dh felt really bad and always goes with my gut instinct now

My son was jumping off a small mound of dirt in the summer and landed awkwardly. I checked his leg, which he said hurt, there was no bruising, lumps or misshape. I took him home and sat him on the sofa. He refused to walk anywhere. He can be a bit melodramatic when it comes to injuries so I thought he was just milking it. However, I did get concerned and after advise from NHS direct took him to A&E. I was horrified to discover he had broken both bones in his lower leg. The very nice doctor told me they always x-ray children because it is very hard to identify when they have broken a bone.

He and I spent 2 nights in hosptital. I still feel guilty.

DS fell off monkey bars after school last summer and landed on his arm. It didn't swell up and he wasn't in a lot of pain but I wasn't sure what to do.

Didn't go anywhere that night, but he woke up crying during the night and I took him to A&E the next day, as he was complaining a lot about it hurting.

He had an X-ray and was fine. But I was glad I took him and also felt right about it being the day after.

Sorry that should be cracked his collar bone and had to wear a holster type thing for a few weeks

i would definitely take him to a&e in the morning if he still says it hurts

Charliesweb: "He can be a bit melodramatic when it comes to injuries so I thought he was just milking it"

-thats exactly how I was feeling especially as hes got the start of a stinking manflu cold too, and tends to really lay it on thick.

I know I'll be awake half the night listening out for him in case he wakes in pain.

Try moving/touching the arm when he is fast asleep - if he winces or cries out then you should probably get him seen to in the morning

Aaah good thinking Wallace.

I did wonder if, when I check him later, he'll be lying on the bad arm or not as its his preferred side. Thought that might be an indication.

I'll have a gentle prod too.

Oh I forgot to say the reason I rang NHS direct was because a friend's son had fallen over and complained of his arm hurting, and they thought it was nothing. They didn't take him to A&E until the next day and discovered it was broken.

What amazed me with my DS was that he was unhappy and in pain, but he wasn't screaming in agony. And if he stayed still he was ok. I assumed for a broken bone he would exhibit much more distress than he did.

I felt so awful because I had put off going to A&E as my DH was away and I had two younger DCs. Having said that even when we were there I was sure they would just send us home saying it was nothing.

Let him sleep then in the morning get an appointment with your GP. They can then give you an xray form which jumps you in the queue at A&E.

I know this as DD was wondering round with a fractured elbow for a couple of days before I realised recently

Wynken you got there ahead of me! I was just reading through this and going to say go to the GP tomorrow. It is SO much faster than waiting to see a doctor at A&E for a reference to X-Ray.

Broken bones take days to begin to set. In fact, if there is a lot of swelling, most times the hospital will only put a support-type brace on until the swelling's gone down, and then do the proper cast. There is no harm done by waiting a day or so before getting a broken bone looked at (as long as it can be 'rested'); it will be more painful if it's not immobilised but it won't do it any harm.

I would second what others have said and take your DS to A&E in the morning, especially if the pain seems to get any worse. My DD1 (11) was sent home from school 2 weeks ago following a fall in PE inside the school hall. The teacher instructed the children to run backwards and DD lost her balance twisting her arm behind her and falling onto it.

This was a Friday during the time we had heavy snow and there was lots of ice on the pavements so I really didn't want to take her to A&E as it was pretty dangerous (also didn't want to expose her to Friday night drunks etc). She didn't seem to be in too much pain at that point, and as DD1 is a bit of a clumsy clot at the best of times, I assumed she had sprained her wrist and gave her a bag of frozen peas and a makeshift sling over the weekend. She even had a friend over the next day and didn't seem to be suffering and there was no swelling. However, on the Monday, DD1 was in terrible pain so we took her to A&E and she had broken her wrist! I felt awful not going to A&E earlier .

Anyway, she's now in a cast and sling which should be removed in another couple of weeks and she's managing fine with it.

So don't feel guilty for not taking your DS to A&E straightaway, but I definitely would take him tomorrow morning. Hopefully, it's nothing more than a sore arm!

When DD was little she was playing horses with DS and fell and hurt her arm. We left it over night but noticed she did not move her arm at all, not even in her sleep. Took her to a&e first think in the, doctors were really sure that she had broken it, but xrays showed nothing. She was in a sling for a couple of days and plenty of nurofen.

Nurofen is better than calpol for something like this as it is an anti-inflamatory ,which calpol isn't

How is he this morning?

Yeap how is he?

I didn't know that about the gp giving a fast pass for x-rays, although hopefully will not need for future reference (please do not burst my delusional bubble)

Well it doesn't work in any A+E I've ever worked in - GP sends you in, you have the XR done, you then book in to A+E to be seen. How would a queue-jump work there anyway?

More importantly, a great deal of GP XRs for trauma - especially paeds - have to go back for more views, or a different bit of the limb, because for most of them their A+E training is a dim and distant memory.

Thanks everyone

UPDATE:

well I checked him during the night when he was asleep and he wasn't lying on that arm, or moving it all . He also woke a few times which is not like him at all as he sleeps like a log normally -he didn't say he was in pain but was just restless IYSWIM.

When he got up he was OK in himself (if completely still) but still wasn't using the arm at all and was in pain when we tried to dress him so we decided to go to A&E.

He was Xrayed and it shows a small break by the elbow so the poor little mite has a full temporary plaster and we have to go back to fracture clinic tomorrow for the consultant to take a look and probably apply a lighter plaster.

I felt really bad about not going last night but the hospital said that I'd completely done the right thing and no harm is done waiting O/N so that made me feel better.

DS was a star and only got upset when they put the plaster on as it hurt when they moved his arm and he didn't like the fact it was so heavy.

He's now happily watching Madagascar with a plate of food next to him (big treat as we don't normally allow eating in front of the TV )

Glad all's sorted.

Poor chicken, don't feel bad, you handled it really really well, its such a hard call to make.