Medication Summary
The goal of pharmacotherapy is to treat the pain associated with the procedure.
Analgesics
Class Summary
Pain control is essential to quality patient care. It ensures patient comfort, promotes pulmonary toilet, and aids physical therapy regimens. Many analgesics have sedating properties that benefit patients who experience pain.
Acetaminophen (Tylenol, FeverAll, Aspirin Free Anacin)
Acetaminophen is the drug of choice (DOC) for pain in patients with documented hypersensitivity to aspirin or NSAIDs, who have upper GI disease, or who are taking oral anticoagulants.
Nonsteroidal Anti-Inflammatory Drugs
Class Summary
NSAIDs have analgesic, anti-inflammatory, and antipyretic activities. Their mechanism of action is not known, but they may inhibit cyclooxygenase (COX) activity and prostaglandin synthesis. Other mechanisms may exist as well, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell membrane functions.
Ibuprofen (Motrin, Advil)
Ibuprofen is the DOC for patients with mild to moderate pain. It inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.
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Subluxation of radial head occurs after longitudinal traction is placed on pronated extended arm.
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In radial head subluxation, subluxated arm is held semiflexed, adducted, and pronated.
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Alternative diagnoses to radial head subluxation should be sought if point tenderness or any obvious deformity is present.
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Reduction of subluxated radial head: supination-flexion. Technique begins with elbow flexed.
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Reduction of subluxated radial head. Shortly after reduction, child resumes using affected arm.
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Reduction of subluxated radial head: supination-flexion. Wrist is supinated with elbow still in 90° of flexion.
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Reduction of subluxated radial head: supination-flexion. During supination, pressure is maintained on radial head.
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Reduction of subluxated radial head: supination-flexion. After supination, elbow is fully flexed.
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Reduction of subluxated radial head: supination-flexion. With one hand supinating wrist, other thumb feels click as radial head falls into place on full flexion.
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Reduction of subluxated radial head: supination-flexion. Technique begins with supination, followed by full flexion at elbow.
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Reduction of subluxated radial head: hyperpronation/forced pronation. With one hand placed distally, arm is hyperpronated while other hand holds elbow steady with thumb on radial head.
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Shortly after reduction, child resumes using affected arm.
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Reduction of subluxated radial head: supination-flexion. Side view of technique.
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Reduction of subluxated radial head: supination-flexion. Front view of technique.
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Reduction of subluxated radial head: hyperpronation/forced pronation. Side view of technique.
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Reduction of subluxated radial head: hyperpronation/forced pronation. Front view of technique.
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Elbow anatomy with annular ligament.
