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Luther is given pain relief


At the very outset, confidence and good communication are important. Anxiety and fear can sometimes promote hysteria. Kind but firm language can help de-escalate fraught situations (remember parents and teachers may be causing unnecessary panic!).

Entonox (laughing gas/gas & air) is an extremely useful agent in this situation. It provides both analgesia and anxiolysis (chills them out…) as they need to concentrate on controlling their breathing.

Immobilisation will stabilise a fracture and reduce discomfort from unnecessary movement. There are bespoke devices to aid immobilisation but simple slings or splinting can also be very effective.

Give oral analgesia where possible; it is useful to consider give paracetamol and an NSAID (i.e. ibuprofen) early. These drugs take time to have an effect so if you wait for the hospital to prescribe the the child will be in discomfort for longer than necessary.

Now that Luther has had a sling applied to his sore elbow, what things do you need to keep an eye on?

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Emergency and Urgent Care for Children: a Survival Guide

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