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Arm Injury

Is this your child's symptom?

  • Injuries to the arm (shoulder to fingers)
  • Injuries to a bone, muscle, joint or ligament
  • Excluded: Muscle pain caused by too much exercise or work (overuse). Covered in Arm Pain.

If NOT, try one of these:


Types of Arm Injuries

  • Fractures. Fractures are broken bones. A broken collarbone is the most common broken bone in children. It's easy to notice because the collar bone is tender to touch. Also, the child cannot raise the arm upward.
  • Dislocations. This happens when a bone is pulled out of a joint. A dislocated elbow is the most common type of this injury in kids. It's caused by an adult quickly pulling or lifting a child by the arm. Mainly seen in 1 to 4 year olds. It's also easy to spot. The child will hold his arm as if it were in a sling. He will keep the elbow bent and the palm of the hand down.
  • Sprains. Sprains are stretches and tears of ligaments.
  • Strains. Strains are stretches and tears of muscles (such as a pulled muscle).
  • Muscle Overuse. Muscle pain can occur without an injury. There is no fall or direct blow. Muscle overuse is from hard work or sports (such as a sore shoulder).
  • Muscle bruise from a direct blow
  • Bone bruise from a direct blow
  • Skin Injury. Examples are a cut, scratch, scrape or bruise. All are common with arm injuries.

Pain Scale

  • Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
  • Moderate: The pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
  • Severe: The pain is very bad. It keeps your child from doing all normal activities.

When to Call for Arm Injury

Call 911 Now

  • Serious injury with many broken bones
  • Major bleeding that can't be stopped
  • Bone is sticking through the skin
  • You think your child has a life-threatening emergency

Call Doctor Now or Go to ER

  • Can't move the shoulder, elbow or wrist normally
  • Can't open and close the hand normally
  • Skin is split open or gaping and may need stitches
  • Cut over knuckle of hand
  • Age under 1 year old
  • Severe pain and not improved 2 hours after taking pain medicine
  • You think your child has a serious injury
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Very large bruise or swelling
  • Pain not better after 3 days
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Injury limits sports or school work
  • Dirty cut and no tetanus shot in over 5 years
  • Clean cut and no tetanus shot in over 10 years
  • Pain lasts over 2 weeks
  • You have other questions or concerns

Self Care at Home

  • Bruised muscle or bone from direct blow
  • Pain in muscle (from minor pulled muscle)
  • Pain around joint (from minor stretched ligament)

Call 911 Now

  • Serious injury with many broken bones
  • Major bleeding that can't be stopped
  • Bone is sticking through the skin
  • You think your child has a life-threatening emergency

Call Doctor Now or Go to ER

  • Can't move the shoulder, elbow or wrist normally
  • Can't open and close the hand normally
  • Skin is split open or gaping and may need stitches
  • Cut over knuckle of hand
  • Age under 1 year old
  • Severe pain and not improved 2 hours after taking pain medicine
  • You think your child has a serious injury
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Very large bruise or swelling
  • Pain not better after 3 days
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Injury limits sports or school work
  • Dirty cut and no tetanus shot in over 5 years
  • Clean cut and no tetanus shot in over 10 years
  • Pain lasts over 2 weeks
  • You have other questions or concerns

Self Care at Home

  • Bruised muscle or bone from direct blow
  • Pain in muscle (from minor pulled muscle)
  • Pain around joint (from minor stretched ligament)

Care Advice for Minor Arm Injuries

  1. What You Should Know About Minor Arm Injuries:
    • During sports, muscles and bones get bruised.
    • Muscles get stretched.
    • Here is some care advice that should help.
  2. Pain Medicine:
    • To help with the pain, give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil). Ibuprofen works well for this type of pain.
    • Use as needed.
  3. Cold Pack for Pain:
    • For pain or swelling, use a cold pack. You can also use ice wrapped in a wet cloth.
    • Put it on the sore muscles for 20 minutes.
    • Repeat 4 times on the first day, then as needed.
    • Reason: Helps the pain and helps stop any bleeding.
    • Caution: Avoid frostbite.
  4. Use Heat After 48 Hours:
    • If pain lasts over 2 days, put heat on the sore muscle.
    • Use a heat pack, heating pad or warm wet washcloth.
    • Do this for 10 minutes, then as needed.
    • Reason: Increase blood flow and improve healing.
    • Caution: Avoid burns.
  5. Rest the Arm:
    • Rest the injured arm as much as possible for 48 hours.
  6. What to Expect:
    • Pain and swelling most often peak on day 2 or 3.
    • Swelling should be gone by 7 days.
    • Pain may take 2 weeks to fully go away.
  7. Call Your Doctor If:
    • Pain becomes severe
    • Pain is not better after 3 days
    • Pain lasts more than 2 weeks
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Copyright 1994-2017 Schmitt Pediatric Guidelines LLC. All rights reserved.

First Aid - Sling - How to Put On

To put on a sling you first need to have a triangular bandage. Many first aid kits have a triangular bandage.

  • Find the two ends of the triangle that are farthest apart. These are the ends that you will tie around the neck.
  • Lay the arm down the middle of the triangle.
  • Take the two ends of the triangle that are farthest apart and tie them behind the neck. (a square knot is best, but any knot will do).
First Aid - Bleeding Arm
  • Apply direct pressure to the entire wound with a sterile gauze dressing or a clean cloth.
First Aid - Splint for Wrist Injury
  • Immobilize the hand and wrist by placing them on a rigid splint (see drawing).
  • Tie several cloth strips around hand/wrist to keep the splint in place. You can use a roll of gauze or tape instead of cloth strips.

Notes:

  • You can make a splint from: a wooden board, magazine folded in half, folded-up newspaper, cardboard, or a pillow.
  • If you have no splinting materials, then support the injured arm by resting it on a pillow or folded up blanket.
  • After putting on the splint, apply a cold pack or an ice pack (wrapped in a towel) to the area.
First Aid - R.I.C.E.

RICE is an acronym for how to take care of a sprain, strain, or bruise. There are four things you should do:

  • REST the injured part of your body for 24 hours. Can return to normal activity after 24 hours of rest if the activity does not cause severe pain.
  • Apply a cold pack or an ICE bag (wrapped in a moist towel) to the area for 20 minutes. Repeat in 1 hour, then every 4 hours while awake.
  • Apply COMPRESSION by wrapping the injured part with a snug, elastic bandage for 48 hours. If numbness, tingling, or increased pain occurs in the injured part, the bandage may be too tight. Loosen the bandage wrap.
  • Keep the injured part of the body ELEVATED and at rest for 24 hours. For example, for an injured ankle, place that leg up on a pillow and stay off the feet as much as possible.

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