An alternative approach utilizes hyperpronation with flexion to achieve reduction Some clinicians use this method as their primary means of reduction, whereas others employ it if the supination–flexion technique fails This approach may be less painful, although any discomfort during a successful reduction maneuver should be short lived As shown in Figure 130.50B , gently grasp the patient’s hand on the affected side as if to shake it, stabilize the elbow joint in some flexion, and place pressure with a finger on the radial head Gently distract the elbow joint and hyperpronate by rotating the hand on the affected side medially As before, a “pop” should be felt with the finger that overlies the radial head ACKNOWLEDGMENTS Jennifer L Green, MS, CCLS, BSN, RN—assisted with Preparation and Assessment of the Child and Positioning and Restraints Mary Frey, MSN, RN—assisted with Accessing Central Venous Catheters, Nasogastric Tube Placement, and Catheterization of the Bladder Suggested Readings and Key References Preparation and Assessment of the Child and Positioning and Restraints Committee on Hospital Care and Child Life Council Child life services Pediatrics 2014;133(5):e1471–e1478 Dingeman RS, Mitchell EA, Meyer EC, et al Parent presence during complex invasive procedures and cardiopulmonary resuscitation: a systematic review of the literature Pediatrics 2007;120(4):842–854 Eppich WJ, Arnold LD Family member presence in the pediatric emergency department Curr Opin Pediatr 2003;15(3):294–298 Farah MM, Thomas CA, Shaw KN Evidence-based guidelines for family presence in the resuscitation room: a step-by-step approach Pediatr Emerg Care 2007;23(8):587–591 Sacchetti A, Paston C, Carraccio C Family members not disrupt care when present during invasive procedures Acad Emerg Med 2005;12:477–479 Umbilical Artery Catheterization Barrington KJ Umbilical artery catheters in the newborn: effects of position of the catheter tip Cochrane Database Syst Rev 2000;(2):CD000505 Lumbar Puncture Amini A, Liu JK, Kan P, et al Cerebrospinal fluid dissecting into spinal epidural space after lumbar puncture causing cauda equina syndrome: review of literature and illustrative case Childs Nerv Syst 2006;22:1639–1641 Baxter AL, Welch JC, Burke BL, et al Pain position, and stylet styles: infant lumbar puncture practices of pediatric emergency physicians Pediatr Emerg Care 2004;20:816–820 Breakey VR, Pirie J, Goldman RD Pediatric and emergency medicine residents’ attitudes and practices for analgesia and sedation during lumbar puncture in pediatric patients Pediatrics 2007;119:e631–e636 Nigrovic LE, McQueen AS, Neumann MI Lumbar puncture success rate is not influenced by family-member presence Pediatrics 2007;120:e377–e382 Nasal Cauterization/Nasal Packing—Anterior and Posterior Joseph J, Martinez-Devesa P, Bellorini J, et al Tranexamic acid for patients with nasal haemorrhage (epistaxis) Cochrane Database Syst Rev 2018;12:Cd004328 Murray S, Mendez A, Hopkins A, et al Management of persistent epistaxis using floseal hemostatic matrix vs traditional nasal packing: a prospective randomized control trial J Otolaryngol Head Neck Surg 2018;47:1–9 Pope LE, Hobbs CG Epistaxis: an update on current management Postgrad Med J 2005;81:309–314 Randall DA Epistaxis packing Practical pointers for nosebleed control Postgrad Med 2006;119:77–82 Svider P, Arianpour K, Mutchnick S Management of epistaxis in children and adolescents Pediatr Clin N Am 2018;65:607–621 Removal of a Nasal Foreign Body Gregori D, Salerni L, Scarinzi C, et al; ESFBI Study Group Foreign bodies in the nose causing complications and requiring hospitalization in children 0–14 age: results from the European survey of foreign bodies injuries study Rhinology 2008;46:28–33 Kiger JR, Brenkert TE, Losek JD Nasal foreign body removal in children Pediatr Emerg Care 2008;24:785–792 Purohit M, Ray S, Wilson T, et al The ‘parent’s kiss’: an effective way to remove paediatric nasal foreign bodies Ann R Coll Surg Engl 2008;90:420–422 Reimplantation of Avulsed Tooth Andersson L, Andreasen JO, Day P, et al International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: Avulsion of permanent teeth Dent Traumatol 2012;28:88–96 Emerich K, Wyszkowski J Clinical practice: dental trauma Eur J Pediatr 2010;169:1045–1050 Keels MA, Section on Oral Health, American Academy of Pediatrics Management of dental trauma in a primary care setting Pediatrics 2014;133:e466–e476 Insertion of a Chest Tube Dev SP, Nascimiento B Jr, Simone C, et al Videos in clinical medicine Chesttube insertion N Engl J Med 2007;357:e15 Replacement of a Gastrostomy Tube Burke DR, El Shami A, Heinle E, et al Comparison of gastrostomy tube replacement verification using air insufflation versus gastrograffin Arch Phys Med Rehabil 2006;87:1530–1533 Wu TS, Leech SJ, Rosenberg M, et al Ultrasound can accurately guide gastrostomy tube replacement and confirm proper tube placement at the bedside J Emerg Med 2009;36:280–284 Reduction of an Incarcerated Inguinal Hernia Goldman RD, Balasubramanian S, Wales P, et al Pediatric surgeons and pediatric emergency physicians’ attitudes towards analgesia and sedation for incarcerated inguinal hernia reduction J Pain 2005;6:650–655 Niedzielski J, Kr IR, Gawlowska A Could incarceration of inguinal hernia in children be prevented? Med Sci Monit 2003;9:CR16–CR18 Rectal Prolapse Antao B, Bradley V, Roberts JP, et al Management of rectal prolapse in children Dis Colon Rectum 2005;48:1620–1625 Incision and Drainage of an Abscess Aprahamian CJ, Nashad HH, DiSomma NM, et al Treatment of subcutaneous abscesses in children with incision and loop drainage: a simplified method of care J Pediatr Surg 2017;52:1438–1441 Duong M, Markwell S, Peter J, et al Randomized, controlled trial of antibiotics in the management of community-acquired skin abscesses in the pediatric patient Ann Emerg Med 2010;55:401–407 Hast MB, Klasner A, Kness S, et al Cutaneous community-associated methicillin-resistant staphylococcal aureus among all skin and soft-tissue infections in two geographically distant pediatric emergency departments Acad Emerg Med 2007;14:35–40 Ladde JG, Baker S, Rodgers CN, et al The LOOP technique: a novel incision and drainage technique in the treatment of skin abscesses in a pediatric ED Am J Emerg Med 2015;33:271–276 McNamara WF, Hartin CW, Escobar MA, et al An alternative to open incision and drainage for community-acquired soft tissue abscesses in children J Pediatr Surg 2011;46:502–506 Shoulder (Glenohumeral) Joint Itoi E, Hatakeyama Y, Kido T, et al A new method of immobilization after traumatic anterior dislocation of the shoulder: a preliminary study J Shoulder Elbow Surg 2003;12:413–415 Miller BS, Sonnabend DH, Hatrick C, et al Should acute anterior dislocations of the shoulder be immobilized in external rotation? A cadaveric study J Shoulder Elbow Surg 2004;13:589–592 Tannebaum RD, Kondabala RK, Stockmal PJ Postreduction radiographs for anterior shoulder dislocation: a reappraisal Ann Emerg Med 2001;37:418–419 Patella Saunders TG, Paruchuri NB, Zlatkin MB MRI of osteochondral defects of the lateral femoral condyle: incidence and pattern of injury after transient lateral dislocation of the patella AJR Am J Roentgenol 2006;187:1332–1337 Zaida A, Babyn P, Astori I, et al MRI of traumatic dislocations in children Pediatr Radiol 2006;36:1163–1170 Elbow Kuhn MA, Ross G Acute elbow dislocations Orthop Clin North Am 2008;39:155–161 Mehta JA, Bain GI Elbow dislocations in adults and children Clin Sports Med 2004;23:609–627 Sheps DM, Hildebrand KA, Boorman RS Simple dislocations of the elbow: evaluation and treatment Hand Clin 2004;20:389–404 Ingrown Toenail Repair Daniel CR 3rd, Iorizzo M, Tosti A, et al Ingrown toenails Cutis 2006;78:407– 408 Eekhof JA, Van Wijk B, Knuistingh Neven A, et al Interventions for ingrowing toenails Cochrane Database Syst Rev 2012(4):CD001541 ... infant lumbar puncture practices of pediatric emergency physicians Pediatr Emerg Care 2004;20:816–820 Breakey VR, Pirie J, Goldman RD Pediatric and emergency medicine residents’ attitudes and practices... lumbar puncture in pediatric patients Pediatrics 2007;119:e631–e636 Nigrovic LE, McQueen AS, Neumann MI Lumbar puncture success rate is not influenced by family-member presence Pediatrics 2007;120:e377–e382... Academy of Pediatrics Management of dental trauma in a primary care setting Pediatrics 2014;133:e466–e476 Insertion of a Chest Tube Dev SP, Nascimiento B Jr, Simone C, et al Videos in clinical medicine