1st- I am so sorry your cruise was spoiled by this and I am sorry your daughter had the injury. You must have been terrified at the thought of your daughter getting hurt when you weren't around, and no one comforting her or doing anything about it. I know I would have been a mess! but...
Before you tar and feather the CM on the
DCL and get everyone paranoid about the club, PLEASE talk to an ER doc/NP/PA about this.
I have working in emergency medicine for over 10 years as a PA.
I lost count how many "nursemaid elbows" I've reduced.
The correct term is radial head subluxation. It is only a partial dislocation of one of the bones that makes up the elbow. It should not be compared to any adult dislocation. Adult dislocations take a ton of force to happen, these do not.
The mechanism of injury can be quite small and the pain isn't always immediate. Many children will hold their arm bent and close to their body while they play for hours after this has occurred. Only crying or complaining when you make them move that arm. With a typical history and this presentation, I usually try to get them to grab something they really want with that arm. If they wont, I have my Dx. (i'm not saying this is how it was with your daughter)
It is usually a tug or pull of the arm that causes it. And it can most certainly go unnoticed. AN ER doctor I use to work with did it to his own daughter one day in the waiting room while we were working. His wife was so mad at him, I had to reduce it. He had grabbed her arm to pull her close to him for a kiss, it happened so quickly. He was devastated. But luckily it is a relatively minor injury. Usually no lasting effects- except once it has happened, the child is at risk for it happening again until about age 6 or so.
Now, The CM may have pulled her hard, may have noticed that she hurt her and didn't say anything, but then again she may not have.
Please note that this injury can happen to any child anywhere by anyone.
Most common causes-
1) swinging the child by their arm
2) pulling a child up
3) You are walking in the mall holding toddler's hand. Toddler sees a toy she wants and pulls the other way- you are still pulling her your way- pop out goes the arm.
My point is, in the grand scheme of things, this is a minor injury. People can still put their kids in the club and feel as safe as they did before.
I hope she is OK now.
Xrays aren't a bad idea if she complains of pain days after this. Sometimes (rarely) they can have a small chip fracture of the radial head. But the treatment at this point would probably be watchful waiting.
Good luck