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In Reply.—We are encouraged by the reports of managing suspected RHS by telephone. We agree that telephone assessment and management is an appropriate alternative, particularly for repeated RHS, if the responsible clinician is familiar with the caretaker and child and thereby is able to assess the reliability of the report and the ability of the caretaker to follow instructions. Unfortunately, emergency room staff are rarely sufficiently familiar with their clients to evaluate confidently a telephoned report of a toddler who will not use his arm.