when jess broke his elbow, my daughter took him immediately to the er, where he was examined. his arm was not casted until the following monday (this happened on Saturday). the md she wanted wasn't available until monday, so his arm was mobilized in a sling and it was fine. she did administer all of his medicine in double doses saturday night and sunday. she does this frequently when jess is sick with strep, ear infections, fevers, etc. which aren't frequent, but she just always doubles up to be on the safe side.