Manchester City were monitoring the progress of Micah Richards after this comfortable victory against 10-man West Ham at Eastlands.
While Elano scored a brace following the opening goal from Daniel Sturridge, the mood of elation was tempered by the injury to the young England defender.
Richards, watched by national team manager Fabio Capello, was left in some distress a minute into the second half after being poleaxed following a collision with team-mate Tal Ben Haim.
He was treated on the pitch for eight minutes before being carried unconscious to the dressing room by a bank of medics. He later came round in the dressing room and was taken to Manchester Royal Infirmary for further checks.
Manchester City manager Mark Hughes later praised the medical staff who attended to Micah Richards after he was injured in an aerial collision with team-mate Tal Ben Haim.
The injury to the England defender tempered the feeling of elation around the ground following the victory against the Hammers.
Hughes said: "Micah was a little bit groggy obviously but the paramedics did their job.
"There are always concerns when you see incidents like this. They stabilised him and got him off the pitch.
"They did all the correct things and by all accounts he was lucid in the tunnel.
"I do not think there is any concern regarding a neck injury, it is more he has a bang on his head.
"He will be observed for the next couple of hours and he may be allowed to go home, providing he has some support there."
With owner Thaksin Shinawatra and members of his family looking on, City bounced back from the defeat by Aston Villa to secure the three points.
City regrouped and went on to make their advantage pay after West Ham midfielder Mark Noble was sent off in the 39th minute for two yellow cards.
It was certainly an eventful afternoon for owner Thaksin Shinawatra and members of his family who were in attendance.
It is an important result as well with a UEFA Cup match to come on Thursday against FC Midtjylland in Denmark, where City are looking to overcome a 1-0 deficit.
City dominated the match from the off and came close to making the breakthrough in the 13th minute when Stephen Ireland's shot was cleared off the line by Valon Behrami.
Then the Swiss international almost scored an own goal, deflecting Ben Haim's effort on to the bar.
This was a promising start by City and they looked to be playing with renewed confidence after that defeat by Aston Villa on the opening day.
Martin Petrov came inches away from making the breakthrough in the 22nd minute, his superb 25-yard free-kick hitting the outside of the post.
Then Sturridge sliced a shot wide in a good spell of pressure by the home side.
West Ham striker Carlton Cole, clearly struggling with a knock, was replaced by Freddie Sears in the 31st minute.
Cole's injury was not what manager Alan Curbishley wanted as his side were finding it hard to get going at this stage. Again without a number of key men through injury, was disappointed at the way his side caved in during the second half.
He said: "I do not think any one of my players can hold their hands up and say they performed.
"Given the personnel we have available, I do not think we were equipped to play with 10 men.
"We needed to defend in the second half with our lives and the first goal is always important.
"It was a poor clearance and the boy (Sturridge) has finished it well and it was back to the wall after that."
City kept the momentum and Ireland picked out Elano in the 37th minute but his first touch let him down.
A minute later the Hammers suffered another blow when they were reduced to 10 men.
Noble was sent off by referee Howard Webb after getting a second yellow card for a stiff challenge on Michael Johnson.
City poured forward and Petrov skipped away down the right in the 43rd minute and delivered a good cross to the back post.
However, Matthew Upson stood firm and made a crucial clearance under pressure with Ireland waiting to pounce on any mistake.
Goalkeeper Robert Green then made a superb save from Johnson in stoppage time.
City regrouped after Richards was carried off and Elano sent a shot into Green's body from the edge of the area after 59 minutes.
They made the breakthrough seven minutes later after a mistake by Hammers defender Upson.
He lost his concentration following a cross from Petrov and his clearance landed at the feet of Sturridge.
The striker took full advantage, hammering a shot beyond Green to put his side in the driving seat.
City went 2-0 ahead in the 70th minute with a cool finish from Elano after he had been set up by Ireland and it was no more than they deserved.
They kept the momentum going and made it 3-0 in the 76th minute thanks to Elano's second goal of the game.
The Brazil playmaker scored with a superb half-volley after again being set up by Ireland to seal a comfortable victory against a West Ham side that looked thoroughly dispirited.