NOT gas!

Specialties School

Published

One of my teachers sent a student last week to me because he complained of stomach pain and "he never complains" (who hasn't heard that one). I assessed him, no rebound etc. No n/v or diarrhea. I instructed him to go get a drink and try to use the bathroom. A couple hour later she sent him back, said he was till hurting. He is a hard kid to read so I went ahead and called his mom. Local dr xrayed and diagnosed gas. Just got word that he is at our Children's Hospital with intussiception!(sp) What the what? I see so many stomach aches every day and this has me nervous! Now I feel like I need to call a parent every time I hear "my belly hurts"...Just needed to share.

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Ug, I know that feeling! A couple years ago I had a student who came in from playing outside with pain to his lower leg and after icing it for a bit, he requested to go back outside and I let him. The next day he came in diagnosed with a hairline fracture. I was calling home for every rolled ankle for a month! The mom was not upset so I counted my lucky stars there! This was also a very dramatic student so I took his symptoms with a grain of salt.

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Specializes in Pediatrics Retired.

You guys are too hard on yourselves. You're trying to read Monday's newspapers on Sunday. You acted based on the presentation at the time. Certainly these experiences add to one's practice base as a Nurse but it doesn't mean that you should have been able to foresee the future.

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Specializes in ED, School Nurse.

I would have done the exact same thing. You assessed him, he still had pain a few hours later, you called mom. It's in her hands after that.

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Hindsight is 20/20. Don't beat yourself up.

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Specializes in school nursing, ortho, trauma.

If it's a non complainer, i may put them through all the normal paces first (bathroom, snack, rest, etc) depending on the situation. but i may also give an FYI call too if it's a kid i never ever see. We are not fortune tellers, we do not have x-ray eyes. We can only do our best. I would be willing to bet that that child's parent would not have rushed him to the hospital at the first glimmer of pain.

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Specializes in DD, PD/Agency Peds, School Sites.

Yes, those parents had to know something was up.

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Did the intussusception resolve?

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He is in surgery as I type this!

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He is in surgery as I type this!

It's okay. He'll be fine.

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Specializes in School nursing.

OP, you stated even the child's PCP thought it was gas. We are not doctors, and frankly, even a doctor could miss things after an exam in my office given the limited tools I (and many of us on this board) have.

I had a student once with consist complaints of stomachache. No rebound pain, no increased pain with palpation. No fever. Just general complaint. I felt something was off, called his Mom to only hit VM after VM. Had student go home to advocate for pushing parent/himself to make appointment with PCP. It didn't feel serious, but I figured a closer look couldn't hurt. Kid's appendix burst at home that weekend - luckily he was okay, no one was upset, but I still felt like I missed something. Like you, I reached out because something felt a little off. At the end of the day, I realized, there are some things that are out of our hands.

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Specializes in Pediatrics Retired.
Like you, I reached out because something felt a little off. At the end of the day, I realized, there are some things that are out of our hands.

This is something that isn't taught in nursing school.."going with your gut." - That feeling that something isn't right even though it may appear so. Many years ago in the ER, I was triage, and a mom brought her 13 year old in, about midnight, because he got up to use the restroom and felt dizzy/unsteady on his feet that evening. The only history of activity was he and another kid were playing earlier in the school day and fell into a chain link fence....no pain, no marks, alert, all vitals were WNL...but something started ringing a bell in my mind that I couldn't explain...they registered and sat in the waiting room but I kept an eye on him (amongst the chaff and ER abuse, at our expense, that fills the waiting room)...anyway, later I looked over at the kid and noticed a faint sheen of perspiration had formed on his forehead/he was leaning over on his mom - and then the siren went off in my head. I yanked him up and dragged him to the only room we had open...in the back of the "fast track." A lot of stuff happened at that point but within one hour the kid was in ICU with a ruptured splenic artery. Prior to that, there he was...sitting there in our ER waiting room bleeding to death. After they were able to tamponade the bleed with about a zillion units of blood he was able to go to surgery for repair and ultimately walked out alive. So....you can't predict the future....but as others have shared - listen to that little voice and "go with your gut."

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