What would you have done?

  1. I just read this article in Yahoo. As a school nurse, it definitely caught my interest!


    I know it's tough to say, based upon just reading the article instead of actually seeing everything with your own eyes...

    I think that if it were me, I would have splinted the arm. Then I'd call the parent to transport the child to ER, and offer to call 911 if they prefer. But for a suspected fractured arm, I doubt I'd think to call 911 first. Naturally, if there was bone poking through skin, I would!

    What do you think?
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    About Tina, RN

    Joined: May '09; Posts: 518; Likes: 923


  3. by   misty_dawn
    I wouldn't have called 911 unless the bone was sticking out. I would have called the parent first and asked them if they would like me to call 911 and let them decide if the policy does not indicate for me to do so first.
  4. by   NutmeggeRN
    After assessing whether or not there appeared to be issues with circulation, broken skin (exposed fracture) the pain level of said child etc. I would have immobilized, called mom/dad advised what my professional opinion was (based on my assessment) and then proceeeded to do what I thought best for the child. In our town EMS will gladly come to the school and do an assessment. They do not have to transport if parent says no (unless life threatening)......As many posters on Boston .com stated.....

    You cant win either way-if you call and incur cost or percieved loss of control by the parent you are in deep doo doo....if you dont and leave the parent in charge....you are in deep doo doo! It is a wonder that anyone does our job some days!!!!
  5. by   Not_A_Hat_Person
    A broken arm isn't life-threatening, so it's no cause for an ambulance ride or a 911 call. I'd do what the nurse in question did: assess the student, stabilize the arm, call the parents, and recommend an ER visit. I would only call 911 if the parent requested it.

    If the nurse had called 911, the parents would be outraged about an EMS bill (even if they decide not to transport, or the parents refuse transport) and an ER bill.
  6. by   Flare
    Unless it was a matter of life or death, I also would have called the parent before calling 9-1-1. I certainly would have offered to call an ambulance if the parents wanted it. I suppose if i couldn't have gotten anyone, then i would have thought about just calling for a transport and sending off, while someone else kept trying to call. People just want it all, and it can;t be like that.
  7. by   caregiver1977
    We just had an incident like this happen last Thursday at my school. Little girl was playing on the monkey bars, fell face first, and was crying and screaming LOUDLY about both arms. She said she couldn't move either one.

    We helped her from the playground, but when she got inside she slumped to the ground still crying and screaming and then started bleeding out of her mouth/nose. The parents were called and mom told us to call 911. Even though the mom got her about the time EMS got here, she was still transported by EMS.

    It turns out both of her arms are fractured in two places around the wrist (just thought you would be curious). There were no real injuries to her face.

    I don't really see why the parents are complaining in this story. Why didn't they have the school to call 911 if that is what they wanted?. A lot of times a parent can get to the school before EMS does anyway.
  8. by   HorizonRN
    Would the parents have called an ambulance from home if she had broken her arm at home? Also, it seems that they are upset because she had to wait in pain. Many people are under the impression that if you arrive by ambulance that you get seen sooner but the reality is that you get triaged the same way that you would if you walked in.
  9. by   Supernrse01
    I would have contacted the parents first (of course after first aid had been administered) and then left it up to them to give the call to contact 911. If it wasn't an open fracture, pulses were good, etc.. not sure why you would need a 911 call.

    I'm guessing if 911 had been called, the parents would have been angry to not have been notified first and then been stuck with the transport bill.
  10. by   bleemadden
    We had a broken arm at my school the third week of school. The student was playing on the monkey bars (No surprise there!) and fell on his arm. No broken skin, good pulse, and no placement abnormalities. Mom was very easy to get in contact of and said she was on her way (she lives right around the corner). I asked if she wanted EMS and she said no. When the student returned to school two days later, mom inquired me about why EMS wasn't called first because the hospital told her that's what should happen. Our district has the same policy of notifying parents first and asking them about EMS if the injury isn't too serious (broken skin) or life threatening. I of course stated that she had denied my offer to call EMS and that's why they weren't called after contacting her.
    If it would have been the other way around, she would have been upset that we called for such a minimal injury and be upset about the transport bill. You can never win with parents.
  11. by   100kids
    If pulses were good and there was no bone exposed through the skin I would have definitely called the parents first. Many times parents can get their child and get them to the ER before EMS.