911

I'm in a tiny K-8 school, approx. 100 children. I completed the entire school year last year with no EMS visits, despite a very brittle diabetic and 3 seizure patients. Worst thing I had all year was a radius fracture - and it happened to be my own child! Wish I could be of better reference for you.

In any case, go with your gut. I'd have done the same in both of your situations. Your license is on the line, and better to be safe than sorry! Forget what admin thinks - you're the nurse! Great calls! How'd the kids make out?

I have been doing this for 7 years and have only called ems once - though it does sound like you made the right call on those occasions. There have been quite a few times that the child was stable, just in need of immediate evaluation and i offered to the parent to call, but those have been declined in favor of parents getting their kids themselves.

At my current school(350+ kids, K-5) I've only had to call EMS once this year, for a child who had a broken arm and we couldn't find the parents. Policy prevents us from driving the child to the hospital, so an ambulance was called.

However, my last school (900+, 6-8) was in an urban/suburban setting. We had a lot of gang activity and weapons. There were fights every single day and those kids woudn't stop until significant blood was drawn(and sometimes severe injuries.) Couple that with the occasional anaphylaxis, severe asthma attack, seizure, chest pain(adult) and serious head injuries and I was calling 911 about once a month. And yes, my principal did think I was overreacting until I explained to her in detail *why* it was necessary in each situation. I always go with the liability angle--and what admin wants to explain to a parent why EMS wasn't called for a serious emergency. I don't know about where you live, but where I am school nurses may call EMS any time they deem it necessary whether the admin agrees or not. I had to override my principal once and she was hopping mad. Too bad, so sad. Not putting my license on the line for an ex-PE teacher/administrator with NO healthcare credentials.

Thanks for all of your input. I really appreciate it! Luckily, in both of these situations, the kids were totally fine... but then, of course, I question my judgement... In any case, I'd rather err on the side of safety. Yes, my school is large and in a very urban setting. It has a high rate of asthma and food allergies and we've had a few bad fights already. I'm just hoping for the best moving forward. Despite all this, I really like the job so far!