Ambulance call

Published

Hi Nurses!

So I had an ambulance call today & would like to see how you would have handled it. I got called about a student who has a history of fainting (doctors are still trying to figure out why). She felt dizzy and fell down hitting her knee first and then her head. She had a headache & said she was "not feeling right." I asked if her neck or back were hurting & she said no. She eventually noticed her hip hurting as well. She was slightly pale still but good vitals. I called an ambulance because I didn't want to move her as she had hit her head hard & I didn't want to move her even though she didn't have neck or back pain.

The ambulance crew allowed her to get up onto the stretcher & her dad ended up transporting. I am not beating myself up but would like your input on how you would have decided to let her get up & move or stay still for an ambulance. She is a 16 y/o high school student.

On a different note--I gave my first epi on Monday! Had to give two epis because she was still very symptomatic 6 minutes after the first dose (dizzy, nausea, flushing on her chest with red streaks going toward her abd., SOB, numb throat). I got her on the floor with her feet up after the first epi & the dizziness improved. But then she started to feel worse :( So she got a second dose of epi. My principal was at the student's head and saw the red streaks receding after the second dose of epi. The ambulance was delayed due to road blocks...

Thanks for any thoughts you might have on assessment of the student who fell!!

J-lynn

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Specializes in Pediatrics Retired.

Oh yea!! This calls for another BAM! Another kid snatched from the jaws of death! School Nurses...that's what we do. Kudos to you for an awesome assessment, intervention, reassessment and reintervention. That's grabbing the bull by the horns and not letting go!!

Never, never, ever, ever, second guess yourself about calling an ambulance...got it?

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Got it, Old Dude!! And thanks so much for the encouragement!!

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Specializes in school nursing, ortho, trauma.

Wow! you're having quite a week. I think the juu-juu that was creeping on me last week moved on to you. Don't ever second guess your instinct to call ems. It's better to have to explain why you thought it was necessary and "did too much" than "not enough". I also like the phrase "being overly cautious" -it makes the parents really feel like you're treating their precious one like a china doll. The parents can always have a RMA form signed if they don't want the transport.

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Specializes in School nursing.

You will never regret calling EMS. You will regret not calling. Good job!!

I was on the fence with Epi yesterday for a student well known to me, but I have learned on the fence - go with your gut to the other side.

(Plus side was student gave the Epi to herself. I went to give it and she tensed and asked if she could do it. Of course, hon, I want you to learn how to do this in the real world when I send you on your way in June. Great result - and parent was NOT upset. But even if they were, I'm not.)

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Way to go on all! Scary that EMS was delayed due to road blocks- must have been so scary waiting for them to arrive. Regarding the student who fell, agree 100% EMS was the right call. Echoing what PPs have said- you will never regret calling 911, but imagine not calling and being asked "why didn;t you call 911"??!

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Specializes in kids.

Well done!!

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Specializes in Peds, School Nurse, clinical instructor.

Better safe then sorry! You did a good job on both your kiddo's.

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Specializes in School Nursing, Ambulatory Care, etc..

You are amazing! Good job on Epi and EMS (both times :) )

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We are the only medical professionals on campus!!! AND with very little tools, we just have to rely on our nursing assessment to make a quick decision about calling 911. I agree with these other awesome nurses, never doubt it!!! You did what you thought was the best thing for that child in that moment and that is NEVER WRONG.

I had a situation a few years ago that I did not call 911 on (and I still stand by that decision because I did not need to). However, the student told me and the counselor the next day that mom said I should have not bothered her and just called an ambulance instead. Lo and behold, the kid came in a few weeks later with the same complaints, symptoms. At that moment, I felt the best decision for this child (to get medical treatment, i knew mom would not follow up) and yes to cover my .... was to call. She got transported and then mom was a little unhappy when she received that bill. Well, be careful for what you wish for.

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Thanks nurses! You are all amazing & I learn so much just following threads on these boards. Unfortunately, I am leaving the ranks of school nursing...I just don't have the organizational skills to keep up with all the tasks & the daunting amount of paperwork. I was given a high school & an elementary school & I've been sinking with the paperwork. I've had emergency after emergency (which I have LOVED) & not enough time to do all I need to do. I do not have the leadership & organizational skills that School Nursing requires. I will miss the autonomy & decision making, and I will miss the teenagers TERRIBLY. I just love taking care of them. And even though I hate making care plans, I have learned SO much from doing them.

I have cried a bucket-load over it & now's time to move on. I'm just not sure where I can go in nursing that will utilize my strengths & not my weaknesses?? I feel like my assessment skills are good & that maybe urgent care is a good place for me...not sure & I fortunately don't have to be in a hurry. Wherever I land, I will continue following this area of all nurses for my own professional growth. Much respect to you amazing school nurses!!

J-lynn

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I think sometimes we are going to be criticized no matter what. I totally agree that relying on our gut, training & experience is the best way to make decisions. This is not an exact science as some people think. There are a lot of judgement calls. One of the most valuable things I think I have learned from this job is not to worry about defending the decisions I make unless asked to. I have done my best each day to triage my workload & to take care of kids to the best of my ability. As much as I'd like people around me to appreciate the care & effort I am giving, in the end my own self respect & doing my best for the kids is the most important thing....

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