EMS call what would you do?

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17 year old male was playing around and hit the back of his head. Upon assessment visualized a mass that is tender to touch, cirular in shape (swollen), and around 3 cm x 3 cm. Vitals stable. No complaint of N/V and no dizzy feeling.

10 min later student complains of feeling dizzy, nauseous, drowsy with unsteady gait. Vitals are stable and WNL.

I called EMS and parent contacted d/t what I believe could be a concussion/ traumatic brain injury. I was cursed out because mother stated that it is not that serious because she is 3 hours away by train (school in located in NYC).

I personally feel like I made the right call... Kinda need confirmation because the lashing from the mother freaked me out...

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when in doubt, send them out....

lets recap: If youdidnt send him out and he died..you would face far worse than a cuss out or a tongue lashing. You did the right thing..don't doubt yourself

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Thank you... as I was typing my post earlier I felt reassured in my decision.

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Absolutely did the right thing, shame on her for being more concerned about a 3hr train ride then the well being of her child! Had a student a couple wks back who fell from 10ft swinging and hit his head, he was fine but due to the height I advised the mother to take him to the ER. She said he would be fine and she had just gotten off a 13hr shift and was getting ready to go to bed. My gut and boss told me to call EMS just incase because the mother wasn't really that concerned. EMS arrived he was still fine, even though they never did a neuro assessment on him. Anyways I CYA because it is my license that would be questioned if something had ever come of it, I really care less about the inconvenience it causes! There is no other person in school that you can go to for advice so you have to do what you believe is right and stand up for your decision!

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Thank you Stephaniepreshar

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Specializes in kids.

You did it absolutely correctly! Just imagine the outcome if you had not. I guess mom may be feeling a little guilty for being so far away.

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I agree with a PP, when in doubt send them out. Doesn't matter if they come back half an hour later.

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Specializes in Maternal - Child Health.

Let's recap: A student hits his head hard enough to raise a significant "goose egg" and subsequently develops nausea, dizziness and unstable gait....

Yes, you did the right thing.

In obvious cases such as this, the parents get to over-rule the nurse if and only if they arrive at school prior to EMS transport. Then they can take the kid wherever they wish for treatment, or home to bed. Otherwise, it is YOUR call, in conjunction with EMS.

P.S. Do you know the outcome of the student's ER visit?

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Specializes in Peds, School Nurse, clinical instructor.

You absolutely did the right thing!

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You did an initial assessment and then a follow up and absolutely did the right thing. Mom needs to check her priorities.

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Specializes in school nursing, ortho, trauma.

oh, yes - definite right call - that 3 hour train ride is the game changer. It's a HTBT type situation, but, if mom were a 10 minute cab ride away or maybe could even get to your office within 20 minutes, maybe - just maybe would i consider allowing mom to meet and pick up - on the condition that if she is not in my office in 20 minutes or if he LOC, 9-1-1 would be called whether or not mom was there. It's not worth risking a child or your license over mom making suppositions over the phone and from the way things sound things were going south quickly with this kiddo. Good call!

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Well done.

Speaking as former EMT and Ambulance Captain in a fairly busy FD, in my opinion you absolutely made the right call. Flare's analysis of why it was the proper decision is spot-on. I'm guessing that the Mom will eventually realize this as well.

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