How would you have handled this?

[radoncrn]

I am the proud mother of 5 children who attend public school in Western Massachusetts. A situation occurred recently that involved my 10 year old son. I do not think it was handled correctly, but maybe it is the mother in me not the nurse...

My son was on the bus at the end of the day. A friend gave him a hard candy....(You can see it comming)...and he choked on it. He was taken off the bus and to the school nurse told me he could not breath, cough or swallow. She immediately gave him the Heimlick (sp?) 3 times and the candy moved. He could breath and cough. The candy did not come out of his mouth. She then put him on the bus to the after school program (no adult on the bus except the driver ). She called me after the bus left. I met him as he got off the bus and he was very pale and sweating c/o throat pain. i took him to the ED (Just down the street) where they removed the candy. (No More hard candy in my house!!!!!)

My issue is this...I do not think he should have been put on the bus without an adult to observe him. I do appreciate that she attempted to clear the airway. This will not go any further...I just wanted your thoughts.

[GooeyRN, ADN, BSN, CNA, LPN, RN]

Im not a school nurse, but I would have called mom before putting him on the bus. I would asked mom if she wanted to take him to the hospital and if I should call an ambulance for her. I don't like the idea that the candy didn't come out of his mouth. I would be afraid it would get stuck in his airway again.

[CHATSDALE]

the candy did not come out because it repositioned with the heimlich and was not expelled...this was a potentially life threatening decision on the nurses part

you owe it to the other children under her care to speak up..LOUDLY

i am so happy that the outcome was good

[jen7393]

the candy did not come out because it repositioned with the heimlich and was not expelled...this was a potentially life threatening decision on the nurses part

you owe it to the other children under her care to speak up..LOUDLY

I am so happy that the outcome was good

I totally agree. The nurse needs to think a little more before she makes decisions. Thank God the candy didn't get stuck again.

You say the removed the candy, was it still in his throat? if so, you should make sure the nurse reviews the incident.

[BeenThereDoneThat74, MSN, RN]

I agree with the rest. She should have called you (or an acceptable substitute) and kept him off the bus. Even if it was expelled, I think the experience was traumatic enough for you to be notified immediatlety, and for him to be monitored closely. Thank God he is allright.

[Kelly_the_Great]

The candy wasn't expelled and she sent him on a bus ride!?!?!?

Speaking as a nurse...this was a serious situation that required more intervention than was given. The candy could've repositioned during that bus ride (or @ any time) causing complete obstruction! He shouldn't have been w/o direct surpervision 'til the dislodgement occured. And there should've been an aggresive attempt made for disoldgement to occur. I don't mean just doing the Heimlich maneuver 'til he can breath - I mean get the forgein body out! This does not mean takin' a bus ride to home. This means Heimlich 'til he can breath w/transfer to ER. I mean didn't you have to sign a emergency medical release form when he was enrolled?

Okay, now, speaking as a mom...I would have been :angryfire .

[Keepstanding, ASN, RN]

I am a school nurse and I would not have put that student back on the bus.:angryfire . If I did the Heimlich and his airway opened, but I did not retreive the candy, I would have kept him with me and called his parents or 911 immediately. Chances are he would continue to have a problem as long as the candy had not been brought out. He was still in a dangerous situation.

The school nurse made a very serious judgement call. When you are dealing with someone's child......ALWAYS 'ER ON THE SIDE OF SAFETY !!

LPN 90

[jen42]

Jeez. Even if the candy *had* come out I would have had his parents pick him up, because I'd imagine he was scared and traumatized! If it hadn't... definitely wouldn't put him on the bus.

[Jeanine]

The student should have been sent to the ER via ambulance. As mentioned before, better to err on the side of caution! Choking is something that I would always send out, even if the object was dislodged/expelled. If the mom gets to the school before the ambulance transports, and wants to sign the release, that's her choice. We should always protect our students and our licenses, and avoid would-have, should-have, could-have situations. That way, there's no regrets.

[BearLV]

Wow, I am surprised that the nurse thought it would be okay to send him on the bus. I am a school nurse and would not dream of doing this. I am glad your son ended up okay.

[Chilenurse]

I agree to all the others. I never would send a kid home without asking the parents before, special after this kind of happenig.

After they now the situation and I would tell them all the risk, then I don`t think they would agree to put them child on any bus.

Greetings from Germany

[bones221]

OK, I'm not a nurse yet. In fact, I don't even start school for a few months yet. A bunch of years ago I was an EMT...So take me with a giant grain of salt.

It seems to me that ANY time Heimlich needs to be administered a trip to the ED is advisable. Especially with a hard candy. Especially with a kid. Especially if the blockage is not expelled. Couldn't the process rupture the traecha or esophogus? Couldn't the unexpelled repositioned item that is still partially compromising the airway reposition itself again and totally block the airway?

Seems to me a call to the parents isn't enough, unless it is to inform the parents that they should be meeting the ambulance at the ED. In my uneducated opinion anything less is negligence!