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.
even if the candy had come out, i would think that performing the heimlich maneuver on a 10 yr old child warranted medical observation directly after the event. Seriously! abdominal injuries could have been sustained...
Please check with the school and find out the credentials of the nurse in question. Is she truly a nurse? As we've talked about on other threads, many people refer to themselves as nurses when they really are not. Ask what kind of training and experience she has? She may indeed be licensed, but if she doesn't have recent and appropriate training to care for school-age patients, she may well make unwise decisions.
If an object was lodged tightly enough for your son to need repeated applications of the Heimlich maneuver, he needed observation, at the very least, after the incident. One reason is that the kind of exertion and straining a person uses to expel a foreign body from the airway with their own efforts can cause the throat to swell. And this swelling can increase for some time afterward. Also, if the object was merely repositioned and neither swallowed nor expelled, it could block the airway again.
I hate to see every childhood scrape and scare turned into a "REASON TO BE TRAUMATIZED." I think we've become overprotective in our attitudes and, at times, plant seeds of hypersensitivity and fear. (I'm not saying you did this, just that we, in general, have become prone to over-reacting.) But even as we dial down the hysteria, we can take the correct action, which, in this case would have been to monitor this kid for a couple of hours after the near-choking incident to make sure his airway didn't begin to tighten and to be reasonably certain that the candy had disolved or passed into his stomach.
Please follow up on this event. The nurse may need further training.
Specializes in Peds Cardiology,Peds Neuro,Pedi ER,PICU, IV Jedi.
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
Totally agree with those posted above!! OMG what was she thinking??
Even if the object was expelled, the child should have been seen by an ER doc. The mucosa in the mouth/upper airway is very sensitive and can swell up given very little stimulation. Oops. Good to hear everything turned out okay!!
Specializes in pedi, pedi psych,dd, school ,home health.
As a former school nurse, I would NEVER put a child on a bus to anywhere after the heimlich unless the parents were contacted and approved. she may not have thought the whole process thru as i am sure she was anxious about having to do the heimlich on a child. Perhaps a meeting with her and a "heads up" on your feelings will make her change her policy if it ever happens again, chances are she is already thinking that way and has been beating herself up about it.
I don't consider myself very bright but there is no way that child would have been put back on the bus. I would have taken him to the emergency room ASAP. Especially since the candy wasn't expelled. All that mean was the candy was in a different place in his throad, waiting to become lodged again.
.thumb.jpg.2605487e9a1cc011342d44bcf46e0b55.jpg){kind=small}
The school nurse made a very serious judgement call. When you are dealing with someone's child......ALWAYS 'ER ON THE SIDE OF SAFETY !!
smk1, LPN
2,195 Posts
even if the candy had come out, i would think that performing the heimlich maneuver on a 10 yr old child warranted medical observation directly after the event. Seriously! abdominal injuries could have been sustained...