One more round of "What Would You Do?"


An Atlanta-area mother is very upset that a school nurse did not call 911 for her 6-year-old daughter's severed fingertip (linked story contains auto-play video). The way I see it, a severed fingertip is not a life-threatening emergency, so 911 is not needed. I would put the fingertip on ice, stabilize the patient, call the parent, and call 911 if requested.

What would you do? Does your school have a protocol for amputation injuries?

Trauma Columnist

traumaRUs, MSN, APRN

153 Articles; 21,229 Posts

Specializes in Nephrology, Cardiology, ER, ICU. Has 31 years experience.

If this is an open fracture, then yes, it is an emergency and yes, 911 should be activated. If there is tendon damage, then yes, it is an emergency.

I vote that yes indeed this qualifies as a 911 call.

coughdrop.2.go, BSN, RN

1 Article; 709 Posts

Specializes in School Nursing, Public Health Nurse. Has 3 years experience.

I had a similar incident happen with a student in woodshop. We called her parents and her mom was there within 10 mins. If we couldn't get a hold of the parents then I would call 911. I've also had a student who had a closed fracture of his wrist, but parents arrived right away and 911 wasn't necessary. Yes this was an emergency, but not every trip to the ED requires a 911 call.


4,123 Posts

Specializes in NICU. Has 8 years experience.

Call the parents. If the parents can come right away, then no 911. If you can't get a hold of parents or the parents want you to call 911, then call 911. You have some time to re-attach.

Flare, ASN, BSN

5 Articles; 4,431 Posts

Specializes in school nursing, ortho, trauma.

If it were my call to make, I agree that a call to 9-1-1 is in order -especially given the amount of finger that the mom indicated that she lost. There would have been no question in my mind. It would have been a call to the parent of can you get here right away or do you want to meet at the ER? I'm guaranteed not to be defending my self legally for sending the child out in this case.

Tina, RN

513 Posts

Specializes in Acute Care, CM, School Nursing. Has 20 years experience.

I, too, would have called 911 in this situation.

Specializes in School Nursing, Public Health, Home Care.

911 for sure


428 Posts

Call parents,

There is nothing an EMT or Paramedic can do for this except give a very expensive ambulance ride to the closest facility.

But, I would make sure the parents know what would be the most appropriate facility to transport to.

Stitchy's mom

34 Posts

Specializes in mommy/baby, home health, school nurse. Has 22 years experience.

I'd call 911 then parents, unless mom or dad was literally in the building. Even then I'd be on the phone to 911 and have someone else paging the parent. :nailbiting:


983 Posts

I definitely would have called 911.

Specializes in School nursing.

I agree with most of the folks here, I'd be calling 9-1-1, then calling the parent to see if they can get to school to meet the ambulance or head straight to the hospital.