One more round of "What Would You Do?"

Specialties School

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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?

Specializes in kids.

I, too, am blessed to have a very supportive EMS/FD. HAve called for lots of things over the years, whats nice is the level of trust that has been forged. If I call and tell'em I need them ASAP, they are here before I turn around, as they know I mean business!

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Specializes in School nursing.
the overall is that most of my parents have a minimum of a 20 to 30 minute response time to begin with (the average time being closer to an hour to an hour and a half). And that's after I call 7 numbers to find someone to pick up / call back or have a working number. Yes, I suppose if it were a child of a parent that I knew for sure that was in town and would be in school within a few minutes, I would maybe give the option of get here - do you want me to call 9-1-1 or are you just going to take to the ER yourself? but for everyone else - if the parent gets here and EMS hasn't transported yet, they can always refuse transport if they don't want the bill.

Now, don't think i'm quick to call 9-1-1 for everything. But in the case of a detached body part... well, after being an emt for about 6 years I can easily say that not only did we go on calls that were of much less emergence, but that our questioning and interview with patient and family certainly did not take 30 minutes.

This. I have waited 4+ hours for a few of my students to be picked up. Average wait time is probably 45 minutes to an hour. So for a detached body part? I'd call 9-1-1.

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Specializes in kids.

Maybe the best bet is to check with your risk managment folks...how do they want you to handle it?

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