Looking for advice. I had a HS student who was assaulted by another another kid - punched hard several times in the face. Face is a mess, blood all over, kid is crying and freaked out. Airway OK, no broken teeth and wasn't choked or anything. Breathing fast but good color, crying and talking in complete sentences, sats good. A&o, recalls events before & after, no loss of consciousness, didn't fall or hit head against anything, steady drip of blood and a big visible clot hanging out but not gushing, nares patent after the bleeding stopped, nose already very swollen, eyes reddened and already starting to bruise but PEARRL and vision OK. No palpable or visible injury to the rest of head, mouth, jaw, ears; no pain in back or cspine, no changes in sensation; no obvious asymmetry or fractures in face, wasn't struck anywhere else. Not nauseated, vomiting, dizzy or confused. Not on anticoagulants, no worrisome medical history.
So, a terrible situation requiring monitoring until he went to a provider (it took his group home over an hour to arrive, despite saying they were coming immediately. Vitals OK and he remained a&o managing OK with Tylenol and ice. But I gave them a stern talk about going straight to the hospital, and wished I would've just called 911 to get him going). But not appearing to be immediately life threatening.
I never worked pre-hospital or in community settings like this before; I'm used to being around other nurses. So running through my ABCDE checklist seems logical and obvious, but I'm thrown off by my coworkers who say and do completely unexpected things (three of them hassling me about the blood while I'm trying to assess the kid - insisting floor should be cleaned up and his clothes changed immediately - while I of course am not concerned with the floor. I want to make sure there's not some c-spine problem or other injury before anyone moves anything). One of them actually yelled out from behind me mid-assessment that the kid should tip his head way back so the blood would stop dripping (um, no).
I'm not used to managing onlookers on a scene. Also not used to a setting where freaked out teenagers can crawl underneath a shelf, making assessment a challenge. I probably should have just kicked all the staff out.
How do you handle your coworkers in these situations? And what else could I have done for this kid? We don't do debriefings at work (we should) so I'm going over and over in my mind about it.