When do you call 911?

rdsxfnrn · Sep 29, 2009

when in doubt call. better to be safe than sorry............. some parents prefer that they are called first but that is just delaying tx.

Purple_Scrubs, BSN, RN · Sep 29, 2009

I have called twice, once when a pregnant parent had a slip and fall in the cafeteria (she was fine, it was just for precautions), and once for a arm fracture. I only called on the fracture because the parent requested it. It was a closed fracture and I was able to splint it, so generally we want the parents to take them to the ED in those cases. This mom demanded transport so I called. In the end, it took much longer waiting for the ambulance than if she had just driven her herself, but it was her choice. The EMTs basically just looked at my splint and left it alone, then waited for transport!

I would call for an open fracture, any suspected fracture to the leg, severe head injury or any unconsciousness, seizure, or breathing problems. I am sure there are other scenerios I would call for but those are the main ones. Generally I would call 911 myself and have someone else in the office call the parent while I was on the phone to get them on the way.

Trueblood83 · Sep 29, 2009

Thanks for the input! I'm used to working in the hospital where you are the code team. So this will be very different. I had a school nurse interview today that I think went really well. I am supposed to hear something tomorrow. I'm just doing a little preparing and research just in case I get it! So thanks to you both!:loveya:

Needsmorechocolate, ASN · Sep 29, 2009

Good information Purple! I have called 911 one time for a student having a seizure.

Good luck with your interview. Keep us posted.

luvschoolnursing, LPN · Sep 30, 2009

Remember, you are on your own in the school with little more than peroxide and bandaids in your orificenal. When in doubt, call EMS. I have called for an unconscious student who remained very confused when he woke who had no medical hx. I have called for a hyperventilating student who was having a mental health crisis. I have also called for a staff member who was having chest pain. We have a very good relationship with our local EMS people and they would rather us call early than too late.

Trueblood83 · Oct 1, 2009

I was offered the job. I told them I wanted a day to think on it. I was really excited about the opportunity to become a school nurse! However, I'm a little iffy about working for the principal. I'll be split between 2 schools, but my home school principal was very unprofessional and I'm not sure about her attitude. I already posted about this. So I'm taking time to think about it. I have another interview today for a corporate wellness nurse position. School nursing is where I want to be though!

mustlovepoodles, RN · Oct 4, 2009

I have to call 911 about once a month. I call for first-time-ever seizures or seizures that last 5 min or longer, altered consiousness(from head injury or suspected drug use), allergic reactions, asthma, suspected DKA. I have called several times for staff having severe asthma attacks*(not moving air at all!), chest pain(was a serious arrhymia), severe abd pain(*gallbladder), and anaphylaxis. Only one time did I make a mistake on this--I had a student who was severe abd pain and was so altered he couldn't tell me his name or phone number. Even his friends couldn't get through to him. So I sent him to a children's hospital ED instead of our local general hospital because i really thought this kid had appendicitis. It turned out to be a severe strep infection(and he didn't even have a sore throat!) The ambulance ride cost over $1000 and the parents couldn't pay, so the school system ended up eating it and they weren't too happy about that. But I still think I did the right thing. If one of my children was a sick as this kid was I would HOPE the nurse would call 911!

The thing you have to remember is that anything that can happen in the "real world" can happen in school and you will have to handle it without meds, oxygen, or back up. You're a one woman show. Get to know your local EMTs and treat them well. :twocents: