First aid policies in primary schools

[pinkcattydude]

DS broke his leg at school after a fall. They called us we collected him and took him to hospital after calling 111. Does anyone know why they would have moved him and not called an ambulance. Is this a policy now? Another child broke his arm recently and was sent home again to go to hospital, but it wasn’t put in a sling just given an ice pack. Many moons ago when I was in school I remember ambulances being called etc, but are they not now allowed. I want to help them improve how they deal with these things if possible. But if it’s policy I understand and know my limits.

@DarcyLewis

Whose car was he carried to?

Ours as soon as we got to the school about 30 mins after it happened so pretty quickly.

We would call an ambulance if necessary but not all. Realms are obvious and we would ring parent as they did .
If parent couldn't come for whatever reason we would drive them to A and E
Ambulance only called if obvious break of a leg ..ie bone sticking out
Otherwise we are trained in supporting the limb if need be.

Unless it is obvious, they won't know whether it is broken. If all schools called ambulances for injuries to limbs for falls or sport, there would be no ambulances available when someone has a serious life threatening emergency. Unless you think that they deliberately caused him suffering and knew he had a possible broken leg then complaining would be unhelpful. The fact that you were able to transport him in the car would suggest it wasn't obvious. I suppose I would ask you why you didn't see fit to call 999 when you arrived at the school. If it was obvious, you would have. You called 111 instead suggesting you were not sure it was an ambulance call or not.

When you got to a&e did the doctor tell you that you should have not moved him and waited for an ambulance?

If the same accident had taken place when you where at a park with him would you have called an ambulance or would you have helped him into your car and gone to A and E?

Mainly because they didn't know it was broken. No xray vision. It all depends on how the injury and the patient presents.

At my school even staff are driven to A&E ,unless really bad or unable to move. Mainly because an ambulance can take ages, especially if the injured person is conscious,breathing,talking etc normally.

The language you're using is very emotive.

@Lulu1919

We would call an ambulance if necessary but not all. Realms are obvious and we would ring parent as they did . If parent couldn't come for whatever reason we would drive them to A and E Ambulance only called if obvious break of a leg ..ie bone sticking out Otherwise we are trained in supporting the limb if need be.

Breaks not realms lol

Unless it's some kind of horrible open fracture why would you need an ambulance?

Thing is, a written policy can’t contain every possibility - staff have to make judgement calls.

If the child was conscious and breathing, no immediate risk to life, parents were available with a car to get to a&e and child could be moved, then they probably decided that was better than leaving the child to wait for an ambulance.

If you or the doctor feels that that was the wrong call, then definitely feed it back to the school.

I'm a first aider in a primary school. I have called ambulances before and would also back up the fact that for a child that is talking and responsive they take forever. I've sent children with parents straight to a&e in the parents car. I've also offered to drive the parent and child to a&e myself. I wouldn't call an ambulance unless it was an emergency. Broken limbs are horrible and painful but not life or death (in most cases). I'd do the same if my DD broke a limb at home - I'd drive her to hospital not wait on an ambulance who could be helping someone in more need.

The occasions I've had to call an ambulance are the ones that haunt me - the suspected stroke, the road accident and the fall from the top of the stairs. If the school call and say your child is hurt but they haven't called an ambulance you should be breathing a sigh of relief - they're not neglecting their duty of care or refusing to do it, they simply do not need paramedics. They need their mum/dad/granny/whoever to reassure them and take them to somewhere for the appropriate medical attention.

You need to ask them what first aid training any of them have had. the child should not have been moved unless the leg was splinted and a broken arm should also have been imobilised. Its not just about the bone coming through the skin, but further displacement could cause nerve damage. Imobilise first.

Our school called ambulance for a break coming through the skin. Ambulance and parent arrived within seconds of each other and the parent went with child to hospital.
Usually we will move them (we have a wheelchair to use if needed) and call a parent.
If we had to call an ambulance for a child I think we need to use 3 adults - 2 to accompany the child (for one child our policy requires 2 adults for safeguarding) and 1 to drive a car behind so the staff can get home again.
That’s 3 members of school staff gone. I don’t know about other schools but we don’t have spare extra staff that are only needed in situations like this, so an ambulance is only called in an actual emergency situation. For something like your ds, we would have done the same thing.

agree they dont need an ambulance, but just picking up an injured person without full assessment is not the right thing to do

I think I just imagined it would be a similar policy to work as in call 999 if life threatening (not the case here), if not call 111 and get advice before moving the patient (obviously as a child calling parent at the same time). As it seems I’m being a bit over protective I will ask that they send the accident report over as handing it to the child in shock meant it got lost and couldn’t be handed in to doctor. It was the doctor that mentioned that it was good that the other bone wasn’t broken as moving him could have made it much worse. I’m also going to donate a wheelchair to the school if they agree as the one they are using isn’t fit for purpose.

In the first school I taught in, two children broke arms and one broke a toe in my lessons. Gym, history and maths respectively, to be precise.

In none of those cases did I (or the child, or the trained first aider) think there was a break.

In all of the cases, we got the child to rest the limb and administered the ubiquitous wet paper towel until home time when I told the parent what had happened.

I felt bad each time at not having recognised the break, but young children knock themselves and fall frequently. The amount they cry or the severity of their reaction really is in no way related to the severity of the injury, and none of those breaks broke through the skin or looked out of alignment.

I can easily see how it would seem more sensible to suggest a parent get the hurt area checked out if it continuedto hurt.

It was a serious incident OP so the school will be reviewing what happened.
You would be reasonable to ask for a meeting/debrief with the Head and feedback about the accident form being handed to the child (definitely an improvement needed there!) and the risks involved in moving an injured child.

I should add, I've also known children complain at school about something hurting from a home injury, only to discover that was a broken bone.
One only complained after a competitive football match in which he had scored a goal. He had broken his wrist at cubs the night before.

I’m surprised an accident report is available to give to the child at the time. In a true emergency surely a verbal handover to the ambulance crew is given. The fact that someone had time to put pen to paper tells me there was no great urgency.

An ambulance is for people who cannot get to hospital

The wait here would be up to 6 hours for a non emergency (which it was)

I'm a first aider at a secondary school so no primary

We would normally get parents to collect children with a suspected broken limb for them to take to a&e

As MildredPuppy said ambulances for otherwise well children would take ages to go

We don't have the members of staff to facilitate the accompaniment of a minor to a hospital. Unless it's a non breathing urgent ambulance needed ASAP situation

I've had ambulances called to school before now, but as a pp suggested, only when the presentation suggests that it's necessary. Twice for seizures and once for an injury when I wasn't at all happy to have the child move before they'd been cleared by a medical professional and not a lowly first aider.

I'm a first aider in a secondary.

We phone the parent to collect the child. I did call an ambulance last year for a child with a suspected broken ankle because we couldn't move him. We waited over an hour and a half for it to arrive because a broken bone isn't an emergency. Had we been able to get him into a car he would have been at a&e within 15 minutes.

I called an ambulance for a child with brittle bones who had fallen and was crying loudly in pain. I told them she had brittle bones and gave them all the information on her so they could see her medical history. I then called Mum. After 20 minutes we had a call back from the ambulance triage people I think who said we were not being sent one because it wasn't an emergency. The girls mum took her to hospital in her car. It wasn't a break but a problem with the bar in one leg and she was off school for a week. Mum said it is very difficult to get an ambulance.

I’m glad the school calls me first in a non-life threatening situation. For my child most of the time it’s an asthma attack and at this point I am the person best trained to treat her attacks in the initial stages and if we can’t get it under control to decide we need to go to a&e. Calling 111 would waste precious time.

I think that is often the case for childhood injuries. We know our kids. We know how they react. So we can tell what is going on better than a stranger going through a checklist over the phone.

Now this of course presumes the parent can arrive in a time that is quick enough for the seriousness of the injury. If they can’t, then yes the school needs to proceed.

The policy at my dc's school is that if a child cannot get up by themselves, or with a little support from an adult, they do not pick them up. If the parent could not get to the child quickly, they would call an ambulance.