School first aiders missed a broken arm..

[NatalieMc82]

My youngest son fell in the playground at lunchtime yesterday (he is 7) and suffered a minor fracture to his arm. I am not blaming the school for the injury - boys fall over - but despite the fact that he saw 2 different first aiders nobody realised the seriousness or phoned home. Because of this he was left with no pain relief of medical attention. It was obvious as soon as I he got home and I asked the usual questions: could he flex his wrist? make a fist? wriggle his fingers? and the answer to all the above was NO that a visit to casualty was in order. There was also clear swelling compared to the uninjured arm. A and E were fabulous and x-rays confirmed a 'buckle' fracture. But am I being unreasonable by saying the school could and should have done more?

Natalie - surely it makes most sense for the First Aid Trained staff to be those who are actually on duty at dinner time (when most bumps happen) ? Depends on the school, that's very common for it to be office staff, and/or dinner supervisors. Many schools will also train TAs, but it would be very unusual for it to be a teacher's responsibility.

I had a boy in my care break his arm once, and he could do all the things you said - the finger wiggling etc - so we didn't realise it was a break. The fact I was his teacher (and first aid trained at the time, through something else I belong to) didn't make me any more able to diagnose the break than had he been seen by the school secretary or a doctor.

My dd fractured her arm last summer - my (highly qualified in first aid) dh didn't think she had, the GP didn't think she had, the raiologist wasn't prepared to commit, the A&E Dr couldn't decide.... keep in mind the last 2 had X-rays to look at.... then the hand specialist at the children's hospital was still unsure. In the end they decided it was a fracture, but there's no way any first aider could have known that.

I sometimes think that people on MN are deliberately obtuse.
The OP did not ask any first aiders to use X ray vision to diagnose a fracture.
She has, rightfully so, identified that the first aiders did not do the appropriate checks, failed to recognise the POTENTIAL for a serious injury and failed to INFORM the childs parents of the incident immediately so that THEY could decide on the appropriate action to take.

gorionine hope you and your family are well on the road to recovery after your accident, as you said sometimes you just look and know that there is a fracture.. that was my exact reaction yesterday..

on the subject of campaigning to improve first aid in schools / nurseries I would suggest looking up Millie's Trust. Not in any way comparing this to my situation but is something my experience has opened my eyes to..

Well, Actifizz, the OP is saying that the school has said they did do the appropriate checks.
Also, people in schools have to make a judgement call with each child as they see them at the time. At the time they judged him to be OK. That's not to say it didn't start swelling later, but they have to judge on what they can see at the time.

Ds fractured his wrist at school. It was the most obvious fracture ever. They applied ice, splint and sling. called me and we went straight to A&E.
Triage nurse in A&E wasn't convinced so removed ice,splint and sling.
7 hours, no pain relief and one Xray later fracture was confirmed and plaster cast applied.
So it can work both ways.

Thank you Actifizz for so fully understanding my point!
The school are now trying to say they made the appropriate checks, however DS can tell me every question the triage nurse asked him but the only thing he remembers the first aider saying was not to split the ice pack!
This is backed up by the note home from his teacher which only mentions the graze to his arm rather than any other action taken..
3litllefrogs feel bad for you and your DS having such a bad experience at A and E.

See Ops post at 15.53.

The school have admitted they have fallen short.
It takes a couple of minutes to phone the parents of s child who had had a fairly significant fall and who continues to cry and complain of pain. The childs wrist was very clearly swollen when he was picked up. Therefore it was very clearly swollen in school and he should have continued to have been checked after the initial checks because he was crying and in pain.

Hakluyt I was trying to type a Norfolk accent.

They were perfectly competent at spotting the broken bone. Once they had appropriate evidence.

I wouldn't trust my 9yo to give an accurate report on that kind of thing.
My 9yo would love to play it up especially if I came to visit to claim he had a terrible hurt arm & he'd try to campaign to come home immediately.

The school were wrong not to contact you if your child was in pain and crying all afternoon.

But, I work in a school and did my first aid training last week. We had no training at all on broken limbs and we weren't told at all what questions to ask if we suspected a fracture, but obviously if the child is in pain and is holding their arm funny I would suggest A&E but that is my common sense and not first aid training.

I'm sorry your son was hurt and hope he is now on the mend, but I don't think you are being reasonable to keep trying to find blame. The school did their best, but they are not healthcare professionals. Breaks can get missed. It is unfortunate, but it happens. You need to move on. Your time and energy would be better employed looking after your son.

I agree with Derek.

I am a Brownie leader and have recently done my first response training. We covered nothing about spotting broken limbs or asking questions to determine whether they were broken. Most of what we covered is far more immediate and life-threatening - choking, CPR, use of defibrillators.

We are all fine now Nathalie Although the car was demolished, we miraculously survived with just injuries such as broken limb (I said it was obvious because her thigh was actually doing a 90 degree angle) lacerations, bruising -internal and external-) we consider ourselves really fortunate. What I was trying to say in my example is that basing a judgement on the fingers movement could also have been a factor in missing your son's fracture if one thinks movement means all is fine.

My mum is a nurse and she didn't realise that my brother had broken his leg during football training until 2 days later when he was still complaining of pain so she took him to hosptial. He ended up needing surgery on it....twice!

It can be tricky to spot these things.

Did first aid training in February and they did mention broken bones

But all of us had at least one story of how broken arms etc had been missed (as did the nurse)

It's not foolproof but there is obviously no harm in up dating training within the school.

vestandknickers I made it perfectly clear in my OP that I was not blaming the school for the accident.
I was simply questioning if his pain could have been relieved quicker if more appropriate action had been taken.
As for the accusation that I am not taking care of my son I find that grossly offensive.
However I do appreciate all the other balanced comments, and also the fact that many other children have had undiagnosed fractures (for all manner of reasons) and not been in any way scarred by it..

I do think that a parent should have been called if the child remained in pain.

DD1 (SN, in special school) fell over last year. Her teachers gave an ice pack, TLC, then thought they'd see if she was being dramatic (as per her tendency) by offering her a swimming session - her favourite thing. She went swimming, but then they noticed she was still wincing after and hadn't used her hand at all. The school secretary let her play with her date stamp and noted that she didn't use her hand either. So they called me.

Today I got an email, a text message, a voicemail and a call went through to DH at home because she fell off a scooter and bounced onto her head - there was only a graze but because she'd managed bizarrely to graze the top of her head from a fall from a scooter, they felt it was enough that I should be made aware.

Nobody wants any child to be suffering obviously but I am just wondering why it is being pointed out that it was someone from the admin staff who was responsible for not carrying out the correct procedure and why that makes a difference? Surely that part is irrelevant? If some people think that only teachers or teaching assistants, who know your child should be doing the first aid in school, what do you think is happening to the other 29 in the class whilst this is going on? All our staff are basic first aid trained with 2 members having an extra paediatric first aid training , anyone of whom is capable of the 'offence' of not realising an injury is a serious one. The office staff and even the caretaker and cleaner at our school all have the basic training with the secretary having the paediatric add on. By having these members of staff trained it means teachers are able to carry on with educating the children, and not disrupting the lessons.

Nathalie
that you felt people thought you were not taking care of your son. It is definitely not the impression I got from any of your posts on the contrary it does look like you are a very caring mum.

my DD broke her wrist aged 7, on a sunday afternoon. no swelling, no bruising, full movement. her First Aid trained Dad had her the next night and also thought it was just a sprain.

A&E on the Tuesday confirmed a greenstick fracture of both bones in her wrist. DD is now 14 and has never let me forget this...it happens.

I didn't say you aren't looking after your son, but there are only so many hours in a day and you seem to be spending quite a lot of time contacting the school and posting on here.

Yes, with hindsight it would have been better for you to have been called so you could have taken to A&E straight away. A mistake was made, but lots of people on here have said that even trained doctors and nurses could have made a similar mistake.

Thankfully your DS is ok now, so time to get over this and move on.

Wait, the school told you that he had been upset and crying all afternoon but still didn't call you?!

Wait, the school told you that he had been upset and crying all afternoon but still didn't call you?!
Where does OP say that? I must have missed it.

As far as First Aid training - at my school we have 3 trained and the course takes 3 consecutive days. There is no money for supply (and no supply available in my area). 9 working days lost and staff from classes. If all staff were trained that would be far, far more. We prioritise those who are most likely to encounter injury (PE, HE and one other) and the rest of us send someone to get them, as required. We are all trained if there is a pupil with high needs - (diabetes, epilepsy, severe allergies) so we can respond to a specific need in a named child.

Terrible for your child but my own fractured wrist went undiagnosed by my nurse mother and visiting doctor godfather. Only my non -medical Dad arriving got me taken to hospital.

Hope he gets well soon.

Hindsight is a wonderful thing, when DD1 had a fall I took her straight to A and E, I was told there it was just a sprain. A few days later it still hurt so I took her to our GP to see if it was healing as expected and was told it was and to encourage her to walk to strengthen the leg, even though it was still extremely painful, I also got a Doctor friend of mine to have a look and was told the advice that the hospital and GP had given me was sound.

Just under a week later it looked like it had started to bow so I took her straight back to A and E, where they didn't want to x-ray as they still thought it was a sprain, but did to shut me up and it turned out her leg was broken in 3 places.

Three trained medical professional missed a break and so sometimes school first aiders who have probably done a weeks course at most may sometimes make a mistake.

I could have complained about what happened to DD1, but I am her parent so ultimately it was also my mistake for not insisting on an X ray on the day of the accident.

DS2 broke his leg when we were on holiday in Cyprus when he was little. Both DH and I are first aid trained, we did all the checks, he could move his toes etc and we missed it. It was only after a sleepless night and more swelling that we consulted a doctor who confirmed the fracture after an x-Ray.

Last year, when he was 16, he was playing rugby at school and he hurt his shoulder. The PE teacher said to me he didn't think there was much wrong because DS didn't feel sick. I could see it written all over DS2's face, because I know my child, that there was something badly up. At that point he started to get neck pain so they called an ambulance. It was found he had dislocated and broken his shoulder in 3 places. One of those fractures was missed by several doctors despite MRIs and X-rays. They only noticed it once it started the healing process.