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?

Sorry to hear about your ds' arm OP.

Ds was sent home from A&E with a broken leg as the doctors weren't sure and didn't want to xray unnecessarily.

My guess would be the swelling came later so wasn't apparent when he saw the first aider and your ds didn't appear to be too uncomfortable so they decided urgent medical attention wasn't warranted. It's also perfectly possible that your ds doesn't remember what the first aider asked him because he was in shock. Or because he's 7 and a lot has happened today.

Hope he is comfortable now?

Right, last post tonight on the subject:
It is quite possible to use a computer and look after children very well otherwise everyone on here would be neglectful.
The point about admin staff was simply the fact that DS didn't know the person very well and they would not have known him very well, and might not have known if he was behaving 'normally' or not and he might not have felt as confident speaking up.
The poster who is at a school where everyone has at least basic first aid training - this is exactly what I would want and expect for every child.
And if we all just 'let it go' when things went wrong, how would standards ever be raised?

This happens to me when I was 12, on a residential. A broken ankle was missed. They told me to walk on it and were cross and forceful with me when they saw friends giving me piggy backs

The next day (or perhaps two days later, I can't remember) they called my parents, who took me straight to a&e. To this day I am astounded my parents did nothing and nothing was actually done.

YAsoNBU, if a child is in pain you check it out! I hope your dc is feeling better now

Did nothing to complain, I mean.

When I was a teacher, we were all first aid trained. There was nothing in the first aid training on how to spot a broken bone though. I will always remember one afternoon, having seen my own class out, when I spotted a Y3 boy trying to get his coat on in the cloakroom. He was almost crying in pain, and holding his arm against his chest. It was obvious to me immediately that it was broken, having had a broken arm myself. I asked if it hurt even when he didn't try to move it, and he said yes. It turned out the accident had happened at playtime, and the fracture had been ok in the afternoon (quietly rested on a desk) because it hadn't displaced until he had tried to put his coat on to go home. I told after school club to phone Mum asap as I suspected it was broken. It was.

The A&E doctor we saw didn't think my DD had broken a bone. Especially as she could do all of the movement requests (DD wanted to do the right thing!). After I insisted on an Xray a broken bone was discovered!

No swelling or loss of movement at all.

Was he in pain, if so that isn't good that he was 'ignored'.

gorionine Another poster hinted at it, so I didn't read up properly. Still think the OP overreacted. If he was distressed, saying that his arm hurt, then the school were BU but otherwise, not sure what could have been done differently?

Anyway, OP, wish your little boy better. Do you they still do casts that you can sign? Or am I getting old?!

I am a first spider at school and we do ask all these questions, look at the site and all the stuff you would do as a parent normally too.

I, 2 other FAider colleagues, the HT his 1:1 TA and the Class teacher still missed a child's broken collar bone last year. The child was upset and crying but no more than his normal reaction to an accident - he is autistic and he was displaying his normal behaviours to any slight knock. And he did calm down too.

He could move it. He took his own jumper on and off during the lesson. And crucially where he was pointing and saying hurt wasn't actually his collar bone.

By the time his mum got him home swelling had started to show and she could see the injury spot. And obviously she knew his reactions far far better than any of us. Sadly it was broken. Fortunately she didn't point the finger at us, she knew we'd done our best for him but this one time it hadn't worked.

No teacher and TA in my experience will deliberately leave a child in pain. Many if us are parents too and treat injured child like we would are own and tbh probably even more carefully than our own.

As a parent my own child broke her foot. I didn't realise. Neither did dh. We sent her to school the next day as normal. It was actually school who sent her home and advised a and e. But it was broken and even those closest to her missed it.

Broken bones on children are very easy to miss.

Although he was dealt with by the member of office staff at lunchtime - a time of day when the teachers are reviewing the morning's work and preparing for the afternoon session as well as perhaps bolting down some lunch - I'm assuming he was back in class with his usual teacher and perhaps TA all afternoon? I'd have thought that gave them plenty of time to spot if he was unusually sad or withdrawn. Which makes me think he probably didn't look too bad.

In our case we didn't call home as the child had calmed down and was moving his arm. the actual incident which caused it was also very minor and we honestly didn't even consider the possibility of a fracture. We spoke to mum when she arrived at school instead. The poor child burst into tears when mum arrived - like many children will do, they hold it in and then release when mummy or daddy come. We just didn't know.

Our FAiders - 3 TAs and 2 caretakers - have done a 3 day general FA course. 1 of the TAs and also the HT have done the paediatric FA course. More staff have done the one day FA course. To be honest the non paed course is rather generally and doesn't really focus on children at all.

We only call home if the child is continuing to be distressed or we think they need to be taken home or to a&e.

We did trial phoning home after any head injury but parents didn't like it. So we've gone back to only calling if it is deemed necessary by the FA, usually then checked by a second too.

DD's friend went home from reception with a broken arm. She'd fallen in the morning and had been seen by the first aider, she wasn't crying or making a fuss and had changed for PE, been riding on the bikes and down the slide etc, put her coat on and so on. Her arm was still sore two days later so her parents took her to A&E - a small fracture!

Another issue with the FA training for all staff is that the qualification only lasts 3 years. So it becomes even more costly to keep everyone up to date paying for the training that often including the cost of supply cover each day out too.

ok was not going to say anything else tonight but seeing as DS is now in bed will give you his quote as I was helping his injured arm into pyjamas 'I was crying to go home because it was so sore, but they couldn't understand what I was saying because I was crying so much..' hope this answers any questions as to whether or not he was distressed enough..
heart broken for him.

If he was crying and distressed all afternoon then yes, school have not acted appropriately. They should have called you if he was still upset and crying and in visible pain after a little whole had passed.

My daughter broke her leg and I didn't realise until the day after. I thought she was just very bruised.
I think this is quite common.

I broke my wrist quite badly as a ten year old - I was able to move it round and it didn't swell. My Mum was a nurse. I wasn't taken to the hospital until the next morning when I said it was quite sore and it had swollen a bit by then. The doctor in A+E was pretty surprised when the x-ray came back, so I don't think you can really expect first aiders to diagnose a broken arm unless the bone is sticking out.

I don't think its re-training in first aid the school staff needs, I think it's simply training in the 'best practice' when there is an injury.

I've been a first aider at school for many years and it's a thankless task (which in most places is voluntary), getting it right with every parent.

There are thoses that refuse to come and collect when I tell them there's been a head injury and we are not prepared to have them in school, those that bring them back after a 'wasted' journey to A&E and those who complain that we should have called an ambulance immediately!

I will always phone the parents. I usually say, 'I am not a HCP, you are the parent and I'd be happier if you made the decision'.

It is tough, when you've probably already dealt with 20 cuts, snotty noses or very minor silly things, but ultimately, you have a duty of care to the children and a promise you've made to the parents to look after their babies in school!

Long and rambly OP, sorry! Basically, they need a knew best practice for dealing with possible injuries, not more first aid training!

I love the fact that Hulababy is a "First Spider" at her school

surely if your son was in a lot of pain and was complaining in school they would have rang you. i would guess the extent of the injury wasn't apparent at first and your son didn't cause too much of a fuss about it. ultimately waiting a few hours before going to the hospital doesn't change anything so i would let it go.

natalie, I have not read the whole thread, but the idea of all teachers being first aid trained is a non starter.

For a start, a first aid situation requires someone with unlimited time to concentrate on the injured or sick child, this is not remotely possible for teachers.

First aid situations happen repeatedly throughout the day, and cause massive disruption to designated first aiders, they can only realistically be staff who's tasks can be stopped and started randomly.

The insurance required to be a first aider is prohibitive. The unions discourage teachers admitting if they have first aid training, and you may actually lose your union support if you are personally advised not to, and do so anyway.

I never ever ever give first aid to a child at school. I don't even make any sort of judgement about whether first aid is required or not, or if the child is faking or not. I just send to a first aider/ call a first aider and they make all the judgements. they are paid extra to do so. Meanwhile, I continue teaching the other 29 children.

These days, you need two people, one as a witness, before you physically touch a child. It requires checking paperwork before you start, and completing much paperwork when you have finished. It is a complex and expensive situation, nothing like simply treating your own children at home.

Having said that, I am first aid trained. I would never officially admit that to the school, or act in any non life threatening situation. Of course, in a life threatening situation, I would, and have taken action, and dealt with the legal and administrative complications after.

I know of a child who did not get her broken arm diagnosed until a week after she fell. it just did not hurt that much at home or school.

NatalieMc82 wow that must have been awful for you both! Hope your son is ok!!

I agree with some of the posters that chances are that it didn't look as bad and although they may not have asked the questions they would have been watching him for movements etc so it is possible that he could move it ok at the time it happened and it is only later as the swelling has come out that the pain increased and movement decreased.

The fact that he says he was crying to the point he couldn't make himself understood would suggest that his pain has been misinterpreted as shock which may account for why they still failed to call home. What appears to be a playground fall and then shock and upset would not normally be a reason to call a parent - although you are correct that his classroom teacher who knows him best should see immediately that he was not himself - was he with his normal class teacher? I only ask because my step daughter at 7 regularly had lessons with teachers other than her standard one for things like spelling.

I work with young children on a voluntary basis outside of the education system and i am relatively highly trained in first aid. If i can see that a child has easy movement i may not ask the questions but i would make notes that i have checked and this should all me noted down in the accident book so it would be worth you requesting a copy of the entry relating to the incident so that you are armed with the information they recorded.

Please don't think that i am trying to make excuses for the school as i am not and they have massively failed your little boy, but I do think that you need to keep an open mind and not just rely on what your son has told you - questioning an upset 7 year old doesn't always give the best results ime.

I am glad that the school have contacted the HSE and that they have launched their own investigations as this shows that they are taking it seriously and that they are aware that somewhere a process has failed. Whilst unfortunately that doesn't help you r son it will lead to improvements that would hopefully prevent this happening to another child.

Hope you get the answers you are wanting and that your son heals quickly!

I think you are overreacting.