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?

If it's any consolation, my friends son had a broken arm for a good few days before it was picked up. It was the increasingswelling and pain and gradual inability to use his limb that prompted A&E. It just wasn't that obvious at the beginning. The first aiders tried to assess him. I'm sure they would be horrified to have missed it, just as my ex A&E nurse friend was to have missed his sons. Hope your son is much more comfortable in plaster and it fixes soon.

I think the tricky thing is, the OP hasn't said at what point he had started crying to go home. Do you know (objectively) at what point this happened? Given the fact that when you're in pain 5 mins can seem like 5 hours, if he had started crying 15 minutes before home time ( and mum worked 15 mins away) then there's no point in calling, but it would look to the child as though nothing was done.

Further, I note that the mother decided to take the child home first rather than going straight to A&E. If it was so immediately obvious and the child was crying so much - why didn't she take the child straight to A&E? This makes me think that perhaps the pain was increasing, which is why it was not immediately obvious to take the child straight to A&E and not to go home first?

So before I criticise the school, I think I would want to know these answers first because it suggests increasing pain rather than immediate which could be why the school didn't do anything ( because it hurt less then). Increasing pain is incredibly common with fractures.

I have recently undergone first aid training and the detecting of fractures was not covered.

But with respect all of these stories about fractures which took 10 years to diagnose are irrelevant. This little boy had an obvious fracture which was diagnosed and treated as soon as he was taken to hospital.
Which would have happened hours earlier if the childs parents had been informed of the incident.
Which is the whole point of the thread

School made a bad judgement call and it's not in any way, shape or form unreasonable to expect them to look at how their procedures for assessing/ erring on the side of caution and most importantly INFORMING parents immediately might need to be tightened up.

But I think I already said all that further up thread so no doubt there will be 30 more posts with missed fractures/'you can't expect X ray machines in schools' type posts.

And as for the snipey 'cry baby' post you should be bloody ashamed of yourself. Nasty.

It wasn't obvious, that was the whole point!

Also, fractures in children are hard to identify, that is fact.

And it is only a buckle fracture, even harder to spot

It was obvious as soon as he was assessed in A&E. Which should have happened hours earlier. And would have done if his parents had been informed that he'd taken a tumble, and remained upset and crying for some time after the incident.
Which is the whole point!

Yes, but fractures can take hours to present themselves. So they could have assessed the child at the time, found nothing only for the injury to reveal itself hours later. This has happened to my daughters. An initial assessment could have revealed nothing, in which case the school has done nothing wrong. My friend who is a nurse, and assessed my daughter's fractured hand at the time it happened (and told me it was fine) says this is incredibly common.

And it should have been up to the childs parents to decide if they took him to a&e straight away, where his fracture was identified STRAIGHT AWAY.

I can't understand why that concept is SO difficult for people to grasp.

We lived next door to a doctor and his son went overnight with a broken ankle- he didn't think it broken. Easy to miss. My mother went a week with a broken wrist.

But Actifizz, the fracture was identified at the hospital straight away hours later. How do you know there was anything to be seen at the time? This is entirely your assumption, and there's nothing in the OP to suggest that was the case. In fact, the OP says they checked it at the time and deemed it to be fine. This is common in fractures and happens a lot.

I'm reminded of a time when my daughter had a gymnastics birthday party, and one little girl hurt her ankle. She cried, we pulled her to one side, she was assessed by the paediatric trained first aider at the time, and my dad who was also a first aider and she seemed fine. She walked at least 6 metres (across the length of a gym) with no complaints at all. She didn't hobble, flinch or anything she walked perfectly normally. After the initial pain, she didn't cry when it was touched, she went on to continue running around as if nothing had happened. We asked her if it hurt, and if she wanted us to call her mum. She said no she was fine. There was no bruising no marks, nothing! Later on that evening, I had a furious phone call from the mother who was angry that by the time the girl had got home, her ankle had swollen and black and blue. But what should I have done - the girl fell over and hurt herself, she then walked perfectly normally, didn't say anything hurt, had no obvious injury at all, and didn't want me to call mum. I told her mum at the end of the party and she left perfectly happy. I know I have the photos of her running on her foot quite happily after the event! Yet, By the time she got home it had blown up and the mother just would not believe me that there were no signs at the time. She was insistent that I must have seen something. Nope, not a thing. So should I have phoned her and called her in to say and "your daughter fell on her ankle, but there is no sign of any bruising, she can walk perfectly normally, does not seem to have any pain, is happy to run on her ankle and doesn't want me to call you". That just seems overkill! Yet she ended up in A&E hours later with her ankle.

Quite often injuries do not always present themselves much later and you cannot judge what is what like hours later to say what it was like at the time.

And how do YOU know that the fracture wouldn't have been picked up on x ray immediately ?
You don't. A little boy was left crying and distressed and wanting his parents for a lot longer than was nessecary because other people decided, having not done an appropriate assessment NOT to inform his parents.

I really don't see the point of saying it again. It's an absutely classic example of MN deviating wildly from the point of the OP.

Yes fractures can be missed, yes first aid training can be woefully inadequate, no, humans don't have x ray vision, no, schools don't need x ray machines, yes, great auntie Sue's uncles gerbil had a misdiagnosed fracture for 40 years.
In the context of THIS thread and THIS situation the little boy was left distressed and in pain for far longer than he should have been.

And now I must desist from further debate as I run a very real tisk of sustaining a skull fracture from 'banging head against wall syndrome'

I played competitive junior tennis for two weeks with a broken arm

I hope your son feels better soon!

Actifizz - can you please tell me at what point during the school day did the boy started crying and how long he had been left crying for? And to what intensity was the cry whilst at school?

If you RTFT Lech, the OP gives you a pretty good indication of all of the answers to your questions. Are you a teacher or a TA by any chance ? Or work in a school ?

Actually don't bother answering. I have a fairly good idea

That's where I disagree, Actifizz. The op picks up her child from school and doesn't even look at the arm herself until she gets home. She says so in her OP. So, if the child such unbearable pain, why did she not check the arm straight away? If my child was in unbearable pain I would not drag them home first, I would check out the arm straight away, even it is only 30 seconds from home.

To me, the mum sounds like a very caring mother, so I'd be very surprised if she did that. It sounds more like the child was not in enough pain to make the mother stop straight away and look at it as soon as she found out about it.

Call me old fashioned, but I like to be receipt of all the facts before I start making judgements about anything negligence and I just don't we know enough yet to make that call. That's obvious by the fact that you can't say whether the boy had been crying all afternoon, had restarted crying when his mother turned up etc etc, too much we just don't know.

Actifizz - are you the OP?

I hate being informed every time my child falls over and gets an Ow-ee. If it's a significant injury, I'll know and they'll know. Otherwise my kids will ham up any injury if they think it's a sure route to time off school so please do not treat every incident as serious.

I was helping out in school last week; 2 girls ever so barely slightly bumped heads. Both giggled, neither cried. It was a nothing event. But I could see poor TA's face fall when she realised that she'd have to fill in the paperwork. That's right, they had bumped heads after all.

I had a call a few years ago from school about my Ds as he had hurt his knee and gad to be helped off the play ground as could couldn't walk!! They called me and I suggested I speak to him at which point I assertained that he was ok just dramatic . Lucky I knew the TA looking after him and was was able to explain he has form for being dramatic!!
Schools can't win !

If when you picked him up you were told "ds has fallen over and hurt his wrist, it didn't seem serious at the time but you may want to get it checked out" then that is not unreasonable. School staff responded to the incident and judged (based on amount of swelling and how much pain your ds seemed to be in) that it wasn't a blue light job, it was an ice and keep an eye on it job. They turned out to be wrong. But some kids will scream the place down with a tiny bruise, others will ignore a broken limb.
If the first you heard about ds injuring himself was from him when you got home, that is cause for complaint.