What would you expect school to do when child breaks a bone at school?

[ThatlittlebellwentBOING]

Just wondered what you would expect from the school.
My child broke her arm at school yesterday and when I got called I was told it looked broken. I got their as soon as I can which still took me 20 minutes. They were holding her arm for her with an obvious bend in it.
I wondered if it should have been stabilised by a first aider into a sling as leaving school holding it and getting into car was so difficult. They said they would have but had no slings at school? They had given an ice pack.
It seemed such a long time til I could get there and no one could get there sooner. My parents wondered why they didn’t call a paramedic.
I’ve never dealt with these issues before and wondered what would considered a normal procedure to follow.
Thanks

( child has arm in a cast now it was badly broken by a simple fall)

A paramedic couldn’t do anything. Calling an ambulance is a waste of precious NHS resources. Whilst an ambulance is coming to you for a broken arm, someone could be dying, and in genuine need of emergency treatment.
I think the School acted appropriately. Putting it in a sling could have been more uncomfortable/caused further damage. Best to let her hold it in the way that is best for her.
I hope you’re dd heals quickly. It’s a shock for everyone when things like this happen.

DOI - Orthopaedic Surgeon

Broken arm is NOT an ambulance call except in very particular circumstances already alluded to by previous posters....

Open (compund) fracture - paramedic can (sometimes) administer the necessary antibiotics

Dislocated joint - paramedic can reduce dislocated joint

Compromise of the blood supply or nerves - paramedic can triage to the appropriate treatment unit.

I see people, including children, day-in, day-out who manage perfectly well to get to hospital with broken arms, broken legs, even broken spines. A broken long-bone often needs urgent medical care, but it doesn't meet the criteria of an immediately life threatening condition requiring a 999 call.

Cherrysherbert the second time my dd broke her arm the paramedics gave her morphine and gas and air - there wasn’t anyway she was moving otherwise. It was an emergency & not a waste of funds or time. Broken bones can be an emergency.

On the first break dd didn’t cry but had obviously hurt her arm badly and an ambulance wasn’t needed to transport her

Each case will be different

I would let the ambulance service triage the call.

The pupil should be taken to A&E straight away (parent meeting them there). That could be by car, but if no teacher willing to drive, then it would have to be ambulance with a teacher accompanying until parent arrives at the hospital.

(Delay in seeking medical attention can be a CP issue, and would probably mean a 'structured conversation' by trained staff during the A&E visit).

I think what the school did was fine. As several people said above it depends on the injury. They usually do call an ambulance if concerned about circulation in the limb, if pain is severe and it will be difficult to move the child or if the fracture is open.

Been called twice, once by primary school , once by secondary due to broken bone and both times I have just picked up the child with no more than a wet paper towel and taken them to A&E myself. Certainly didn’t expect an ambulance to be called. The first time actually needed an operation to reset the arm, second time I had to try and support a 6 foot adolescent while he hobbled to the car but it never crossed my mind to expect the schools to do anything more.

The school called an ambulance when my DS dislocated his knee, because he couldn't walk or get up. Knee dislocations can cause nerve damage apparently.
The paramedics gave him gas and air.
Do people think an ambulance shouldn't have been called?

Now I'm wondering if I should have asked someone to help him into my car? The paramedics assured me it was right to call them but maybe they were just being kind.

I'm a school admin, but not a first aider. First of all a first aider would have giving him a sling if they thought it necessary as we do keep them on site. Secondly a member of SLT would have called 111 for advice. (111 would call an ambulance if they thought it was needed) If the parent didn't drive, SLT would have driven mum and child to the local hospital if required.

First auders are told not to manipulate if the person can hold in a certain position e.g moving the arm to put it in a sling could cause more damage hence why no slings in schools terrified of someone accusing them of more damage.

Secondly no an ambulance should not be called. An ambulance is needed for a life threatening situation. A broken arm is not life threatening. If they had of called an ambulance one of two things would have happened. Either you would still be waiting for it now as your child would be so low on the priority list or whilst it was attending your child’s broken arm someone could be having a heart attack and not receiving the urgent care they need to stay alive. As much as it is upsetting your child was not going to die from a broken arm.

Just out of interest, was the advice different in the 70's and 80's, when not so many people had cars, and couldn't so easily take children to hospital themselves? I remember so many children's stories of children falling off their bikes, and ambulances were called for broken arms and legs, but of course that may have been the age-appropriate advice for children; leave the decisions about NHS resources to the adults. These guidelines change every time the wind changes.

I also remember a teacher driving me to hospital in her car when I fell and hit my head in the playground, in 1986. She just did it without hesitation, no discussion, the questions were asked later. Things may of course be different now.

First auders are told not to manipulate if the person can hold in a certain position e.g moving the arm to put it in a sling could cause more damage hence why no slings in schools terrified of someone accusing them of more damage
That's what we were told.
This is from NHS: Avoid moving the affected arm as much as possible– it may help to support it in a sling that goes under the arm and around the neck; find outhow to make an arm sling
Sometimes a sling is appropriate. Sometimes it's not.
I would err on the not moving it around to fit it in a sling. If the person is already holding their arm in a slingable position then I'd use a sling.

There is no need for an ambulance.
There is no need to call 999. 999 is the EMERGENCY number, not an advice line, but it's great we are getting the 'I pay taxes' line. We have 111 for triage, advice and signposting, but why would people want to use that when drama llama status is given for 'and we had to call 999!'

The school did the right thing.
No ambulance was necessary as it wasn’t a serious injury (regardless of how it felt to the mother).
If you call an ambulance they would eventually attend because they do but it might be a good wait of up to four hours. They wouldn’t say anything because they see it all the time, but it’s a huge waste of resources.
No requirement in law for a first aider at the school for pupils. Most do have but the law is HSW legislation relates to a requirement to provide a first aider for staff.
A standard first aid box as required by law for employees does contain a triangular bandage.
Most people would not feel comfortable putting a sling on a child, with or without a first aid certificate, for fear of causing more damage or inflicting more pain. One day’s training doesn’t make you particularly knowledgeable.
The correct course of action is for the parent to attend and take child to A&E. That happened. It’s not very nice for the child to break an arm but the school did nothing wrong. Many children walk around for several days with broken arms and come to no long term harm.
My GP friend left her daughter two days, as they weren’t sure it was broken - and they were on holiday with an A&E consultant. These things happen and nobody is to blame.

They called an ambulance for my son - I met them at the hospital. Had just had half my highlights put in - Great timing

I think it’s high time some people were given basic training in when exactly it’s appropriate to call an ambulance.

^^ this is what is wrong with health care and why the NHS cannot cope. People who have no basic common sense and want hand all responsibility over to someone else for the smallest of illness/injuries.
Emergencies are life threatening events, this is not rocket science people/snowflakes.

Our school would have given a wet paper towel to hold on it and sent them back to class!!! No joke!!

Our school policy is to call an ambulance and headteacher accompanies child where possible. They could have other injuries etc, and staff can't be expected to drive their own cars.

I think school did the right thing. A broken arm doesn't require an ambulance (unless there's bone sticking out) we had a head injury at school a couple of years ago. Child had fallen from equipment and was vomiting. Ambulance said they could be up to 5 hours. They were taken by car and parents met them at the hospital

The last first aid training I did we were told not to use slings. The person/child with a broken arm is better placed to hold it in the most comfortable position. Putting a sling on incorrectly can cause more damage

My 80 year old mother took herself on the bus to A and E when she fell and broke her arm. Not only that she waiting until after 9am so that she could use her bus pass!

Many years working in school admin and the school did the right thing, apart from having a sling available. My favourite parents are the ones that come in with a pack of 5 from home bargains, asking if these would be useful for next time.

Absolutely no paramedics; it would go down as a cat C and the school would be closed before the ambulance arrived. If the parents were not available then two members of staff would accompany the child the hospital, but we would try to avoid this as it has an impact on the rest of the school.

That is totally unnecessary and one of the reasons why there are such long waits for ambulances.

STOP

Please stop saying people are wasting resources by calling an ambulance for a broken arm. It depends entirely on the fall, ther are some nasty breaks and if in doubt you call either 111 or 999.

The NHS says you should

If you think you or someone else has a broken arm or wrist:
go to your nearest accident and emergency (A&E) department or call 999 for an ambulance if it's a bad break – minor fractures can often be treated at a local minor injuries unit
avoid moving the affected arm as much as possible – it may help to support it in a sling that goes under the arm and around the neck; find out how to make an arm sling.

www.nhs.uk/conditions/broken-arm-or-wrist/

They were right not to call an ambulance even if they had they wouldn’t have treated it as a priority and you would have near them to the school because a broken limb is very painful but not life threatening. If the parent hasn’t been able to come quickly I would expect one of the staff to take her to minor injuries or similar. Ive had paediatric first aid training but it didn’t cover slings I would be reluctant to move the limb too much In case I caused further damage.

I had a call from the school when my son broke his wrist. He was clearly in pain. No medication had been given because the school won’t give it unless it’s prescribed but I picked some up before I headed to school. His arm was in a sling. I took him to minor injuries. Mind you one TA did suggest a wet paper towel and was shocked when I said I was taking him for an X-ray!

And of course minor injuries IF they are open.

Our nearest A&E is 45 minutes drive away so our school would have taken the child to minor injuries which is 5 minutes away.

On the basis last summer I was waiting over 2 hours with someone who had collapsed with possible stroke, but was now conscious (if somewhat confused) I wouldn't have thought an ambulance would arrive before mum

Good god who would call an ambulance for a broken arm?! Unless obviously it had pierced the skin.

Yes it hurts but the pain would be perfectly managable without the need of ambulance level stuff.

Maybe this is why the ambulance service are so over stretched.