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)

An ambulance can be needed in certain circumstances with a broken arm. I fractured my humerus a long time ago. I was in so much pain that I was doing the whole screaming my head off without knowing it thing, which I didn't even realise was possible. The pain was so extreme that there's not a chance that I'd have been able to get up and into a car.

An ambulance was called yes, by a team of doctors as that's who I worked with so evidently they thought I needed one even if they weren't sure it wasn't broken. The paramedics didn't think it was broken but gave me much needed entonox though it still hurt like hell. The very rude doctor st the hospital said he didn't think it was broken. One X-Ray later and it's revealed that it's badly broken and requires surgery. The radial nerve was damaged and I had months and months of physio therapy, and 18 years later I still have a lot of problems with that arm, so a fractured arm can be much more complicated than it appears.

Also just because one person isn't in a lot of pain, it doesn't mean that others might not be. It depends on the individual fracture and how it aligns.

I wouldn't think an ambulance appropriate unless there was very immediate danger, like lots of bleeding & high infection risk.

DD broke her arm at school about 1pm when I was working there, I checked her out, finished 10 minutes of work, off to MIU, and we were back by 3pm to fetch other DC. When DS broke his elbow this summer, that was on a residential so the teachers took him to A+E that evening & we took DS back for his cast fitting next day.

Nobody called an ambulance (nor should they have done) when I broke my arm in public (3x). An ambulance was called when I gashed my arm open extremely badly (about 3" wide, not bleeding so much, but very ugly). Really only got an ambulance cuz nobody else to transport me to hospital (miles from home in pre-cellphone days).

DH probably needs an ambulance each time he dislocates his shoulder, although morphine+other painkillers don't help. It's just the paramedics are better than me at dealing with someone in terrible pain. I'd rate the shoulder dislocation as more ambulance worthy than a mere broken arm likely to be.

A first aider can’t even give a prescribed inhaler - the casualty has to donit themselves. A parent can give medication but a first aider should not.

Are you seriously saying that a first aider should sit and watch someone die rather than give them an inhaler or an epipen? Don't be ridiculous.

There are too many variables to say "don't call 999". Each case should be treated on its own merit and one broken bone bone might need an ambulance and one might not.

There is no requirement in law, or H&S, to have a first aider on the premises for customers or service users. First aid at work is for the employees.

@sweeneytoddsrazor you could call it luck, or you could call it the ambulance system triaging appropriately! Clearly leaving someone for 2 hours having seizures is a catastrophic failure of the system, but it's not a race to the bottom where an appropriate callout for a small child in unbearable pain with a very bad injury (which needed immediate surgery) is somehow 'lucky'!

These threads lack all nuance and common sense. Clearly, a broken arm where a person is ambulant and in not unbearable pain is not an ambulance job. But to say 'it's just a broken arm, suck it up snowflakes', as if a broken limb can't ever be an ambulance-worthy emergency, is just idiocy of the first order. Both the ambulance service and an orthopaedic surgeon upthread are very clear that it can be. Anyone with an ounce of common sense should be able to see that all breaks are not created equal.

While I wouldn’t necessarily call an ambulance for a broken arm (unless seems multiple breaks or serious trauma, on its own), I would expect a splint to be put on the limb to stabilize it (stops the bones moving against each other unnecessarily, potentially causing further injury) - using a bundle of photocopying paper or a bendy text book if nothing else available (2 long rulers would be good!).

Then put the arm in a sling across the belly (not an elevation sling). If no triangular bandages available, one can be fashioned with a cardigan, a zip up hoodie, a male teachers tie, a scarf,......an outfit with sleeves from a dressing up box in a juniors classroom....

Ice helps, but stabilizing and elevation make a big difference.

And then making sure the parent has a way to get to hospital - if no car available to them, a teacher driving or arranging a taxi for sure.

I agree no pain relief (not allowed unless under instruction from medical professionals) and nothing to eat or drink (moisten lips if patient is very thirsty).

But also treat for shock - keep warm enough (not too hot, but prevent from getting cold, take indoors out of any wind or rain etc), and keep them sitting, preferably on the floor with their back to the wall in case they
Go unconscious and need to be placed in recovery position. Better to slide from sitting to lying on the floor than potentially fall off a chair or be much harder to assist to lying from a chair.

You do not need ambulance for broken arm. Yes monitor and if child is getting worse (eg medical shock due to internal bleeding), then ambulance. Supporting the arm is surprisingly effective as support.

A mere broken bone can damage the nerves and blood supply. A mere broken bone can cause such extreme pain that it isn't possible for the injured person to be moved without medical assistance. That was certainly the case for me.

If there's no obvious displacement and the person isn't in such pain that they can't move to the car then great, but sometimes it really isn't possible and medical assistance is required.

"a mere broken arm"

The irony of that phrase when right afterwards someone posts "the radial nerve was damaged and I had months and months of physio therapy, and 18 years later I still have a lot of problems with that arm" ?!!! There is nothing 'mere' about a broken arm. It's like saying 'oh it's just a mere cut' to someone whose arm has just been chopped off with a rusty saw.

And while there are many first aid reasons to not necessarily call 999 if you know what you are doing, if you are ever unsure, they prefer you to ring and be reassured you are doing it right, and can talk you through what to do if necessary- than not to ring and it be the wrong choice.

They may instruct you to take the patient to hospital yourself rather than tasking an ambulance, but the dispatcher can also give good advice and support even in that case.

I'd have dropped everything and taken my DC to A&E. No need to call an ambulance. It's painful but not life threatening. Those guys are needed elsewhere.
I'd expect a sling but to be honest, my main concern would be a clear diagnosis of a break which would be made by the on duty docs at the hospital.

Whilst I am very aware that first aiders at workplaces are there for staff not general public, I am a bit shocked that this apparently applies to schools too. Surely there is a duty of care towards the children and this should involve first aiders for children by law. Do care home for the elderly only have to have first aiders for staff too?

Sorry? I should have said call 111 - we only have the 999 service in ireland and not the lesser 111. They. Can decide if it needs upgrade.

The school would have most likely been told that an ambulance would take a significant amount of time to get to school, most certainly longer than it took you to get there.

I think they did the right thing. You were there very quickly and able to get her to hospital probably quicker than waiting for an ambulance.

I think its a judgement call about calling an ambulance and they were right on this occasion. If a child had experienced concussion or was in serious pain then it might have been otherwise.

Dont use up your energy getting cross with school.

Still laughing at "that's what I pay my taxes for."
Like it's some sort of choice!

@nokidshere a first aider is allowed to administer an epipen. They are not allowed to use an inhaler or an insulin injection. They can help but it has to be in the patients hand and the patient has to be the one pressing it. That is the law, I did a 4 day renewal course less than 6 months ago and we were explicitly told that.

I think they did the right thing, a sling placed wrongly can cause more harm than good. I was always told that a rational concious casualty will always hold themselves in a way to do the least harm and should be supported in doing so if there is a lack of knowledge.
An ambulance may be required but that would be a judgement call at the time, it likely would have taken longer than you did.
In junior school in the 80s 2 of my classmates broke their arm within a 1 hour lunchtime. Both got put into a teachers car as soon as it happened and driven to hospital by that teacher, I dread to think how people would view that now.

I wouldn't call an ambulance for a fracture unless there were other complicating factors such as bone piercing skin, underlying medical issues. Generally you get to the hospital. Broken bones are common and would take up the whole fleet of ambulances if it was standard to go to a&e in one.

Ambulance not required as they called Mum who could probably get DD to hospital quicker than waiting for an ambulance would.

A sling....that would have been a better idea and tbh if the school told me they didn’t have one I’d make sure they got a new first aid kit with a sling ....even if I had to buy it for them.

Apart from. The sling they did all the right things.

Jeez some of the replies on here are bordering on hysterical. An ambulance for a broken arm? Seriously!!!

Yes I would perhaps have expected them to support the arm somehow but the fact it took so long for you to get there is not the schools fault. Sounds like it was just a genuine accident. On the positive side, it’s good there was someone sitting with her. That wouldn’t always happen for that length of time

Ambulances are for emergencies only, absolutely ludicrous to suggest this would have been appropriate. The only exception would be a compound fracture. CHild would have been waiting hours as it would be so low on priority.

I am not medically trained. If I don't know what to do, I would call 999 so I can speak to someone who does know what to do. That is what I pay my taxes for.

Good grief! No that is not what you pay taxes for!! Paying taxes doesn't give you a free pass to misuse the 999 system!!

It's an emergency line, not a First Aid advice line!

111 is the number for non emergency medical issues.

If it's a simple break (ie no blood/bone sticking through the skin) then I'd expect a phone call to the parent to collect and take the child to A & E. I'd expect my child to be sitting quietly, with their arm properly supported and with someone comforting them when I collected them. I'd hope their arm would be somehow bound to their torso, perhaps with a towel or some bandaging, just to keep it still. Not having a sling is no excuse - you can always improvise, can't you?

If it's a fracture where there's shattered bone coming through the skin, that IS an emergency and I'd expect them to call 999 without any messing about. That kind of break can be life changing or even threatening if the bleeding is heavy as it might mean damage to an artery.

Someone with a life threatening respiratory condition here, I go to hospital frequently, always by ambulance and always as a priority under blue lights. I know my local paramedics really well and get a sense of the frustrations they feel for some of the jobs they get called out for.

It's a myth that you will get a telling off for dialling 999 for inappropriate reasons, unless it's for a non medical reason, if you request an ambulance for a medical matter it will come eventually. So some of the reasons an ambulance has been called in my area recently:

A painful splinter - not taken to hospital
A flare up of eczema - not taken to hospital
Constipated young adult, as in hadn't had a dump for a few days!!!
Sprained ankle
Sore arm, person thought it was broken after bumping it on a doorframe
Stubbed toe - person wanted pain relief
Forgot to get a repeat prescription
Saddle sore after a long bike ride
Stiff legs after going to the gym for the first time in years

They also get called out frequently for coughs, colds, upset stomachs, sore throats, insect bites and drunk people (which I do understand can be life threatening it they are unresponsive)

I'm really lucky, I never have to wait but I really feel for the people who do genuinely need an ambulance for seizures, strokes, nasty accidents etc and have to wait hours because paramedics are wading through minor injuries and illnesses because people don't understand what a medical emergency is and think a potential broken toe is a life threatening accident.

Do I worry that the service is under so much strain that one day an ambulance might not make it to me in time - yes, every day.

Maybe the NHS should charge people for an ambulance if their condition is non life threatening.

I am baffled by the people on here who think an ambulance should have been called!? Are you serious.... for a broken arm... get a grip. Ambulances can't get quickly enough to people having strokes and heary attacks. A broken arm is not remotely a priority.