Kid broke his arm--did we all handle this properly?

[Garga]

Today, I was at a playground.

 

An 8 year old child who was part of a daycare group fell off the monkey bars and broke his arm. It was an accident, and nothing could have prevented it. No one was at fault.

 

Be we clearly heard the arm snap and the child screamed in pain for a few minutes. He stopped screaming after a few minutes, but then was moaning and it was clear that it was some serious pain. His eyes were rolling around in his head and he was pale.

 

A part of his arm was bulging.

 

The daycare worker was alone with the children in her care (there were about 8 children in her care.) She called her daycare supervisor to come to the park to instruct her on what to do. I don't know if someone told the child to lie still or what, but he lay there completely still, moaning, and crying out occasionally.

 

The mother was not called at this time, as the daycare worker did not have the mother's number and was waiting for her supervisor to arrive. The supervisor brought the child's emergency contact number, but did not call until after she arrived.

 

I was at the park for a birthday party, so was with a group of friends. One of the mothers in my group went to the boy and comforted him, as the daycare worker seemed a bit flustered and was busy making the phone call, and no one was speaking to the boy and comforting him and saying things like, "You're doing great, buddy," until my friend walked over there (5 minutes after the break.)

 

My group was distressed by the fact that there was going to be a wait (about 10 minutes) for the supervisor to arrive, and the fact that the boy's mother wasn't called as soon as possible.

 

At that point, before the supervisor arrived, we insisted that the daycare worker on the scene call for an ambulance. Since none of us were the child's mother, we felt that no one should move the child unless they were trained medical personnel.

 

The daycare worker clearly wanted to wait for her supervisor. Remember--the child is moaning, eyes are rolling and he's getting more and more pale and is almost hyperventilating from the pain. We are mothers and were feeling sick in our stomachs at the sight of the child and imagining what we'd want someone to do with our own child.

 

It sounded as if the daycare people's plan was to drive the child to the hospital themselves.

 

But after we insisted that she call an ambulance, she finally did.

 

Now--the question: Did we overstep our bounds? Did the daycare worker do what was appropriate? What if the parents didn't have health insurance? I know that ambulance charges can easily be between $400 and $500.

 

Should I be outraged that there was a delay because there was a wait for the supervisor before calling for an ambulance? Or should the daycare people be really irritated at us overstepping our bounds and creating a mountain out of a molehill?

Edited August 22, 2012 by Garga_

[NatashainDFW]

You did the right thing. The threat of shock is very real and it sounded like he was having major, major pain issues. Its one thing if its a minor break and the child is tolerating it well and another when he is pale and his eyes are rolling back into his head. Honestly the daycare licensing agency in your state should be notified so they can help them come up with clearer guidelines for the future.

[jhschool]

You were right in insisting on an

ambulance!

Costs can be dealt with later.

A broken arm is *not* a molehill.

You don't know if the child has

juvenile diabetes (could die from the

shock), some kind of other condition that needs some other medication,

etc. A broken arm (that you

heard snap!!!) needs *immediate*

medical attention, not waiting for a

supervisor!!

You did the exact right thing!

[ILiveInFlipFlops]

You absolutely did the right thing. Shock was a very real concern, as was further damage if they'd taken them in their own car. Even if the parents don't have coverage for the ambulance, they'll figure something out. Increased bills from a more complicated medical outcome would be much higher than $500 for sure. Worst case scenario is that their son suffers even more!

 

I agree about calling the licensing board too.

 

That poor little boy :(

[Joshin]

You did the right thing. I probably would have called 911 myself! A broken arm isn't likely to kill anyone, but shock can.

 

IMHO, the daycare worker was very poorly trained. I'm sure it varies by state, but when I worked at preschool we had to call 911 first, then we reported it to the director who would contact the parents. Accidents that happened in our care were paid for by our liability insurance, so the parents wouldn't have been responsible for the bill anyway. I figure that's likely the case in most states.

 

I'm also shocked that only one worker was in charge of that many kids for an outing/field trip!

[Dmmetler]

As a former daycare worker, the teacher probably didn't have the parents' phone numbers right there, and the supervisor would have called the parent and gone down the emergency contact list so someone would be there to meet the child at the hospital. In addition, the supervisor would have been able to pull the "permission to treat" form and authorize treatment-so that's what the 10 minute delay was. Without either the parent or that form, the child wouldn't have been treated for anything non-life threatening. I do think she should have called 911 FIRST-because of the chance that there was something more than a broken bone.

 

As far as calling an ambulance or not, for something non-life threatening, in most cases you'll be seen about as fast if you drive in-and for a broken bone, some outpatient centers have X-ray machines and could do the same thing as the ER with less wait, so it might have been better, depending on your area, to wait. But as a mom, I have to say that if my child's writhing in pain, especially after a bad fall which could potentially have caused other injuries, I'm probably going to call the ambulance, too-and worry about the bill and whether my insurance will cover it later.

[regentrude]

I am pretty sure the daycare worker has strict orders what to do in case of an emergency and is not authorized to call an ambulance unless there is clearly a life threatening situation. The parents may have filled out a form authorizing the daycare to transport the child in a non-lifethreatening situation.

I also find it understandable that she could not contact the mother immediately, because the emergency contact information is at the daycare in the office; I doubt every worker takes all the info on a park trip. You do not know whether the supervisor contacted the mother as soon as the daycare worker called. So I do not think the worker was remiss.

 

I would have hoped that a daycare worker would be trained in first aid and CPR and would assist the child (shock prevention!), but in this sue crazy country it is possible that she may not be allowed to do so to because of liability issues. I actually feel sorry for the daycare worker because she was bound by rules that rendered her unhelpful.

 

Did any of you moms offer first aid? That would have been my first thought, before calling the ambulance.

Edited August 22, 2012 by regentrude

[Dobela]

1 teacher to 8 kids is actually a low teacher to student ratio for our area. They would be allowed to have 15-20 here at that age.

 

When we took kids out, every center I worked for made me carry the emergency sheets with me so there would be no hesitation in an emergency.

[elegantlion]

As someone who is not insured, I still think you did the right thing. Last time we used the ambulance it was 1200.00, that was for dh. However, as a parent, I would be upset that I wasn't called to the park and I would not want my child being transported by childcare personnel to the hospital. Their liability would be much higher, just looking at it from a business perspective.

 

It's one thing for a scratch or a possible broken bone, but this obviously was more severe.

[Based on Faith Academy]

I am actually surprised that they didn't have the emergency contact information with them. I know as a church we bring everything with us on any outing that we go on whether it be down the street at the park or out of town. You did the right thing. As a parent, my kids safety and well being are way more important than any amount of money I may end up having to spend out of pocket.

 

 

~Christina~

[ILiveInFlipFlops]

I am pretty sure the daycare worker has strict orders what to do in case of an emergency and is not authorized to call an ambulance unless there is clearly a life threatening situation. The parents may have filled out a form authorizing the daycare to transport the child in a non-lifethreatening situation.

I also find it understandable that she could not contact the mother immediately, because the emergency contact information is at the daycare in the office; I doubt every worker takes all the info on a park trip. You do not know whether the supervisor contacted the mother as soon as the daycare worker called. So I do not think the worker was remiss.

 

I would have hoped that a daycare worker would be trained in first aid and CPR and would assist the child (shock prevention!), but in this sue crazy country it is possible that she may not be allowed to do so to because of liability issues. I actually feel sorry for the daycare worker because she was bound by rules that rendered her unhelpful.

 

Did any of you moms offer first aid?

 

I don't think the daycare worked was remiss in not calling the mom at all. I think that delay was completely understandable. But IMO, a fall bad enough to break an arm with an audible snap is a fall bad enough to cause a hidden head injury and require an ambulance, particularly for a child, who may not be able to articulate exactly what they're feeling. I can't imagine a policy that says otherwise.

[Flowing Brook]

Honestly I think you over stepped your bounds. The mother should have been called and she should have made the decision to call an ambulance or not. If the delay was too long to wait for the supervisor, perhaps you could have offered to comfort the boy so the daycare lady could call her supervisor back and get the number.

[justLisa]

I don't think the daycare worked was remiss in not calling the mom at all. I think that delay was completely understandable. But IMO, a fall bad enough to break an arm with an audible snap is a fall bad enough to cause a hidden head injury and require an ambulance, particularly for a child, who may not be able to articulate exactly what they're feeling. I can't imagine a policy that says otherwise.

 

That's what I was thinking. A head injury is kind of an ASAP thing. Pale, eyes rolling back. Seriously, that seems like a no brainer.

[Kaleidoscope]

I'm shocked they didn't have all the emergency paperwork with them. When I worked in day care we never left the building without all the medical release forms and contact numbers with us. Though 1 to 8 isn't a high ratio we also never were allowed to leave the building with just one teacher. Even if there was only 1 child there were 2 teachers.

[Kathryn]

I would have done the same or else called myself. They should have procedures in place, and if so, they should have been able to explain them to you as you insisted on 911 being called. It sounds like they didn't.

 

We were at a park next to a police department last spring when a child fell from the top of a slide about five feet up and hit the back of his head. He had a small cut on the back of his head and was crying as his mom held him. The police came running out and insisted that nobody touch him and insisted on calling an ambulance rather than have his mom drive him somewhere.

[Mallory]

When we took kids out, every center I worked for made me carry the emergency sheets with me so there would be no hesitation in an emergency.

 

I am actually surprised that they didn't have the emergency contact information with them.

 

I also am surprised that they didn't have contact info with them. We always had to carry it with us if we left the school grounds. I wonder if this is differnt by state. Of course, I haven't worked anywhere in several years, but I wouldn't have had a phone with me. Even during times I might have actually owned a cell phone it would have been back at school in my car or purse, not on a walk to the park.

 

I also think 1 to 8 for school aged kids is a great ratio, I can't imagine it is lower in any state.

 

 

If this had ever happened while I was teaching, I would have asked someone at the park to go to a phone (not as many cell phones then) and call 911, and someone to go to the school and get the director.

 

I think you did the right thing.

[Walking-Iris]

Seems to me that the daycare worker seemed a little flustered what to do in emergency situations. Leaving the child to strangers (no offense to you and your friends help at all--seems like it was needed) would have bothered me as a mother. I would want to know the workers would know what to do in those situations. One worker alone with 8 kids would have bothered me. Who is able to keep an eye on the other children in that situation? How to get the other children back to the daycare safely *and* transport the injured child as well. Who accompanies the scared injured child in the ambulance? The other children obviously can't be left at the park. And I also agree that anyone caring for another's child, daycare or otherwise, ought to be able to contact the parent's right away as needed.

[TranquilMind]

Garga: He stopped screaming after a few minutes, but then was moaning and it was clear that it was some serious pain. His eyes were rolling around in his head and he was pale.

 

A part of his arm was bulging.

 

My group was distressed by the fact that there was going to be a wait (about 10 minutes) for the supervisor to arrive, and the fact that the boy's mother wasn't called as soon as possible.

 

At that point, before the supervisor arrived, we insisted that the daycare worker on the scene call for an ambulance. Since none of us were the child's mother, we felt that no one should move the child unless they were trained medical personnel.

 

The daycare worker clearly wanted to wait for her supervisor. Remember--the child is moaning, eyes are rolling and he's getting more and more pale and is almost hyperventilating from the pain. We are mothers and were feeling sick in our stomachs at the sight of the child and imagining what we'd want someone to do with our own child.

 

 

It sounded as if the daycare people's plan was to drive the child to the hospital themselves.

 

But after we insisted that she call an ambulance, she finally did.

 

 

Now--the question: Did we overstep our bounds?

Oh, my goodness! NO! You didn't overstep your bounds. She had no clue what to do! This is the stuff that daycare nightmares are made of...what do you wanna bet she has NO kids!

 

Did the daycare worker do what was appropriate? What if the parents didn't have health insurance? I know that ambulance charges can easily be between $400 and $500.

 

No, she did not err on the side of caution.

 

 

Should I be outraged that there was a delay because there was a wait for the supervisor before calling for an ambulance?

 

Yes. Or at LEAST the MOTHER, immediately, who would have probably said to call the ambulance. Yikes

 

 

Or should the daycare people be really irritated at us overstepping our bounds and creating a mountain out of a molehill?

 

They can be irritated all they want. Idiots.

[Pamela H in Texas]

I can't imagine that any accident to that magnitude wouldn't automatically be called into licensing. In Texas, the center would be in a world of hurt if they didn't self-report and there is a time period in which to do it!

 

I do think 911 should have been called immediately. What chances *I* take as a *parent* (bio/adoptive) is one thing. But people entrusted with children (daycares, schools, foster parents, etc) are held to different standards as well they should be. It is better to over-react when your charge is someone else's child, IMO. It is also best to be appropriately prepared (have the emergency sheets on you).

[magnificent_baby]

You absolutely did the right thing. He needed his arm stablized right away, and that would have been a nightmare for him to try to get up and into a vehicle, never mind trying to put on a seatbelt. It could have turned into an open fracture had he been moved and that would have made it worse. Or if he passed out trying to get him in, or on the way...yikes, so many bad scenarios in this situation. When in doubt call an ambulance, that is what they are there for.

 

You should not be outraged though, at the workers. I am sure they were frantic and in an emergency, sometimes you just cannot think clearly.

 

:grouphug: I am sure that was traumatic for everyone!

[justamouse]

I would have been calling the ambulance myself. They can deal with the fallout later, the kid needed care NOW.

 

If I were the worker, the FIRST call I would have made was to 911, the second to my supervisor. THe kids come first. There was one adult there to supervise 8 kids--and if one gets hurt? THis is why there should always be two adults in situations like that.

 

PUtting the kid in a car and driving them to the ER? Dumb idea. Not unless it's YOUR kid do you drive them. That way leads to lawsuits, and undue pain for the child.

Edited August 22, 2012 by justamouse

[Little Nyssa]

Overstepped? No way! I would have called 911 myself, immediately, and sat wih the poor child until they came. Never mind someone's ridiculous 'procedures'. And I'd be writing to the director of the daycare center too.

[justamouse]

Overstepped? No way! I would have called 911 myself, immediately, and sat wih the poor child until they came. Never mind someone's ridiculous 'procedures'. And I'd be writing to the director of the daycare center too.

 

:iagree:

 

Their SOPs in such situations needs to be reviewed.

[Garga]

Overstepped? No way! I would have called 911 myself, immediately, and sat wih the poor child until they came. Never mind someone's ridiculous 'procedures'. And I'd be writing to the director of the daycare center too.

 

 

See--I agree with you. I feel pretty horrible that I didn't call them right away myself.

 

When I first saw the daycare worker on the phone, I thought she was calling 911. It wasn't until later I realized that neither the ambulance nor the child's mother had been called and she was waiting for the supervisor.

 

It was when it dawned on us that the daycare worker had no intention of calling the ambulance until her supervisor showed up that we started to insist.

 

And one of my group did comfort the boy. The daycare worker was too flustered, so my friend sat on the ground in the dirt next to him, covered him with a blanket and kept talking to him to keep him awake (because of the eye rolling and the pale face).

 

Oh--and get this: when the worker did call the ambulance, she downplayed it. She said, "The arm might be broken," but didn't mention the audible snap or the screaming or the eyes rolling or the pale face. My friend finally left the boy in the care of the supervisor, and re-called 911 to let them know the arm was certainly broken, and the at the child appeared to be going into shock.

 

It wasn't until later that I wondered why the daycare people were so blase about it, and whether we were just being silly chickens. I mean, people break their arms all the time, right? But the rolling eyes and the pale face were pretty scary.

 

And I'm not sure how he'd have made it to the car on his own. Even after the paramedics arrived and splinted the arm, he screamed a few times when he was jostled.

[justamouse]

See--I agree with you. I feel pretty horrible that I didn't call them right away myself.

 

When I first saw the daycare worker on the phone, I thought she was calling 911. It wasn't until later I realized that neither the ambulance nor the child's mother had been called and she was waiting for the supervisor.

 

 

:grouphug: I think most rational adults would have thought that was why she was on the phone.

[swellmomma]

Absolutely the right thing. Legally the daycare likely can't drive him anyway and the supervisor would say call an ambulance. It sounds like the worker is untrained in first aid and was in a bit of a panic not knowing what to do. You did the right thing

 

I am sure teh daycare will catch flack for not having emergency records with them. It is the law here with licensing that you MUST have the child's emergency records and a first aid kit with you at all times.

[FaithManor]

Honestly I think you over stepped your bounds. The mother should have been called and she should have made the decision to call an ambulance or not. If the delay was too long to wait for the supervisor, perhaps you could have offered to comfort the boy so the daycare lady could call her supervisor back and get the number.

 

 

DD's response as a paramedic: The above is not correct. The daycare provider has a HUGE liability for NOT calling 911 first. They are in no position to choose to triage someone else's child. Mom can't make the call that yes it's bad or no it's not over the phone.

 

Additionally, a fall that will cause the arm to snap (you can hear it fracture) is a fall that was strong enough to produce neck and head injuries. Moving the child and choosing to drive to the hospital is something only a parent or guardian can choose, NOT a daycare provider.

 

Case in point: one month ago, a child fell off a slide at a playground when a teenage sitter was watching him. Child at first acted fine so sitter didn't call mom. Child then got worse so sitter called mom who incorrectly told 17 year old sitter to drive child to ER and she would meet them there. Child had a neck injury and closed head injury and should have been transported backboard, c-spine precautions taken. DD and EMT ended up meeting the teen en route when child collapsed and stopped breathing and she was frantically calling 911 from the side of the road. Let's just say that it ended up being a pretty crappy day on the job for dd.

 

We parents, we make these judgment calls for our own kids. Daycare providers should NOT do that.

 

Faith

[SKL]

I think a 10-minute wait is no big deal under these circumstances.

 

Honestly, if I was the parent and I got socked with an ambulance bill for a broken arm, I would be really upset. I'd also be upset if someone with no skin in the game came up and basically forced that decision on the people in charge of my kid.

 

Used to be just about every kid got a broken arm at some time or other, and I have never heard of anyone calling an ambulance for such a thing. I have also never heard of serious harm coming from waiting even hours to have a doctor work on the broken bone.

 

I think it's a little scary that the vast majority of responders think a broken arm is such a frightful injury. No wonder today's kids aren't allowed to climb trees etc.

[swellmomma]

DD's response as a paramedic: The above is not correct. The daycare provider has a HUGE liability for NOT calling 911 first. They are in no position to choose to triage someone else's child. Mom can't make the call that yes it's bad or no it's not over the phone.

 

Additionally, a fall that will cause the arm to snap (you can hear it fracture) is a fall that was strong enough to produce neck and head injuries. Moving the child and choosing to drive to the hospital is something only a parent or guardian can choose, NOT a daycare provider.

 

Case in point: one month ago, a child fell off a slide at a playground when a teenage sitter was watching him. Child at first acted fine so sitter didn't call mom. Child then got worse so sitter called mom who incorrectly told 17 year old sitter to drive child to ER and she would meet them there. Child had a neck injury and closed head injury and should have been transported backboard, c-spine precautions taken. DD and EMT ended up meeting the teen en route when child collapsed and stopped breathing and she was frantically calling 911 from the side of the road. Let's just say that it ended up being a pretty crappy day on the job for dd.

 

We parents, we make these judgment calls for our own kids. Daycare providers should NOT do that.

 

Faith

 

:iagree:Almost all daycares have a form in their registration packet that explains steps incase of emergency. Yes the parent will be notified asap, BUT in the case of something like a broken bone it states clearly that 911 will be called FIRST and the parent second. When a parent signs their child up for daycare they sign that form okaying that order of steps.

[NatashainDFW]

I think a 10-minute wait is no big deal under these circumstances.

 

I think it's a little scary that the vast majority of responders think a broken arm is such a frightful injury. No wonder today's kids aren't allowed to climb trees etc.

 

The broken arm is not the issue here as much as the signs of shock. Shock can kill a child and he was displaying signs of shock. In this case I would be having a massive conniption fit if it was my child and I found out 911 wasn't called immediately.

[ILiveInFlipFlops]

I think a few people here mentioned first aid. What first aid could a layperson have implemented in this situation? If there's bleeding, yes, that's easy. But what else could anyone have done? You can't splint a limb or move someone with broken bones. What else is there to do?

[swellmomma]

I think a 10-minute wait is no big deal under these circumstances.

 

Honestly, if I was the parent and I got socked with an ambulance bill for a broken arm, I would be really upset. I'd also be upset if someone with no skin in the game came up and basically forced that decision on the people in charge of my kid.

 

Used to be just about every kid got a broken arm at some time or other, and I have never heard of anyone calling an ambulance for such a thing. I have also never heard of serious harm coming from waiting even hours to have a doctor work on the broken bone.

 

I think it's a little scary that the vast majority of responders think a broken arm is such a frightful injury. No wonder today's kids aren't allowed to climb trees etc.

 

 

I don't think the injury is frightful. I think that liability issues for teh daycare mean that protocol needs to be followed. Daycare workers can not personally transport kids. In the case of broken bones 911 is to be called and parents notified so they can meet child at hospital and from there make the medical decisions. Parents that put their child in daycare have to accept the costs incurred because a provider made sure the child got medical attention asap. Cuts needing stitches, call the parent and wait, broken bones and other serious injuries (and a broken bone is considered a serious injury when it comes to liability)need to have 911 called to transport. That is just the way it is with daycare, they can not decide to make the child lay on teh ground in pain waiting for parents to show up. Yes a 10 minute wait is no big deal but for the parent to arrive could take an hour or so depending on distance, and traffic, in that time if child goes into shock daycare is responsible.

[ILiveInFlipFlops]

I think a 10-minute wait is no big deal under these circumstances.

 

Honestly, if I was the parent and I got socked with an ambulance bill for a broken arm, I would be really upset. I'd also be upset if someone with no skin in the game came up and basically forced that decision on the people in charge of my kid.

 

Used to be just about every kid got a broken arm at some time or other, and I have never heard of anyone calling an ambulance for such a thing. I have also never heard of serious harm coming from waiting even hours to have a doctor work on the broken bone.

 

I think it's a little scary that the vast majority of responders think a broken arm is such a frightful injury. No wonder today's kids aren't allowed to climb trees etc.

 

Um, if I'm not there to make the call, I'd really rather the adults in the situation err on the "better safe than sorry" side of things. That's far more important to me than a potential ambulance bill. I can't even believe that a parent would say something like this :confused:

[fraidycat]

Pale, rolling eyes, audible snap, visible deformity. Absolutely 911 should have been the immediate response.

 

This is coming from the mom who waited 2 days to take her DD in to the hospital and both bones were broken in her wrist/arm. She was not pale, she walked home under her own steam, I wasn't there, so don't know if there was a snap, and there was no obvious deformity, just swelling.

[swellmomma]

I think a few people here mentioned first aid. What first aid could a layperson have implemented in this situation? If there's bleeding, yes, that's easy. But what else could anyone have done? You can't splint a limb or move someone with broken bones. What else is there to do?

 

I think if the person had training in first aid they would have been more level headed about what to do rather than calling the supervisor and then doing nothing else. The worker should never have been alone with the children in the first place. Ideally and legally there should have been 2 workers. When the incident happened, 1 worker should have rounded up all the other children and called 911 and the mother from the emergency card that they should have had with them.

 

The other would have hit the sand next to boy, put something on him like a blanket when he started showing signs of shock, talking and comforting him etc.

 

With proper first aid training, they would have been able to deal with the situation with clear heads right away even if their hearts were racing, instead of not really helping the boy properly. They could not do much for the broken bone but they could have recognized and addressed the signs of shock until EMTs arrived.

[fraidycat]

I think a few people here mentioned first aid. What first aid could a layperson have implemented in this situation? If there's bleeding, yes, that's easy. But what else could anyone have done? You can't splint a limb or move someone with broken bones. What else is there to do?

 

One sentence: Recognize the signs of shock.

 

ETA: It has been a really, really long time since I've taken any CPR or First Aid training (probably 20ish + years), but I can tell you this: My immediate response to an injury/fall is deadly calm. Do not move the kid, do not panic and scare the kid more, calm, quiet, assess.

 

My DH...gets kicked out of the dang room because he is more a pain in the rear, panics and just about passes out himself, all while scaring the kids and making my job more difficult.

Edited August 22, 2012 by fraidycat

[kb44]

When we took kids out, every center I worked for made me carry the emergency sheets with me so there would be no hesitation in an emergency.

 

:hurray: to you and your friends! Previous elem. teacher here, and the above statement was true for ps, as well.

[Hockey Mom]

I think if the person had training in first aid they would have been more level headed about what to do rather than calling the supervisor and then doing nothing else. The worker should never have been alone with the children in the first place. Ideally and legally there should have been 2 workers. When the incident happened, 1 worker should have rounded up all the other children and called 911 and the mother from the emergency card that they should have had with them.

 

The other would have hit the sand next to boy, put something on him like a blanket when he started showing signs of shock, talking and comforting him etc.

 

With proper first aid training, they would have been able to deal with the situation with clear heads right away even if their hearts were racing, instead of not really helping the boy properly. They could not do much for the broken bone but they could have recognized and addressed the signs of shock until EMTs arrived.

 

Perhaps this is what it boils down to for this particular daycare?

 

A couple of decades ago, before I was a mom, I worked at two different daycares. We always had to have two adults on field trips. At the summer camp my boys went to, they had two adults on every field trip.

 

I have to wonder if the daycare worker was more concerned about "CYA" procedures rather than what was in the best interest of this boy.

 

OP: you did the right thing.

[justamouse]

I think a 10-minute wait is no big deal under these circumstances.

 

Honestly, if I was the parent and I got socked with an ambulance bill for a broken arm, I would be really upset. I'd also be upset if someone with no skin in the game came up and basically forced that decision on the people in charge of my kid.

 

Used to be just about every kid got a broken arm at some time or other, and I have never heard of anyone calling an ambulance for such a thing. I have also never heard of serious harm coming from waiting even hours to have a doctor work on the broken bone.

 

I think it's a little scary that the vast majority of responders think a broken arm is such a frightful injury. No wonder today's kids aren't allowed to climb trees etc.

 

10 minutes to a kid who has such a severe break that they are going into shock and rolling their eyes is an eternity.

 

Secondly, the daycare's procedures are wrong. They should have had paperwork, two adults there, and directives in such cases to call 911 first. If for only the fact that they could have the pants sued off them for denying the child appropriate timely care.

 

To even put a kid in a car like that is --I can't even imagine how a parent could cause such willful pain to a kid-and that's just with the obviously fractured arm-you don't know what else he injured.

 

Also, when I worked in daycare-we were all required to have CPR and first aide? Isn't that a requirement anymore?

[brehon]

As a former daycare worker, the teacher probably didn't have the parents' phone numbers right there, and the supervisor would have called the parent and gone down the emergency contact list so someone would be there to meet the child at the hospital. In addition, the supervisor would have been able to pull the "permission to treat" form and authorize treatment-so that's what the 10 minute delay was. Without either the parent or that form, the child wouldn't have been treated for anything non-life threatening. I do think she should have called 911 FIRST-because of the chance that there was something more than a broken bone.

 

As far as calling an ambulance or not, for something non-life threatening, in most cases you'll be seen about as fast if you drive in-and for a broken bone, some outpatient centers have X-ray machines and could do the same thing as the ER with less wait, so it might have been better, depending on your area, to wait. But as a mom, I have to say that if my child's writhing in pain, especially after a bad fall which could potentially have caused other injuries, I'm probably going to call the ambulance, too-and worry about the bill and whether my insurance will cover it later.

 

 

As someone who is a paramedic (and has worked this gig a *very* long time) I have to call a big, ol' NEGATIVE here. In my state (and most states have very similar statues) I am authorized to treat minors whose parents/guardians aren't on scene under implied consent. The injury or illness doesn't have to be life threatening, either, for me to treat a child. And, frankly, most urgent care centers here will call an ambulance about 5 minutes after the child is brought in, thereby increasing the time to definitive care. If the break is bad enough and/or involves tendon/ligament damage, the child might need surgical intervention.

 

It would be helpful to talk to the supervisor on the phone so she can give the medics the child's medical history, any medications the child takes, and any drug allergies, assuming the parents filled the form in completely and accurately. You wouldn't believe how many parents don't fill in critical information like drug allergies. However, I would NOT need a parent or a form to treat this child. If either the caregiver, supervisor, or I/my partner could not reach the parent in a timely manner, then I am authorized to transport the child to an appropriate ER. Obviously, the supervisor and/or caregiver would know this information so they could relay it to the parents. At the ER the child would be stabilized (including being given pain medication if I haven't done that) and the hospital staff would then try to reach the parents.

 

Of course different states have different regulations regarding the treatment of unaccompanied minors. EMS tends to have a little more leeway than hospitals inmany places. But, I think the take home lesson is don't delay calling an ambulance if needed -- paramedics can do a lot to help patients these days.

[Murphy101]

Um, if I'm not there to make the call, I'd really rather the adults in the situation err on the "better safe than sorry" side of things. That's far more important to me than a potential ambulance bill. I can't even believe that a parent would say something like this :confused:

 

But the OP is not the adult in the situation. The actual worker the child was entrusted to by their parents was in the situation. And a bunch of by standers overrode that person for a non emergency reason.

 

If I was the mother, I'd be royal POd that my child was left with someone who didn't know how to contact me or have my child's medical info at hand. Penicillin allergy? Medications they are on? That should be on hand at all times. No exceptions.

 

That would be the last day my kid went to that daycare because of that alone. The end.

 

Second strike is not standing with my kid the entire time.

 

Third strike is letting some random yahoo off the street step in. (no offense, it was nice, but should not have been necessary)

 

The broken arm is part of childhood. No big deal. Certainly not ambulance worthy. 10 minutes to dig out the papers from the bag, call the office to explain and get backup, then have mom/boss show up is fairly quick. Possibly faster than many ambulances in some places. I would have gotten there ASAP and driven her in for a quick X-ray myself. In fact, that IS exactly what I did several months ago. My sons called me and said dd tried to pole vault over the sofa and landed on her wrist. (Yeah. I know. I'm raising geniuses here. Stupid olympics and sibling rivalry giving them ideas.:tongue_smilie: ) Her brothers stood on either side of her comforting her until I arrived, assessed, and hauled her in for X-rays. (she was fine btw.). This is pretty much the norm as far as I'm aware until this thread. I've never heard of anyone calling an ambulance because a kid fell and broke their arm. Not at school, sports, or home. They just have the child be still, take deep breaths, maybe an icepack, and wait for mom and drive them in unless there is some other reason to think there are other unseen crisis injuries.

 

1:8 ratio doesn't bother me. Seems rather light given my daily life ratio.;)

 

ETA: Actually it does bother me. Always 2 adults is a good general policy for just this reason. It doesn't matter whether one can handle it. They probably can. But 2 heads and 4 eyes are supposed to be better than one and provide backup when needed.

Edited August 22, 2012 by Martha

[Dobela]

I think if the person had training in first aid they would have been more level headed about what to do rather than calling the supervisor and then doing nothing else. The worker should never have been alone with the children in the first place. Ideally and legally there should have been 2 workers. When the incident happened, 1 worker should have rounded up all the other children and called 911 and the mother from the emergency card that they should have had with them.

 

The other would have hit the sand next to boy, put something on him like a blanket when he started showing signs of shock, talking and comforting him etc.

 

With proper first aid training, they would have been able to deal with the situation with clear heads right away even if their hearts were racing, instead of not really helping the boy properly. They could not do much for the broken bone but they could have recognized and addressed the signs of shock until EMTs arrived.

I don't necessarily agree with this. I know a first aid trainer, a well trained nurse with many years experience, who did not keep a clear head when her child was seriously injured. She couldn't even find the hospital she worked in a few blocks away.

 

In all the years I kept my first aid certification up to date, and attended annual retrainings, I honestly don't know that I would have recognized shock right off. Especially when I had 7 other children I was trying to manage, keep calm, and take care of at the same time.

 

While I think the situation could have been better handled, I can just imagine all the things going thru the poor worker's mind. She has one seriously injured child, and then 7 more she has to keep track of and keep calm while waiting for assistance. She was alone, without help, and now she has a bunch of homeschool moms trying to tell her what to do in a probably not so nice tone. It would be a lot for many people to handle at once. At least she called for help. Some people would just make the kid get up and return to the center before asking for assistance.

 

And, yes, the state licensing board will know about it most likely. We had to write accident reports for every injury - large or small - and those reports were individually reviewed every year at license renewal. Not to mention the insurance company also expected to have copies of the accident reports as well.

[catz]

Um, if I'm not there to make the call, I'd really rather the adults in the situation err on the "better safe than sorry" side of things. That's far more important to me than a potential ambulance bill. I can't even believe that a parent would say something like this :confused:

 

:iagree:And where would the daycare be if they moved the child on their own and a bone came through skin or shifted further? Or the child went into shock? When you drop your kid off at a daycare, you are putting your child's life in someone's hands and I would fully expect that they would not hesitate on the side of safety. If the child was fine and chatting and seemed ok, that would be one thing. Pale and eyes rolling? Completely different ball game.

 

To me, it sounds like at a minimum that daycare needs to be retrained on their protocol. I'm shocked they didn't just have paperwork to pull and didn't immediately call an ambulance.

[justamouse]

The broken arm is part of childhood. No big deal. Certainly not ambulance worthy. 10 minutes to dig out the papers from the bag, call the office to explain and get backup, then have mom/boss show up is fairly quick. Possibly faster than many ambulances in some places. I would have gotten there ASAP and driven her in for a quick X-ray myself. In fact, that IS exactly what I did several months ago. My sons called me and said dd tried to pole vault over the sofa and landed on her wrist. (Yeah. I know. I'm raising geniuses here. Stupid olympics and sibling rivalry giving them ideas.:tongue_smilie: ) Her brothers stood on either side of her comforting her until I arrived, assessed, and hauled her in for X-rays. (she was fine btw.). This is pretty much the norm as far as I'm aware until this thread. I've never heard of anyone calling an ambulance because a kid fell and broke their arm. Not at school, sports, or home. They just have the child be still, take deep breaths, maybe an icepack, and wait for mom and drive them in unless there is some other reason to think there are other unseen crisis injuries.

 

I don't disagree with you that they are common, but an audible snap, with a pale kid who is moaning and whose eyes are rolling back in their head? That's not a simple break. I bet if your boys saw your daughter like that they'd be freaked.

 

This daycare person obviously did not know how to handle the situation and I'd most definitely not want those people to transport my kid.

 

Regular break? Yes, I'd put them in the car and off we'd go.

[Just Kate]

I would have been calling the ambulance myself. They can deal with the fallout later, the kid needed care NOW.

 

If I were the worker, the FIRST call I would have made was to 911, the second to my supervisor. THe kids come first. There was one adult there to supervise 8 kids--and if one gets hurt? THis is why there should always be two adults in situations like that.

 

PUtting the kid in a car and driving them to the ER? Dumb idea. Not unless it's YOUR kid do you drive them. That way leads to lawsuits, and undue pain for the child.

 

My kids attended a daycare this summer, two days per week. I have to say that I always assumed that there had to be at least two adults with my children at all times! One adult just can't care for 8 children in a situation like this. If I was this child's mother, I would be livid that there weren't two adults present.

 

To the OP, I think you did the right thing in this situation. Sadly, we live in a world where everyone feels like they should mind their own business and not offer help when it is needed. I am glad to know that you were there today to offer comfort to the boy and support to the daycare worker.

[jujsky]

If that had been my child, I would have been thankful to you b-day party moms. Your group did the right thing.

[justamouse]

Cupcakes for all the moms who told the supervisor to call!

[brehon]

Martha, what you decide to do with your child is vastly different than the legal obligations places like day cares, schools, etc have when a child is ill or injured while in their care. Now, every little temperature of 99 or scrape, bruise, etc doesn't need EMS called and I'd be surprised if an ambulance were called in those types of situations.

 

However, given the scenario as described by the OP, this was more than a "simple broken arm". [And, by the by, any obvious or suspected fracture would warrant a 911 call by schools, etc. In many states those entities are legally obligated to call 911. The key here is the parents aren't on-scene to make the decision.] Even if the fracture were indeed "simple" there was simply no way to know if other, more critcal injuries were sustained or if the child had an underlying medical condition which caused him to present with a couple of shock-like symptoms. Pain itself can cause paleness and eyes rolling back. And, as I mentioned before, unless one has X-ray vision there really isn't a way to tell how serious a fracture is - unless there are bone ends sticking up through the skin and then I think we'd all agree that was pretty serious.

Edited August 22, 2012 by brehon
ugh...late night editing...

[Murphy101]

I don't disagree with you that they are common, but an audible snap, with a pale kid who is moaning and whose eyes are rolling back in their head? That's not a simple break. I bet if your boys saw your daughter like that they'd be freaked.

 

This daycare person obviously did not know how to handle the situation and I'd most definitely not want those people to transport my kid.

 

Regular break? Yes, I'd put them in the car and off we'd go.

 

Ha! You don't know my life or kids then. They have seen shock and seizures and screaming in pain and pale/cold sweat/passing out in pain on several different occassions. Sometimes we even called an ambulance and I loaded all the kids in the van and followed it to the ER. Such is life. We stay calm. We pray. We stand together. We get through it.:)

 

Oh and I completely agree the worker sounds like she didn't have her act together. And I wouldn't want the worker to be transporting either. That's a call for a EMT or the parent.

[Murphy101]

Martha, what you decide to do with your child is vastly different than the legal obligations places like day cares, schools, etc have when a child is ill or injured while in their care.

 

Right. I didn't say otherwise either did I? The mother should have been called the minute, possibly, and likely, followed up by 911.

 

My point was that:

 

I think that center is seriously screwy for reasons that have nothing to do with how quick or not they called 911.

 

And that I don't necessarily think a broken arm, even a bad one, is an automatic 911 call.