Children Run Hard and Play

Children run hard and play hard, and do not always make choices that are in the best interests of safety. Oftentimes, their bodies are growing and they do not have the coordination that allows them to judge distance or their ability to negotiate heights, stairs, or other obstacles. Indeed, at Hally's age, bones are growing fairly rapidly, which also contributed to the ease of break (Kids and Their Bones, 2011). Our scenario involves Hally, an 11-year-old child at the local Elementary School.

Hally tripped while leaving class for recess, and hurt her right arm. School personnel immediately called for assistance, and the local paramedic units arrived to assess the situation. It appeared that Hally had broken her right radius and ulna. Hally was checked for shock, her arm immobilized, and then transported to the Accident and Emergency Department at the local Hospital. Once there, her case was managed by a nurse practitioner. X-rays were taken, and it was confirmed that Hally had broken her right arm at the radius and ulna area.

The Nurse Practitioner determined that these were clean breaks, no fractures, and no sign of additional trauma. Hally was given an injection of a muscle relaxer and light dose of anesthetic to allow for reduction of the break. Then, Hally was given a split to stabilize the area and a partial cast to aid in stability and healing. Hally's mother was advised to give her Children's Ibuprofen to help with pain and swelling (3, 50mg chewable tabs three times a day) (Sears, 2011).

She was also advised to have Hally keep the cast dry, to use a towel wrapped in ice above the cast to help with swelling. Hally's mother made an appointment to see her regular doctor, a GP, the following week, and then every 3rd week until the cast was removed. At the end of the cast period, Hally was scheduled for a few weeks of therapy with a physiotherapist.

A broken arm, particularly in the area of Hally's injury, is the second most common childhood break injury (next to collarbone breaks). The two bones, the radius and ulna, are the forearm, connecting the elbow with the wrist. Hally had no broken skin, so her issue was known as a closed fracture, which is far less serious than a bone broken in multiple places (comminuted fracture, a dislocation (bone out of joint), or a compound fracture in which the bone is sticking through the skin (Baniukiewicz, 2011).

Hally will need to be wary of excessive movements of her right arm; certainly taking steps to minimize further injury, keep swelling to a minimum, and get enough nutrition, particularly calcium and vitamins a, D and C, to aid in healing (Tremblay, 2011). She will need to be patient when writing, and may need some extra time completing some assignments. However, because her break was clean, set quickly and professionally, and because she is young and healthy, she should heal quickly and be out of the cast in 4-6 weeks.

Part B- There were a number of health and human service professionals involved in Hally's case: School Personnel -- Teacher who discovered the injury, School Nurse who assessed the situation and called 911 for EMT Emergency Medical Technicians -- First responders; assessed situation, took Hally's vital signs, helped her calm down, isolated arm and prepared for transport.

ER Nurses -- Evaluated situation, helped calm Hally, retook vital signs, prepared for NP ER Nurse Practitioner -- Examined Hally, ordered X-Ray, reviewed all symptoms and signs; interpreted x-ray, with Nurse, administered muscle relaxer and anesthesia, set arm in cast. X-Ray Technetium -- Took X-Ray films of Hally's right arm; processed for NP's review. General Practitioner -- Follow up after ER visit, watched for signs of infection or discoloration; insured blood flow to arm, managed pain and swelling medication. Removed cast at appropriate time.

Rehabilitative Personnel -- Specialized to help Hally gain full use of her arm through exercise therapy, ultrasound, Jacuzzi, and massage therapy. Part 3 -- in its very basic form, broken bones are quite common in children.

However, there were a number of factors that needed to be assessed by health professionals during Hally's incident: Location and type of Break -- Ensure no bone or part of bone is sticking through the skin; assess location of potential break; immobilize, consider age, level of activity and distance to treatment facility Symptoms of Shock -- Prevent shock by keeping Hally warm, head down if necessary, and keep her calm. Ancillary Wounds -- Check for secondary or ancillary wounds; including head wounds (concussion) or other scrapes or cuts from injury.

Assessment of break and appropriate procedure -- Through x-ray assess whether bone is broken cleaning, how much reduction is necessary, and the actual type of dislocation (Wrist Bone Connected, 2011). Ability to set.