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Helping One of Your Own...!)

post #1 of 18
Thread Starter 
Here's one for group,

Last Saturday I had the very distressing task of transporting my own son off the hill. He's 8 years old-and Saturday was his 1st day on the hill this year (been that kind of a winter). In fact, it was the first day I had the whole family on the slope (Wife, other son who's 4).

Anyway-I was skiing with my older boy-second run of the day-on a gentle green helping to get his legs back into the swing of things--he was skiing pretty tentatively, and, I uttered the fateful suggestion that he try and "open it up a little" (his speed not his stance)--which he did, and then as he tried to slow down-some how he crossed up his skis took a tumble and proceeded to exclaim "I hurt My leg!". I skied up, (I was in my full patroller regalia btw)-did a quick survey-he wasn't overly distresssed or tearful, just said his leg hurt-pointed to a specific spot above his ankle (but inside his booT). I tried to see if he could put weight on it and he could but he said that still made it hurt. I radio-ed for a sled (and by that I mean snowmobile) got him a ride to the Patrol Shack where his mom (a pediatrician btw) and I met him. I removed his boot by myself (!) and his mom and I examined hiim. I then spent several hours in the Patrol room with him-drawing funny pictures, telling jokes, keeping him comfortable while my wife skied with my 4 year old (who was bursting with excited pride over his new found skiing abilities---he's the ripper of the two). Though my son was certainly laid up and injured, he wasn't in any obvious pain-except a very pronounced point tenderness on his upper ankle-but was otherwise in good-if somewhat sedated spirits.

Later that day X-rays revealed a tibial fracture-6 weeks in a non-weightbearing cast. It's been real tough on the boy but he's tougher than I realized and he's shouldering it well (and school, friends, and community have gone out of there way to make his life as easy as possible-for which I'm dearly grateful!).

The reason I'm posting is that-as I've reviewed the situation I realized how differently I treated him because he's my son-Surprisingly-he didn't get morer careful, better treatment-but much worse. I didn't splint him on the hill-no sample or vitals. Transported him seated on the back of a snowmobile. Tried to get him to stand. Back at the patrol room--since everyone knew him the other patrollers were encouraging and jocular and kind (which was appreciated) but no one-(including me) treated him as a patient (still no vitals or splinting-we did ice it thinking it a sprain). Part of this was due to my Son's calm demeanor (when the guys found out later he had a broken leg they were shocked!)-but also familiarity bred a slack attitude (of which I was part)) and that certainly isn't a good thing.

I guess I'm, in retrospect, feeling bad about this on many levels. Not recognizing the severity of the situation, not giving my son the same professional treatment I routinely give to the sons of strangers on the hill, and a host of other guilts engendered when your son get's hurt under your watch.

I don't know if other's have been in this situation or have similar experiences-but it's just something I'm thinking about right now.

post #2 of 18
Don't feel bad . You know your own son very well ,as does your wife . Even without both of your extensive training your parental senses would have told you something was wrong if he suffered more than a broken bone . It sounds as if he did not experience shock to any serious extent . I think your family is very fortunate to have such experienced parents to guide and care for them and have no doubt you would have handled a more serious situation with clarity . I hope your son heals quickly and is out with you again soon . Happy Trails .
post #3 of 18
I agree that we don't treat our own the same. I guess we like to deny that it might be as bad as it is and we want our kids to me mature and tough and not fake an injury for sympathy. But both you and your wife are medical professionals, and you know your son. So if it had been something worse, you probably would have acted accordingly. In the back of your mind, I'm sure that you knew that even if it was a fractured tib, that you weren't inflicting any additional damage or making your son experience any more pain than he would have if he'd have been splinted and gotten a taboggan ride down. If your son had shown a lot more main and discomfort, I'm sure you would have acted accordingly. And to be honest, the mental trauma of going through the whole formal routine may have been more distressing to your son than the pain he felt when trying to put weight on it.

I really don't think you put him in any danger of aggrivating his injury by the way you handled it. So try not to be so hard on yourself (although that's going to be hard to do).
post #4 of 18
rather than condemn, I applaud you. Had you done the full show for your son he would have been much more nervous and thus less able to provide you with good feedback, making him feel like something was REALLY wrong etc- "dad isn't usually this serious, I must be in bad shape". Yes, you did treat him differently based on information that you have that you do not have about another patient.

It seems to me that the entire notion of the full workup is that you are looking at each patient as a totally unknown entity and thus can make no assumptions. Here you could use your past knowledge (not patient reported info, but info known to you as fact) of the patient to guide you.

A hypothetical- let us suppose that the patrol director at your hill had a chronically bad shoulder. Occasionally when hauling a sled it dislocates rendering him in pain and not really able to function properly. After umpteen years everyone in the shack knows how to perfectly extend his arm, twist and voila- back in the socket and in 5 minutes the muscles have relaxed and he/she is good to go. Do you do the full patient workup every time????

as parents we have so many things to beat ourselves over- let this one go I think you acted well professionally and as a parent.

"Do no harm."
post #5 of 18
It's kind of everyone to support you but the truth is - you messed up. We can all learn from your experience. I'm guilty of underestimating an injury, just like probably everyone here. It's a good reminder to use the training we work so hard to perfect. Don't beat yourself up over it, after all it did work out fine.
post #6 of 18
I agree with the idea that the "full work up" may have scared your son. But I think if you had THOUGHT to do a full work up, but told him, "We just have to do this because it's part of the rules here." that it might have achieved the same results --> kid not worried, but you remained a professional. Just something to remember the next time. Naturally, you went into "parent mode" this time.
post #7 of 18
Don't feel bad. People are conditioned to expect no broken bones or other painful injuries unless the patient is screaming bloody murder. I've had a few occasions where licensed physicians had to see an x-ray, before they would believe I had broken a bone. I've had to argue just to get the X-ray taken. Just because someone is calm and not screaming or crying does not mean they are not in pain either.

Experience is a good teacher; we've all got a lot to learn.
post #8 of 18
Given his level of consciousness and over all affect, your professional and personal assessment was.... no need for vitals. And you were right. You were also right to pursue further testing to make sure there was no serious break...there was.
Overall, your assessment and judgement was correct. Would you do it differently with this info in your bank? Perhaps, and thats what adding to the experience scale is all about.
None of us who care for others in our professional lives ever stops learning if they are a decent practitioner.
Give yourself a break (pun intended)
Life and especially our children, are here to teach us to be better people.
Just my personal philosophy.
post #9 of 18
Of course you treated your son differently than any other patient. He is your son after all. Perfectly normal. As for what can be done better next time. As parents in the medical field you should insist on someone else treating your child whenever possible. Don't let parent patrollers treat their kids.
post #10 of 18
This is pretty common among medical professionals, and one of the reasons why doctors are not supposed to treat their own families. So don't feel badly, but it was a bad judgment call.

Over the years we've had a couple family members on the patrol get injured, and I've learned that one of the best things to do (circumstances permitting), is to get a rookie to do the paperwork (required anyways right?!?!) and the assessment. They get to do more work on a live patient who's going to give better feedback, and they're usually quite thorough. And up here in Canuck land, they're fresh out of our medical course, so they're usually pretty sharp too.
post #11 of 18
Years ago, my daughter turned out to have had a fractured wrist for almost an entire day before my wife and I finally decided to take her to get it looked at.

I felt bad for her after they casted her wrist. But ---if I was to do the whole day all over again---I bet she would have had a broken wrist for the better part of the day before I took her for treatment!

It was similar to your son, she just didn't present with the "right" symptoms for higher level care.

More recently, I helped get Bonni comfortable, but backed off when patrol arrived, giving them her pertinent medical history and suspected injury. I assisted in the load and go---but I did no assessment and no treatment.
post #12 of 18
Originally Posted by skier_j View Post
Years ago, my daughter turned out to have had a fractured wrist for almost an entire day before my wife and I finally decided to take her to get it looked at.
Don't stress that one. I skied 3 days on a broken wrist out here when I was still a tourist (I did have it x-rayed before my trip. When I got back home I had a message from the doc saying they wanted me to come in for additional x-ray as they had "found something"). The only movement that hurt was the pole swing...
post #13 of 18
I've treated friends twice now (ok, one was an ex) and under-treated. (Then again, treated a bunch more appropriately.) Very similar to what you describe, that they didn't seem that bad. For the ex, in retrospect the group that worked on her decided that we all came to the same conclusions and would've treated someone we didn't know the same way. Then again, maybe we were wrong...

I guess I'm trying to say don't sweat it, he's ok now (FYI, I'm in the middle of 12 weeks non-weight bearing as we speak, and it's not much fun) and doing things differently would not likely have changed the short or long term outcome at all. If he'd complained with weight, or really anything, you would have done things differently based on the different info.

And who takes vitals?

post #14 of 18
This reminds me of a case that happened here. One of our patrollers, who has around 10 years of experience was called to a scene where one of the snowboard instructors had taken a hard fall and had broken her wrist. When she got there, she saw the injury, then recognized that the instructor was in fact her daughter. She basically lost it, and was unable to do anything other than hold her daughter while the other patrollers stabilized the injury and transported her down the hill. She freely admitted that the shock of seeing her injured daughter made her forget her protocols for that time. Although, I believe that if she had been the only patroler there, she would have done it herself.
As for Liam's case: Like someone else said, your parental instincts overrode your patrollers instincts. To me, this is a no-brainer, and is entirely normal, because if your patrollers instincts are stonger than you parental ones, I would wonder what was wrong with you. If your son had reacted in another way, leading you to believe that there was a serious injury, I am sure you would have treated him far differently, and you would very probably have done all of the protocols that were necessary. In your situation, I would have done the same thing. We know our kids, we know their reactions to different situations, and this allows parents to make instant (and usually accurate) diagnoses of different injuries. You did exactly that, but due to the fact that your son's injury was serious but NOT painful, the diagnosis was wrong. In the end, everything worked out just fine, so treat it as an educational experience, and soldier on. Besides, if your wife missed it as well, how can you possibly blame yourself?

I remember another case that I saw at Mont Orford in Quebec. A little girl had taken a weird fall in front of the clinic, and was taking a while to get up. A patroller passed and asked if everything was all right, and the parents replied that she had fallen, but that they would continue skiing in a little while. The patroller backed off, and continued to watch the situation. The little girl was sitting in the snow, speaking calmly to her parents and she tried to move her leg. Suddenly her left foot flopped 90 degrees to the left in spite of the fact that her knee was pointing straight up. The parents started to yell for the patrollers, and the little girl, well, she sat there looking bemused at her leg and everyone else. I never saw her cry.
You can never tell how kids, adolescents or adults will react to an injury!

post #15 of 18
Originally Posted by amason View Post
(ok, one was an ex) and under-treated.
yeah well, fair enough

I've heard many medical professionals say that they are much less sympathetic etc towards their families than they would be towards a patient. you're certainly not the first, dude, and I'd say not the last either. Learn from it how difficult it can be to remain entirely objective at times.
post #16 of 18
Last year I had an conversation with an Austrian instructor. He told me it is good custum in Austria to let there own kids take lessons with other instructors. Not only in case of injury, also because of the objective observations an independent instructor has compared with the parents of this child. Parents are usely to carefull with there own (in Austria apparently??) ;-)
post #17 of 18
If you had taken your sons pulse, resp, BP, etc you would not have found any indicators of fractured bones. It is not a big deal that you did not perform a full PT assessment as per EMS protocol. If you took vitals every time one of your kids fell down and went boom you would be doing it 100s of times a year. : You and your wife know your son and he passed the look test, which is more important.
post #18 of 18
Thread Starter 
Hey-this thread has been revived!

Apropos, I'm going to take my son back on the hill for the first time since he broke his leg last year (we'll go tomorrrow-and yes, he's getting out of school to ski with dad!). He has has some trepidation (not just because he got hurt-but he is cautious by nature as well)-but, we'll take it pretty slow. He likes skiing around with my while I'm patrolling anyway.

All in all, he healed up well and fast (like most kids). And it's a new season-and so far a good one at that. Thanks for all the positive thoughts and comments, gang.

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