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Sept 15, 2002 It was on July 23rd---I will never forget that date. My son had turned three just 13 days before and was at a center for creative learning, a day-care setting. I received a call at work telling me that my son had fallen off the slide and was not able to put any weight on his one foot. I asked her if he was ok, and if she thought he had sprained his ankle. Well, she really didn't know, but he was crying and could I please come. It did not sound like any serious injury had occurred, but I left work immediately. The day-care was only a couple miles from my job, so made it in less than 10-minutes. As soon as I walked in to the day care and saw my son laying on his stomach, crying in more of a sobbing moan, I knew something was wrong. As I got closer I saw his one leg was bent and bulging between the knee and ankle. It was definitely fractured, but I did not know how severe the break was at that time. I did not panic. I may get stressed out over little things, but in an emergency situation, I tend to "batten down the hatches" and deal with it. My husband was about 45-minutes away in nursing clinicals, so could not call him--I had to get help fast. There was no caregiver there who could leave to go with me or drive me (nice, huh!), so I picked up my son and carried him out to the car. I did not know just what the total of the injuries were so I laid him down on the front seat next to me so I could keep an eye on him and comfort him while I drove. Now I know you have to keep your kids in a car seat for safety, and you need to keep them in the back, not the front, but this was an emergency and I was by myself---I broke some normal safety rules I would normally follow. But I found out later that keeping his leg straight, not bent like it would have been in the car seat, most likely kept other more serious problems from developing. Now, I had to drive by the Pediatrician's on the way to the Hospital, and for some reason, sanity leaving me for a moment, I pulled into the parking lot at our Doctor's, got my child out and carried him in to the office. I got immediate attention, and our Dr. (a most wonderful pediatrician), came right out to examine him basically in the hallway. The Dr.'s wife happened to be there and he told her to drive me to the hospital and to keep his leg straight; he said without knowing if there was any hip joint involvement keeping the leg straight would prevent any constriction of circulation, development of blood clotting, or prevent any damage that might already be done. They would call ahead and let them know we were coming and to alert the orthopedic surgeon. The Dr. told his wife to NOT let them put my son in a wheelchair, to make sure they kept his leg straight. So off we went again, the moaning become more and more quiet, like his body was going in to shock. I had to call my mom on the cell phone, as I would be at the hospital without my car, AND I had a six-month old at the sitter's that I had to nurse before too long. Telling my mother what happened was the first time I felt my grip on control loosen---I started to cry, and then had to get off the phone and calm down for my child's sake--he was the one who needed the help! Once at the ER, you can bet the attendants wanted to plop him right down into a wheelchair. Our Dr.'s wife started barking orders direct from her husband, and since reception knew we were coming, we went right back into an ER room. The Orthopedic Surgeon that the Dr. wanted was there on-call, he ordered x-rays, and called the Anethesiologist to "knock him out." It is kind of scary to not only be in that situation, but having the Doctor's going over their pharmacology books with a calculator to figure out the right dose to deliver. They were also on the phone with our Pediatrician conferring. About the time they were giving my son his medication, my mom, sister, brother-in-law and niece all showed up at the ER. It was about that time that I had to leave---I was letting down and had to go nurse my other baby (the one who took no bottle ever). I borrowed my mom's car and made one heck of a quick trip to the sitter's and back. At least I knew my family was there and would do whatever they needed to do while I was gone. It turned out that "sprained ankle" turned out to be a complete fracture of both the tibia and fibula, right on the edge of the growth plates. His hip was not fractured but was severely bruised with some deep muscle contusions. They casted his leg, from toes to hip, bent at 90-degrees at the knee, to prevent him from putting any pressure on that leg. He now became a patient of the Orthopedic Surgeon who would follow him until the fractures were all properly healed. Pre-school was started in September with cast in tow. He managed to "walk" in a half-tilted way, and did not let that cast get in his way. His cast stayed on for about 12-weeks, with recurrent visits to the Ortho Doctor who would cut the cast to put shims in to correct any angles that were going off kilter during the healing process. When the cast finally did come off, his leg was so skinny and weak, that it took another 2 to 3 months for his leg to gain back it's strength, muscle mass, and coordination. The Dr. followed him until there was complete healing--and there was no danger of problems with the growth plates. What I would like every parent to know and to check out is what playground equipment your child is allowed to play on at their day care, the sitter's, or school. I found out that my child broke his leg as he was climbing up the ladder to a slide, a metal slide that was about 12-feet high---he slipped backward, his right leg getting caught under one of the steps, snapping his leg, leaving him hanging upside-down with 2 broken bones. The slide he was playing on was NOT age appropriate for a 3-year old. He was playing on equipment for children 8 and up. I found out the center had numerous pieces of playground equipment that was not age appropriate for the children there; the center took children from 1 year to 5-years old, and more than half of the equipment was for older children. Since this was the first such accident that happened at this center, I did see action in the removal of unsafe equipment, but my little boy did not go back to stay---he did go back with me to see his little friends who were worried about him and wanted to know what happened. They all got to see his cast and draw pictures on it. Remember, kids can be highly affected by what they see--they need to have closure just as much as adults. Some things you can do to help ensure unnecessary accidents are not in the forcast for your child, there are a few things you can check out next time you stop off at your child's day care or sitter. Check out the condition of the equipment--are there rusty or sharp areas that could cut or scratch your child? Does the equipment move freely? Is it in good repair? Is the center/sitter aware of the age ranges the equipment they have is for? How much supervision is actually provided on the play area? Are the caregivers interacting with the children and roaming the area, or are they sitting on a bench talking amongst themselves? Are there any "blind" areas of the play area--can you see the children well or do you have to move around to keep an eye on them? Does the center have an open-door policy so that you could "drop" by during outside play and see just what does go on? Sometimes a center may ask you not to come during quiet time or a certain activity if possible to avoid a disruption, but if a center did not have an "open door" policy, I would really question leaving my child there. Also, check out how the center/sitter is insured against any accidents---this is ok to ask---they need to be insured if they are licensed! If there are exits to the play area, how are the gates or doorways secured? Could your child climb up on a play house, for example, and then go over the fence and out as part of a game? Could a stranger reach in and grab your child (how high are the fences/gates; are they on a busy street or sidewalk)? Are the grassy areas mowed and neat? Are there weedy areas that might hide biting insects? Are there things (like tires) that could hold water after a rain and breed bugs in them? Are the sandy areas relatively free of rocks or stones? Does the sand look clean and fairly level? Are there shock absorbant matting under play equipment that children may jump from (like monkey bars, tube mazes, swings)? What is the emergency policy in case of an injury to a child? In case of the need to evacuate the building? Are the caregivers certified or have they received specialty training in child care? You do have a right to know this, so don't be afraid to ask! It is never to late to check these things out if your child is already settled in to a place. If you are looking, keep these safety issues in mind when you visit a place. I learned from this experience. I hope you never have to experience any such injury to your child. Don't wait for a phone call---Do safety checks, and drop-in visits. Ask questions. Do what you need to do to keep your child safe. And by all means, if I neglected to include an issue, please put it in the comment section--thanks. ------------ Judy Duncan is an Occupational Therapist, self employed working with infants and toddlers in their homes. She also writes on Epinions.com. Email Judy: djduncan@epix.net Comment on this column in the forum. ------------ |
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