Kids as Patients

When I work events that are youth oriented, such as soccer, football, and even triathlons, I always strive to remind myself that kids are not "small adults". Many people in EMS treat kids as if they were, which is not good for a variety of reasons, including:

• Their physiology is not the same as adults
• Their understanding of what is happening to them is not on the same level as an adult
• They sometimes display differing symptoms than adults for the same problem

I was never reminded more of this than on Sunday, when I treated a young man with a very probable ankle fracture. This kid was trying to act as an adult, but clearly was very scared, and in a lot of pain. His ankle was swollen, even though this injury happened mere minutes before. His pain was in a specific location above his ankle along the bone called the fibula (Technically, it isn't a broken ankle at that location), and bruising was starting right at the point of impact. When I asked the him to show me where it hurt before I touched his ankle, he drew a very defined line across the bone.

I explained to him that splinting him was going to hurt, but then it would get better. Its never easy to tell a child you are going to hurt them for them to feel better. So I set to the task at hand. I gently removing his shoe, as he was complaining of some tingling in his toes. Turns out, his shoe was causing the tingling, which went away as soon as the shoe came off. Then I splinted his very painful ankle, with his father assisting as an extra pair of hands and talking his son through this procedure. Once the splint was on, you could see the relief in this youngster's face. Was it really relief from the pain? Or relief that the splinting was completed? I think it was a combination of the two. He was still in pain, but not as much as before I splinted him.


The adults around us kept trying to offer the child support, but making statements that clearly went above him. He had a puzzled look on his face when one of the coaches told him, "Now that its splinted, we can get you back out there playing.". The child didn't see that this was humor. To him, what his coach said was serious. He looked at me, and I told him it was a joke. Then he smiled a bit.


I offered ambulance transport, primarily for pain control, but the father decided to take his son to the emergency room himself. So, I helped get this young man over to their vehicle, using the motorized cart I had. I gave the father instructions on how to get to a nearby emergency room. And then they were gone.