A Case Study on Handling a Pediatric Emergency in a Pandemic
The break was bad. The idea of going to a hospital during the COVID-19 pandemic was even worse.
With the threat of COVID-19 lurking in our communities, knowing where to go for a medical emergency these days can cause as much anxiety as the injury itself. Unfortunately, this is the exact dilemma in which Nicole James* found herself when her 11-year-old daughter fractured her wrist after a recent bicycle accident.
“I got the call from my daughter, who’d been riding her bike at a friend’s house,” Nicole recalls. “She was crying, she said, ‘Mom, it’s really bad.’” So, I drove over there and saw that her wrist was dangling. The bone was not sticking out of the skin, but it was protruding. It was absolutely broken. But I still wasn’t sure if I should go to the ER. In COVID times, it’s scary.”
This uncertainty only intensified a hard situation. “I have plans for a lot of things. I have a fire escape plan. I have a Call 911 plan,” Nicole says. “When you have a plan it’s supposed to alleviate stress. But, I didn’t have a broken bone in a pandemic plan.”
The severity of her daughter’s wrist injury meant time was of the essence, so Nicole quickly started investigating what to do. “I called my pediatrician, I called my insurance company, and I called a friend in the medical field, all while my daughter was sitting there crying with ice on her wrist,” she explains. “Should you go to the pediatrician? Should you go to urgent care? Should you go to the emergency room? I got different advice from everyone. Interestingly, my daughter was more scared about going to a doctor’s office during COVID than she was about her arm.”
Fortunately, Nicole’s neighbor, who is a radiology technician, came over to see the injury and advised them to go to straight to the ER. At the hospital, x -rays confirmed the fracture and Nicole’s daughter was sedated, the bone was re-set, and her arm casted.
The next day Nicole says she “waited with bated breath to get to Bucks County Orthopedics. They fit us in right away with Dr. Sue Griffith, their pediatric orthopedist. They took new x-rays to see if anything had moved and fortunately, nothing changed and my daughter didn’t need surgery.”
Dr. Griffith expects Nicole’s daughter to make a full recovery and also sympathizes with the dilemma Nicole faced with the injury. “It’s unsettling, it’s uncertain times, there’s no doubt about that,” she says. “But it’s important for patients to go and get the care they need. If there is a deformity of the limb, if it is crooked, they should go to the emergency room where the fracture can be stabilized and immobilized, just like Nicole did.”
If there is no deformity to the limb, then there are a few choices. “You could go to an urgent care, call the pediatrician, or schedule an appointment to get evaluated with x-rays at BCOS,” Dr. Griffith explains. “In the office, we reassure children that they are safe and that we are taking precautions to avoid transmission of this virus. It really helps calm kids and make them more comfortable with what is happening. If an injury occurs after business hours, we also always have a doctor on call to offer guidance.”
In the end, Nicole learned a valuable lesson that she wants to share with other parents. “In our situation, we could not avoid going to the hospital, I just wish I had known what to do at the time and skipped the hour of stress and panic as we figured out what to do,” she says. “We ended up doing the best thing.”
In less severe circumstances, her decision is also clear. She shares, “if it’s not an emergency and Bucks County Orthopedics is open and they’re able to x-ray and cast…why wouldn’t I just go there?”
*Name has been changed to protect privacy.