From the Nurse Graham Files

Scenario:
3:00 p.m. First grader brought to health room by her teacher in a near hysterical state (the 1st grader, not the teacher) and only saying her neck hurts. Earlier in the day she apparently fell from either the big toy or the monkey bars, was given some ice by the secretary, and returned to class. I had seen her at 1:45 p.m. because she said her neck was still hurting. I did a brief exam, including palpation of the head and neck. She didn't flinch at any time even when I touched the areas she said was hurting. So I, too, gave her some ice and sent her back to class.

So now it is time to go home and the teacher is concerned about sending the girl home on the bus. And who would put a student on the bus when she appeared to be in immense pain?  I tried to call her parents, but neither answered their phone and there were no other emergency contact numbers listed. I tried to assess her again, but she was so upset and crying so hard that it was difficult to determine what was going on. I asked her again to point to where it was hurting and this time she pointed to the front of her throat and said it went around to the back. Thinking maybe her throat was sore I got my flashlight to look at the back of her throat. I asked her to stick out her tongue. Not only was she unable to stick out her tongue, but when she tried it deviated to the left.

Red flags and alarm bells start going off in my head. I have a 1st grader who is hysterical. Doesn't know her sister's name or where she goes to school (I thought maybe I could look up the sister and see if she could come); can't get a hold of any parents; and maybe there is some sort of cranial nerve impact from the fall.

So I called 9-1-1. I didn't feel like I had any other option at this point in time. Sometimes it is hard to be the only medical person in the building and people are looking at you like you should have all of the answers. So I called in back up.

In the time it took for the first responders to arrive the girl, who up until this time adamantly denied needing to go to the bathroom and refused to go, decided she couldn't continue with the "potty dance" and finally went in to the bathroom.

She finished in the bathroom as soon as the first responders arrived. She walked out of the bathroom saying her neck felt much better. Her tears dried up instantly. She could stick out her tongue just fine without any deviation. She was just a totally different kid.

The EMT's examined her and gave her the all clear. And I sent her home on the bus.

Oh, and her parents finally called back at almost 4 p.m.