A&E treatment of Sprained ankle/suspected broken ankle

[MyShinyWhiteTeeth]

Would it be typical for someone (male, late 20's) to be seen by the triage nurse at A&E then expected to return home without any X-rays taken, crutches or pain relief. They were told to keep the leg raised for a few days, keep off their feet and take pain killers. They were told to see their GP if it got worse. They are hobbling about and it looks slightly swollen.

They were in A&E for less than 10 minutes. A friend dropped them off at the door and went to park. By the time the friend found a space and was on their way back, they were phoning to be picked up outside.

This person is supposed to be helping with moving house this weekend and the accident seems a very convenient way to get out of helping. It is not the first time they have backed out of helping at the last minute and then made a miraculous recovery.

Am I right to be suspicious?

Nurses who are emergency practitioners or advance nurse practitioners can sign patients off if they feel they don't need further treatment.

Im an A+E nurse and we discharge people from triage all time

Depending on the a and e it can be possible to be in and out super quick.

The sprain being worse than a fracture thing may be that they've said the pain and swelling can be worse than a fracture, that can be true it doesn't mean he needs crutches.

If it's a bad sprain he'd definitely need a few days resting it at the least.

Nurses in a and e can discharge patients it all depends on what the patient is presenting with.

You can’t get to our A&E without either being brought in my ambulance or going through triage at the urgent treatment centre.

Urgent treatment centre will triage and discharge at the front desk for malingerers/inappropriate attends. He could have been triaged by a ENP and sent away with standard sprain advice.

*by ambulance.

Well, I don’t think that sounds too odd personally. I went to A&E 2 weeks ago for a suspected ruptured tendon/ankle sprain. I waited about 5 minutes, consultant (not even a triage nurse) saw me for about 1 minute, said it could be a ruptured tendon or maybe not, if you still can’t bare any weight in 5 days, go see your GP. Biggest waste of my time. No x-rays, they seemed annoyed I was even there.

@mindutopia, with the greatest respect it’s because you didn’t need to be there. When you say “suspected” do you mean you suspected? What did you want A&E to do about a sprained ankle?

A lot of people are missing the point here.
Yes, of course nursing staff can discharge appropriate patients. Yes, it is often fairly easy to diagnose a sprained ankle and if it is obvious it doesn't take long. Yes, some severe sprains are just as painful and take at least as long to heal as some fractures. And no, crutches are not routine for sprains.
BUT the type of sprain which is severe and likely to take as long to heal as a fracture is NOT usually easy to differentiate from a fracture on a quick clinical examination. That type of sprain would be very likely to tick the boxes for requiring an x ray, or at least require a very thorough examination by an experienced clinician to determine that an x ray was not needed. And that would be very unlikely to be done and dusted in 10 mins.
If the OP's "friend" had said they had a minor sprain and had been in and out in 10 mins that would be believable.
If they had said that they have a serious sprain that is going to take as long as a fracture to heal then that would also be very easily believable.
But the two do not fit very well together. More serious injuries take longer to assess and are more likely to need imaging.
If I was a betting woman I would guess that the person has a genuine injury but is over egging it somewhat. But we will probably never know.

Just to go against most people - I took teenage DD to MIU this week with what we thought was a broken ankle - we were out within 10 minutes after triage, with no crutches or painkillers, having been reassured it was a bad sprain and would take a few weeks to heal. So I would say it's definitely not impossible!

The last time I went to A and E was to hand over some snacks and chocolate the week after I had been admitted.

It took about 10 mins to get to the receptionist and hand the bag over, and they didn't even take details.

The week before I had gone in by ambulance, the Dr had me moved to majors to give me morphine and told me I was being admitted before he even examined me, I was still in A and E for an hour or so while they did tests and examined me fully.

No,no crutches,despite the fact I was hobbling. But they said that if I'd actually broken it,I wouldn't be able to bear ANY weight on it at all. My GP said this was nonsense,as people have been known to walk considerable distances on broken ankles.

So, has all the work for the move been done now?
Will he have a miraculous recovery soon, I wonder?
Minor sprains/strains these days are meant to take analgesia and mobilise as much as possible, aren't they?

I wasn't up to helping much yesterday but everyone else except him finished the unpacking, his ankle then seemed to miraculously ease up. My friend then treated everyone to lunch and he heroically managed to go as well and be included in the free meal.

Apparently he was walking with no problems today.