Should we go to A&E? Hive mind advice needed

[Elisheva]

My dd(11) injured her shoulder 10 days ago. We went to the minor injuries unit who sent her to A&E, she had an xray and they said she had sprained the shoulder joint which would resolve with rest and painkillers. All good.
Except she hasn’t moved it since then, she says when she tries it pops and feels like it’s grinding and that it’s too painful to move properly.
I am almost certain that it is muscular and that her muscles have seized from not moving it for so long, so she just needs to work through the pain and get them going again. But she won’t.
We returned to the walk in, who says she should go back to A&E as they can’t see the original x rays.
My dd is autistic (high functioning for the purposes of this discussion), and cannot tolerate another long wait. It took all her resources to cope the first time. We tried to go back and she just walked out when they said it would be 3 hours wait.
I phoned 111 who said that A&E is the appropriate route.
I don’t know what to do. I am as sure as I can be that there is nothing seriously wrong, but a tiny voice says what if there is! I can get her through another long wait, but I think they will just send her away and say she just has to start moving it. Which she won’t. Aaargh!

It is her dominant arm. They said in A&E that the x ray was inconclusive. It was reviewed by the virtual fracture clinic who were the ones who said to start mobilising. They only did the X-ray. No one examined her shoulder, or even looked at it, because she said it was too painful.
I called their advice line on Thursday and Friday but no one got back to me.

Thank you, that’s been so helpful. I’m on my own and it’s difficult to make decisions sometimes without someone to talk it through with!
111 did try to make an appointment at the walk in but there were none available. She is refusing to go to A&E anyway, so I think I’ll call the GP in the morning and try and get an appointment. There are none available to book online for 4 weeks.

So X-rays can be inconclusive when there is swelling- she does need repeat xray. Maybe a ct if suspected ligament /tendon damage.

I would GP and see if he can arrange an urgent xray appt so you can avoid the long wait - as your daughter is ND then they should be able to do that as a reasonable adjustment particularly if there is no urgent risk to health that warrants a & e … alternatively keep trying a&e and see if they can book an appt (some do!) or again arrange a follow up xray/ct that they can review without having to reattend

I assume the 3 hr wait means it’s a dedicated paeds a&e - sometimes you can literally just hit the sweet spot for waiting times. You could also ask when tends to be the quieter time and walk in and wait at this time

another option is some a&e have an urgent care. Ie your leg isn’t hanging off but you may need escalating to xray etc so a little different to a walk.in GP. waits can be a little less -

If it's broken I think often they can't operate? Or don't need to. Can she actually lift arm, squeeze hand, write? Has she got a sling?

I broke my shoulder and the recovery was very long and painful. The X ray may well have missed a fracture.

so that's a bit of a different scenario to your OP. It sounds like she needs to be reviewed in the real-life fracture clinic so they can decide if it needs reimaging/anything else doing. If the fracture clinic aren't replying then perhaps the hospital switch board may have another number or the ED should (or they'll at least know what the clinic opening hours are).

I don’t think it’s broken, it’s painful but not excruciatingly so. They did give her a sling, but the virtual fracture clinic said she can take it off and start mobilising it. When I take it off she just uses her other arm to support it.
It is a pediatric A&E, but at a big hospital so it’s always busy.

If you’ve been referred to peads an and e ring them up and ask if there are any adjustments they can make for attending with your DD. For example turning up and booking in and them calling you when your slot appears. A quiet waiting room etc.

I broke my shoulder a few years ago and apart from rest and painkillers there is nothing more they can do.

I was advised against an operation as it would have involved pins and months of rehab. The pain was excruciating for weeks and still i dont have full movement.

A couple of weeks ago i fell on the other shoulder, xray confirmed nothing is broken, just soft tissue damage again it extremely painful and i can feel a clicking. Try to encourage gentle movement, only time will help sadly.

Unless DD is in significant pain, I would wait to go back to A&E until tomorrow during the daytime. Before you go, call the hospital learning disability and autism liaison nurse if the hospital has one. Even if the hospital only has a learning disability liaison nurse, most will still support DC with ASD without LD. They can help support reasonable adjustments, including waiting elsewhere (in or out of the department). They can also help with a hospital passport for DD if she doesn’t already have one or NAS has one online.

The GP won’t see her.

GP can refer her to orthopaedics or can you self refer to physio?

111 say A and E, but you don’t know what to do, and are asking us. You need to go to A and E, I’d say.

We’re going to have to I guess. But it feels like such a waste of their time.