Sister been given 4 day wait to see doctor for dislocated shoulder and fractured collarbone

[Joffmognum]

My tween sister got thrown too hard at martial arts practise on Friday, and was screaming afterwards. Taken to A&E, she was hyperventilating and crying from pain, couldn't move EITHER of her arms.

She had an xray which showed a big crack through her collarbone, other small fractures other than that, and her right arm is way out of socket. Left arm is still in place but collarbone is damaged near that joint too and she can't use that shoulder/arm joint without a lot of pain. She can still use her left elbow, but other than that is useless from the chest up.

She was given a bandage sling but no painkillers despite asking for them and was told she couldn't see a doctor til Tuesday. Again, this happened on Friday.

On Saturday she slipped out of a chair and waited for 2 hours until someone found her and helped her because she couldn't move and couldn't reach a phone. She has to be spoonfed and cannot go to the toilet unassisted. Someone has to pull her trousers up and down and wipe her. She's 14 and this mortifies her. Showering is standing in the bath and mum runs her with a flannel. We've scribed her homework.

We thought this was ridiculous and that it must just have been the hospital or the supervisor and that we'd have better luck with another hospital. Again, got turned away from a&e, offered a fresh bandage for the sling but no painkillers and told we still have to wait.

Is this normal?????!

I have no idea why she hasn't been considered a priority. One shoulderblade looks about 4 inches lower than the other. Why can't we see a doctor for 4 days??? They didn't even let her have gas and air in the emergency room. It's cheap, non addictive and has few negative side effects.

If anyone with an M.D. could shed some light on this I'd love to hear it

Ouch, my DH was in agony with a dislocated shoulder. They relocated it there and then in A&E and he had to return about a week later to the fracture clinic. I would recommend that you arrange some private physio for her as the NHS wait can be long and this would help recovery.

Do you have any Walk-In centres in your town/city?

Your DD could be seen by a doctor there and referred to the Fracture clinic.
That way you be seen the same day instead of waiting for gp.

Just want to add, that wasn't me being unsympathetic. My DH was in a worse state in terms of not being able to look after himself.
More that unfortunately that's standard for those injuries. There's not much they can do once it's been x rayed and strapped if it doesn't need surgery.

Okay, A lot of people are suggesting she's being treated normally. I'm not a healthcare professional at all

If it's a collarbone break there's not a lot to do apart from strapping it up.

It is sore. But it is less so after a few days. It heals quite quickly.

And yes- I was also 14 when I broke mine and took to wearing light dresses for a month so that I could take a pee without having to worry about doing up jeans etc.

Oh my god..are you in England..what the actual fuck us the NHS for ...if you are in England.get her back to a and e and refuse to move.i would never of taken a child home like that.i would simply of refused to move

But even if they were leaving it until the specialist is seen for some reason, they'd surely give her painkillers in the meantime?? I had loads of painkillers given even after they'd put it back in.

Thanks guys
I know collarbones must be left, it's the pain and the lack of explanation for leaving the dislocation I'm confused about (I wasn't there in the hospital to ask, I think my mother and sister were too in shock to)

My OH is an ambulance practitioner and has been for 20odd years.
He suggests making a figure of eight sling. Use a crepe bandage doubled over, under the armpits and then the loose ends round the neck and tied to the back, pulling till it eases the pain. He works with jockeys and this is the method the doctors use.

Not surprised. I was ill and taken in in agony and given morphine and hours later told sorry, we can't give you anymore
Feel so sorry for your sister.
I'd go and get some cocodamol from the shops and then get her seen at the gp.
Mine were much more helpful!

You don't need to be prescribed pain relief - my DD broke her collarbone and it was agony for the 1st week. Paracetamol every 4 hours, and Ibuprofen every 6 hours. She could have co-codamol instead of paracetamol but ask the pharmacist for the right dosage. Poor kid.

Op I'm a nurse consultant and worked as a ENP for years. There's a few things that don't quite add up. A dislocated would need to be relocated. If there's an unstable fracture this complicates things and orthopaedic opinion would used. I would not discharge a patient with an obvious dislocation. As another pp stated it would be a normal wait for fracture clinic which makes me think there's a few gaps in the history, who did your sister have with you? A fractured clavicle can give the appearance of a dislocation . Clavicle fractures can be incredibly painful but are usually treated with a collar and cuff style sling using gravity. I think it's really unlikely that your sister only saw a nurse and not a dr or ENP. She absolutely should have been given adequate analgesics to go home with, paracetamol codeine and an NSAID are standard if there's no contradiction . Make sure your sister is taking regular pain relief, ask the pharmacist for advice (they can give a low dose of codeine paracetamol combined). She should be sleeping supported semi upright with lots of pillows, I would take her back to ED tomorrow morning or tomight and ask to go over with a dr exactly what injuries she has , the treatment and next steps.

DS has dislocated his shoulder multiple times (over 15). It has always been put back immedietly as you do risk nerve damage. This is at two different hospitals and once abroad

As ever, what jumps out at me is the lack of good communication.

I would expect a dislocated shoulder to have been reduced (put back in place - often this happens spontaneously). The apparent position of her shoulder blade does not tell you reliably whether her upper arm bone is in socket or not.

However, it IS horrible that she and your mother has not been informed about what's happening in such a way that they understand why things are done the way they are done. If your family feels up to it, it is well worthwhile putting that in writing.

Re painrelief: it is rare to treat youngsters with opiates. She should take a full adult dose of Paracetamol (1g four times in 24 hrs) and Ibuprofen (usually 400mg 3 times in 24 hours).
And yes, she will be sore. And very limited in what she can do - not being able to use, never mind two shoulders is very limiting.

Oh my god..are you in England..what the actual fuck us the NHS for ..
Nice bit of anti NHS sentiment with no medical knowledge or personal experience of the injuries in thr OP.

OP Me and DH bought a full fabric sling off the Internet as he found it a bit more comfortable than foamy one from hospital.
Depending on how it goes at the fracture clinic they'll probably refer you to physio. That's what happened to my DH.

Unfortunately they're rubbish painful injuries. You can buy cocodamol and / or narproxen over the counter though.

Your poor little sister,no one on here can see how your sisters body looks and it doesn't sound like your Mum knows much about what happened/is happening(as you've said because of the shock)I'd honestly take her back to the hospital(as in you take her)hopefully you'll get more answers and help for your sister than she's had so far.

When anything bad happened to me my Mum was pretty much useless bless her,because like your Mum because of the shock but sadly because of that I've been left with lifelong injuries that weren't fixed properly at the hospital from when I was a child and I'm in my 40's now.

She's so young and you want to make she's getting the right treatment for her,God forbid it get's left and doesn't heal the way it should.

Fingers crossed they get it all sorted for her quickly

I think rather than ask people on the internet you need to phone the ER and ask whether the shoulder was relocated or not, and if not what the treatment plan is likely to be.

The collarbone being left for a few days is one thing, but leaving a dislocation is something else entirely, which makes me think they have actually relocated it.

But please do get your mum to phone and check.

Leaving a dislocated shoulder is not normal.

DS2 dislocated his when he was 16. He fractured it in 3 places, too. It was a rugby injury. He was taken to A&E by ambulance because he did it at school, and they weren't sure if it was a neck injury or not. He was in and out of A&E within an hour or so, and they explained that it had to be relocated urgently so as not to damage vessels and nerves. His arm was put in a sling and he had a fracture clinic appointment with a shoulder specialist the next day.

He had an MRI scan a few weeks later, unfortunately he did it in the winter and it was very busy at the hospital so waiting times were long, and they injected dye so they could see all the soft tissues. It showed his rotator cuff (I think) was damaged. As he was young he had extensive physio.

Unfortunately he lost a lot of movement in that shoulder and had to have surgery to repair the rotator cuff and something else. It was quite a big op, and he doesn't have full range of movement in that arm. He's a student nurse now, 4years on, and he's in pain after a long day.

Your sister really needs to go back to the hospital to be seen. She must be in so much pain, poor love. Good luck

This is also a downside of not giving patients a copy of the treatment notes at the time of discharge (bug bear). I see your mum was with her so I'd advise you get her toting the first ED and ask to speak to one of the nurses. If ds is over 16 it may be easier for her to talk to them. A low dose opiate like codeine is often given in older children with severe pain, again ask the pharmacist who can ask the appropriate questions- that is if she doesn't go back tonight!!

Don't really understand the lack of codeine she's been prescribed. I was given codeine to take home when I've been to ooh with major pain.

However, for now, I'd suggest you get to a pharmacy and purchase the highest strength codeine and paracetamol and ibuprofen and codeine for her. Then you can combine the two to get as much pain relief as possible. Be aware that they may be wary of giving you that much.

Take care not to let her OD on paracetamol.

I slipped rock climbing and dislocated my shoulder. Then we had to get out of there. It was about 6 hours after the event that I got to A&E. But they wouldn't let me leave until it was put back in place and it was so stiff I had to have a GA to get it back in place.

I'm really surprised they let her out with it dislocated. It hurt like a mofo!

I missed the bit where apparently it's not been relocated.

I find that very odd. DH was in bloody agony the longer it was out and the 2nd time it happened he was put under general anesthetic to put in back quickly.

Are you sure it's actually out still? Is there a chance thay because of the other injuries she's holding herself funny so it looks out still? Did the Dr definitely confirm it was a dislocation in the first place? (Please don't shoot me, I'm only asking because it would be very very unusual.for them to send someone away without it being put back in).

Very sorry, your poor sis, make a fuss, make a fuss.

As others have said, it would be VERY unusual to not have been relocated at the time. It has either dislocated again or she is holding herself in such an unusual position to avoid worse pain to make it look still dislocated IMO.

Taking her back to A+E because of uncontrolled pain is entirely reasonable if over the counter codeine/co-codamol does not work.

Hmm this doesn't sound right - I used to work in A+E and we would routinely put dislocated shoulders back in.