To ask what you would have expected the hospital to do in this situation

[Mylandra]

I was recently involved in a major accident which resulted in a lot of trauma to my body. I was taken to hospital by ambulance, and taken straight in onto a bed. Whilst I was there, the nurse did an ECG, took my temperature and took some bloods. After 3 hours they sent me home

I was complaining of severe pain to my collarbone and ribs and also to both knees. The hospital didn’t do any x-rays or scans, just said everything seemed fine and sent me on my way. I was able to walk, so I didn’t think I’d done anything to my legs, but the pain in my chest has been getting worse, to the point it’s unbearable. I’ve since had to go back to another hospital where they did do x-rays, and it turned out I’ve broken 2 ribs and my collarbone

Aibu to wonder if they should have been doing all that the first time I was taken to hospital? I’ve never been before so I had no idea what to expect

Seems quite common really, I think everyone knows someone who went to hospital with a pain in their arm/leg/hand/foot and was sent away and then 2 days later went back was X-rayed and it was found to be broken.

So perhaps there is a general policy of 'wait and see' if its not too obvious at first?

I guess all the people whose pain settles down and don't have a fracture don't tend to post it on social media or tell all their mates. It's only news if the Dr is wrong

Also I think some types of fractures particularly in feet and hands (not yours op!) Don't always show up on x-rays until a few days later

That’s bonkers. Really hope you are ok OP.

@CovoidOfAllHumanity sorry I don’t think I explained very well. The only thing they did was bloods, ECG and temp. I wasn’t examined at any point, nobody checked me over or looked at where it hurt. I was expecting to have to take my clothes off and be checked over, or something along those lines. At the time I was so shocked I didn’t really think anything of it. I’m not blaming them, as they were very busy and understaffed, I was just a bit surprised that’s all

Agree with @GeneLovesJezebel.

It would be helpful for you to give feedback to the initial hospital. You had to seek further medical attention soon after their assessment. Multiple rib fractures were diagnosed. Those are easy to diagnose just by a proper examination, so there was either a failure of diagnosis or a failure to communicate the info to you.

The emergency dept will have someone who can run through your case with your doctor. They might learn something useful about diagnosing and managing rib fractures, and discharge instructions.

You don't need a chest xray to diagnose rib fractures but if the dr thinks someone has them you will almost always get one - to look for associated injuries (pneumothorax, haemothorax, etc). CXR radiation is so minimal compared to chest injury risks but bedside ultrasound can also be done to look for some of those with no radiation.

Rib fractures do make a difference to your treatment, over bruising:

1. Your expectations. Your pain will take some weeks to fully improve, not days.
2. This may impact your work, caring duties, sports and hobbies. You may need a longer sick certificate. You may need additional help with kids. Etc
3. You should perform respiratory physiotherapy to minimize your risk of pneumonia or resp failure
4. You should have been made aware of signs to look out for of complications that need medical attention - sudden worsening of pain, shortness of breath, fainting, coughing up blood, fever --> back to doc
5. If you have significant underlying conditions (lung diseases, elderly) you may need to be admitted for pain relief and physio if you deteriorate at home. They would consider an anaesthetic technique similiar to epidural if needed to help you breathe.

Here is a link for some breathing and chest exercises. There are plenty of similiar nhs guides via google. Make sure you are deep breathing and able to cough strongly enough to clear mucous. Take analgesia if you cannot and/or try again in 30mins.
www.webmd.com/a-to-z-guides/best-exercises-broken-ribs-recovery

I have no idea how anyone can say ‘X-ray minimum, CT ideallly’ or that rib fractures don’t need treatment on the basis of the above. I’m interested to hear how many of the above PPs are surgeons/Ed physicians/Intensivists at major trauma centres…….

The mechanism, history and examination findings guide imaging and we have none of that.

It is also quite simply incorrect that ‘nothing can be done about’ rib fractures. In fact some need surgical repair and others are an indication for CT imaging.

As usual nobody who knows what they’re talking about can give a definitive answer: the only people who see this very clearly based on the info you’ve provided are people who don’t have clue.

I'm always surprised how many people can defend what is not defendable. Of course they should have done x - rays!!! The OP was hit by a motorbike ffs!
When you've been on the end of medical negligence - admitted and settled. Then you're more aware of what can happen and that sometimes it's not a simple oversight!!

@Mylandra Thanks for the update. Being struck by a motorbike and complaining of chest pain should definitely have scored you a basic clinical exam at least. I would give formal feedback if I were you.

They may be very busy but a basic look, feel and listen to your chest was required before discharge. Don't think of it as trying to get anyone in trouble - think of you contributing to a doctor getting more education, or the department getting further proof they are underresourced.

As for talking up at the time. It's really hard when you're in pain and in a weird intimidating environment and don't know what's expected. Go easy on yourself.

Well if no physical examination of any kind was done then that is hard to defend and you should make a complaint

Had the paramedics done any assessment before bringing you in?

You should definitely have been examined. The examination and information about how it all happened would then have determined whether x-rays were needed.

I've worked a lot in a&e.

You should absolutely make a complaint, their lack of basically any care is unacceptable.

Then yes, the should have xrayed you. There isn't much they can do for either condition, but seems very lax not to have done xrays if you complained of real pain. You need a thorough examination and scans etc for the insurance claim/police report.