Dd injured - not happy with A&E.....

[whojamaflip]

Posting here for traffic

Dd took a crashing fall from a height at sports training last night and has hurt her foot and unable to bear weight on it.

Went to A&E last night and they took X-rays and said her ankle was fine. They wouldn't listen to her when she repeatedly told them the pain was under her arch and across the top of her foot not in her ankle. Sent her home still unable to weight bear with no crutch's and a self care leaflet for ankle injuries.

Would ibu to take her to our local minor injuries unit today for a second opinion? She's on paracetamol and ibuprofen alternating every 2 hours and it's only just taking the edge of the pain. Foot is swollen along the outside and across the bridge and is very painful to the touch. She also has a high pain threshold so when she is crying in pain I sit up and take notice!

Dh reckons they will review her X-rays as a matter of course this morning and will ring if they've missed anything - is this right?

I bandaged it for support

No!!

Paracetamol every 6 hours (4x in 24 hours only) and Ibuprofen every 8 hours. (3x in 24 hours only). Especially for mid term pain relief. (Spent lots of time in hospital on said regimes).

It doesn't matter when you take either. I would take them both at the same time at bed time and work out the schedule from there.

FtR I have anaphylaxis off Ibuprofen now

This is ridiculous, they watched her hop out?!

Glad to hear you're taking her to be seen again.

The radiographer adds a red dot to any xray with an abnormality e.g. obvuous fracture. So it's unlikely there is an obvious fracture that needs surgical management. The XR would also have been reviewed by which ever doctor reviewed her in ED. There are many small bones in the foot and she may have a small non displaced fracture which will only be picked up by someone with more experience (e.g. radiologist, senior ED doctor, orthopedics). If its a small fracture such a crack without displacement and no loose bone fragments, they won't do anything. You could ask for crutches from someone who has them but they'll need to be adjusted for her height. If you think it's a ligament or tendon rupture it won't show up on an XR but they might see fluid and swelling. If you're not happy, consider a second opinion.

Assuming she goes to sleep at some point and misses some, how is that a high dose?

This is ridiculous, they watched her hop out?!

Not being able to weight bear doesn't necessarily mean a break.

It does sound like a foot xray wasn't done, so that is needed, but soft tissue injuries and sprains can easily be bad enough to give the symptoms the OP describes. Including the inability to weight bear.

@whojamaflip i would seek a second opinion. My DH hurt his leg (dropped a fridge on it when moving!), went to ED and had it x-rayed. They said it was all fine. Turns out, after going back twice more and having further imaging, his leg was broken! It had started to heal at this point (5-6 weeks after injury) but he was hobbling and in so much pain. Always seek a second opinion if you think there is something more to it.

She may well have broken one of the many little bones in the foot and it's been missed. It happened to me. However as other posters say, it often ends up with the same treatment anyway. Rest it. I would return though.

She can have co-codamol every 4 hours - may help more than paracetamol.

I've got torn ligaments in my left foot and it's making me question my sanity, OP. It's incredibly painful, and I've had a set of complete xrays of my foot so know it's not broken.

Octomore I'm not saying it is broken

I think they should have given her crutches

I have had an accident abroad and had to pay for crutches (claimed back later on travel insurance). If that's the only option, fine, but at least I was offered them.

and why didn't they listen to where the poor girl said the pain was?

I hope they can help today op.

I would also go for a second opinion.

My GP and also the Nurse Practitioner, who I presume are both highly qualified, advised me that you can take pain relief every 2 hours by alternating paracetamol and ibuprofen so each drug would be every 4 hours, as long as you keep to the 24 hour dosage rule as well. They both said that seeing as most people sleep at night, then you only take them during waking hours and therefore don't overdose.

They said the same about DD and the liquid versions when she was little.

The whole point is that you can top up every 2 hours.

OP, take her back if you are unsure, DD injured her ankle when she was younger and I didn't take her in to A&E as she was jumping on the trampoline again the following day so I thought it couldn't be broken, but it has given her so much trouble over the years now she must have damaged something at the time :(

I tore ligaments in my foot, told it can be just as painful as a break and can take longer to heal. I didn’t get crutches or painkillers when I went to A&E

Same. I hopped in and hopped out. I couldn't put weight on it for several days, well over a week, at least and used a walking stick for a couple of months. They told me to buy paracetamol.

Read the pack instructions people!

In my limited experience I have fractured (not broken) bones twice. Both times I went to A and E, both times I was x-rayed, both times I was sent home, both times I continued in agony, both times I went back and the second lot of x-rays confirmed the crack.

I would go back and ask for a foot x ray. Your poor Dd. She's telling you what hurts and where and she's being specific, definitely focus on that area. I have also wrecked the arch on my right foot and definitely agree to check for soft tissue damage, too. Can be much harder to find. Maybe book a physio appt as well?

I double sprained my hypermobile ankle, spent two weeks nursing it and within 3 days of walking well enough to go back to work, I trod on it funny, had another fall, re-sprained it and bruised a bone in my other foot as I banged it on the pavement; it ended up out of alignment. The re-sprain was so painful I went into shock. Foot injuries are horrific and often underestimated!

Sorry @CrookCrane what are you saying is wrong? You can alternate paracetamol and ibuprofen 2 hourly ie paracetamol at 12, ibuprofen at 2, paracetamol at 4, ibuprofen at 6. This is absolutely fine and in fact recommended - as long as the dosing schedule keeps you within the maximum 24 hour dosage limit.

Respecrfully, are you maybe misunderstanding what people are saying? No one is saying they take paracetamol every 2 hours or ibuprofen every 2 hours - they space them out so that there is a minimum 4 hour window between each respective medication, but alternate the 2 every 2 hours.

cocodamol is paracetamol + codeine, and has the same dosage of paracetamol (500mg per tablet) as standard paracetamol, so would be subject to the same rules - adults can take 2 tablets every 4 hours, but no more than 4 doses in 24 hours.

When this happened to me i got a phone call two days later when the xray had been reviewed.

I had been sent home from a&e where they pretty much told me I was being a wuss, there was nothing wrong and i should just walk on it.

Then the dr on the later phone call said absolutely don’t put any weight on it, there is a break that needs surgery.

i didn’t care about the mistake but how the staff in a&e made me feel on that first visit is still with me!

You mustn't exceed the directions which are USUALLY 3 x a day. You can take ibroprufan and paracetamol as they are different types

Was just about to oust the same thing.

She's going to run out if doses. Stretch paracetamol to six hourly.

The OP posted early morning and said she’d been injured last night and in A&E overnight. That made me think if she was still in agony they’d be carrying on with 2 hourly doses. Others seemed to presume the same.
OP has now confirmed she’s aware they can’t carry on like that for the rest of the day.

Never more than 6 x Ibuprofen and/or 8 x paracetamol in any 24 hour period, and never mix Ibuprofen with other NSAIDs. You can take paracetamol and ibuprofen at the same time, but two hours apart (whilst also adhering to the 24 hour rule!) can give better pain relief for a longer period for some patients (I suspect this has caused the confusion!). You do not need a big paracetamol dosage to overdose, which is very dangerous!

Brufen is not exactly the same as ibuprofen. It's stronger and should not be taken so frequently. It's also not generally recommended for children. I don't think the OP mentioned Brufen, though.

@StressedToTheMaxxx is 100% correct in her advice.