To go back to A&E or wait until tomorrow?

[RainRainRain33]

We're on holiday in the South West. Yesterday dd17 fell whilst walking on a footpath. Her left ankle twisted in the fall and is badly sprained (x-ray confirmed it isn't broken). She can't weight bare on it at all despite painkillers. In the same impact her left knee hit a rock and took most of the impact. It's badly lacerated most of the way across. They patched her up in the local A&E and dressed the knee (they didn't feel that stitches would help and it would be better to leave it open.

Dd just called me into her room whilst she was changing the dressings. Her knee has swollen, hot to the touch and I think has become infected

We are due to drive back home tomorrow morning. It's an 8 hour drive. Would you take her back to A&E tonight or wait until we get home tomorrow and take her to the local A&E? I'm concerned that we'll be stuck here if she's admitted tonight/tomorrow

Thanks

Definitely go back tonight - if it’s hot and swollen she needs antibiotics and 12 hours or so till you get home is too long to wait.

Call 111 and see what they suggest

Can you ring 111? Someone may be along with better advice. She may have pulled ligaments in her knee which would swell up. Salt water is good for wounds.

I think if you told them your situation they wouldn't admit her unless it was absolutely necessary. And if it was absolutely necessary, it would be worth being stuck for!
But actually I'd probably ring 111 and hope for OOHs for antibiotics.

Sorry to hear this, op. If I’m honest I wouldn’t risk leaving it, I’d go back now. Also, if she’s twisted her ankle badly, have they checked for damage to her Achilles tendon? A family member has found out recently to their cost what a catastrophe it is to have a ruptured tendon go undiagnosed and untreated for months, resulting in a permanent limp. Hope all goes well for your dd.

Did they washout the wound? Did they give her any antibiotics? Its unlikely to have got significantly infected in 24hrs to require admission, it obviously will swell

I would go tonight. Even if they do say she needs an admission (which I doubt) you could always ask for a dose of IV and follow up at your local A&E

If you think it's infected, it would be very risky/negligent not to seek medical advice now.
Even in healthy young people infection can be serious.

If it’s infected you need to go back.

Being concerned she’d be admitted is an awful reason not to take her to be honest OP, if it was bad enough she needed admitting could you imagine avoiding that really?

Take her back tonight to get antibiotics, leaving it 16+ hours is a bad choice

Oh that sounds miserable, I think you need to go back…

You can’t risk leaving that
Infection could spread very, very rapidly

Likely needs antibiotics go tonight

If I were in your shoes I wouldn’t wait. Not unheard of for doctors to miss a broken bone - I fractured a rib and no one spotted it despite being in 8/10 pain when presenting to A&E. Go back and I hope your DD gets better soon.

Back to a&e but take ibuprofen and a cold pack with you for the wait to help with pain. Poor girl.

I'm taking her back to A&E tonight after speaking to 111.

We've come up with a back up plan, that if she does have to be admitted (hopefully not - fingers crossed that they will prescribe oral antibiotics and we can go home) then DH and our Ds's will go home on the train tomorrow. I will stay down here with the car and DD

Hoping A&E won't be too busy at this hour and we get seen quickly

Glad you’re taking her
Hope she’s alright

Fingers crossed it’s quick. I hope she feels better soon OP

I'm glad you're taking her tonight, it's the right decision.

It you’re off to the RD&E, it’s a pretty efficient hospital and hopefully you’ll be sorted quite quickly.

Sounds too soon too soon for infection. If she has no fever, I would be tempted to get her in the car and get her home overnight while roads are quiet and then get to your local hospital, who can give ongoing treatment. However you can see her and know if she is ill which would mean hospital down there.

How'd it go @RainRainRain33 ?

She's been admitted. They were concerned with the infection being over a joint. She's had a fever pretty much since we arrived at hospital so it's obviously progressing.

She's having IV antibiotics and they've taken her to surgery to wash out the wound. Just waiting for her to come back to the ward now

You made the right call. Hope surgery is a success.

I second the tendon question. My husband did his ankle last December. Urgent care confirmed no break, just a sprain and told him to rest it for a week or so and gave him exercises. He followed the instructions to the letter but it didn't heal properly and when we paid privately for a physio she was horrified and said it absolutely should have been in a boot. He's been working with her for months now and it's starting to improve well at last but it definitely didn't get the right care at the time.

I hope you've managed to make it home, OP. How is she now?