A resident in my home was found lying face down on the floor in his room with a wound on his head and bruising to his left wrist/knee/head/elbow. The man said he was in no pain and was assisted to sit. Wound cleared up and GP consulted via telephone. GP says if man is not in pain (which he repeatedly said he wasnt) and if he could move limbs (the man never lifts his arms anyway but wrist could be rotated and elbow straightened without evident pain), then unlikely to be fractured or dislocated as this would be agony. He did not visit but advised to give analgesia if required and observe. By 2pm the man still insisted he was in no pain but would not move left arm (particularly at elbow and shoulder), I phoned the GP again and a different doctor advised to send for x-ray.
My problem is with my colleague she thinks the man is just scared and wont admit pain and I should therefore have given him analgesia even though he did not want any when I asked. She said the man has history of osteoporosis (this is not in his notes) and the GP should have sent him to hospital straight away. I however agreed that in the circumstances he was right to wait as I have had residents go to A&E unnecessarily before and have to wait 4 hours to be seen and 8 hours to get an ambulance back. When I left work, the ambulance still had not arrived but the man was watching television in his room and spoke pleasantly to me as I entered. If this man was n agony I take my hat off to him. What would others have done!
PS I done 15 minute checks on him for 4 hours following the fall to check for head injury, he was alert at all times and blood pressure and pulse normal.