"Incorrect clinical knowledge resulting in a perpetuated failure"

My adult son who has a diagnosis of Autism and Hypermobility recently fell and hurt his leg. On contacting our GP we were advised to ring for an Ambulance which we did. An initial estimate of up to a 10 hour delay was in fact only some 90 minutes, when a crew were stood down from another job.

They were from a station in Elgin some 30 miles away and were obviously keen to get back.

They assessed my son and in being told that he had, with help, managed to walk back from the kitchen to the sitting room with the support of two people, determined that he had not broken anything, as according to them, you can't walk on a broken bone.

They insisted that he get up and take some steps using a Gutter Frame despite his obvious distress.

We were then told that because he was just sore, if we wanted him seen in casualty in Inverness they would help us get him to our car, but the ambulance was really only for emergencies.

My son then struggled to get to the front door where we have a ramp installed for our wheelchair using daughter. 

Our son was weeping, looked ashen and on leaning on the railings said he couldn't go any further.

He had told them that he was afraid of the unknown and they had assumed he was talking about his feelings, and he was told that the ambulance crew was not there to give a lift to anxious people.

My son was then given a very patient explanation regarding the virtues of overcoming adversity and pushing through.

However, they finally realised that he was not able to walk and put him on a trolley and said they would take him to casualty. At no time was my son offered pain relief.

When we arrived at the hospital, it was repeated by the crew to us that it was extremely unlikely that he had broken anything and this must have been the story they gave to the receiving team. We sat in casualty for over 4 hours without being assessed, as the crew had told the charge nurse that he didn't need to be seen, as he was only there for an x ray.

My son waited without analgesic, in shock and having to cope with a vast array of stimuli  until we were  eventually told that he didn't need an x ray, he just needed to mobilise. Something they then strongly encouraged him to do, until eventually his inability to do so meant he was sent for an x ray.

Whilst in there he overheard the technician say there were obvious discrepancies. However, we were actually told that everything was fine and that he just needed to mobilise. Which they then insisted he do with the aid of some nursing staff.

My son was then sent home, in a condition whereby he could hardly weight bear, needed three people to help him stand and where he was left in agony every time he moved.

He had a fractured hip. Something we found out three days later. Luckily he does not require surgery but the trauma of the event will last a lot longer than the estimated 6-8 week recovery period for his leg.

My point is that incorrect clinical information regarding what you can and can't do on a fractured leg, and how much pain someone can be in, resulted in undue suffering for my son.

That the crew then took this assumption and advised the Charge Nurse to forgo initial assessment as he was actually okay, which resulted in them leaving him sitting in agony without seeing any one for hours.

Their "diagnosis" coloured his treatment when he was eventually seen, and because of this we were told that he didn't actually need anything other than to mobilise. 

No one was rude, people took their time to talk and assist him, but it all seemed to be with the aim of meeting their goal of getting him compliant enough to agree with them, when he knew something was very wrong. He was effectively made to do things against his better judgement.

An ambulance crew assess casualties based on knowledge and prior experience. 

They were wrong.