I discovered yet another reason to avoid alcohol, namely that it can mask the symptoms of otherwise obvious illnesses and injuries. We got called to a 60 year old man who had fallen in the street, as it was 2am we could guess that alcohol was involved. When we arrived on scene the patient was standing against a wall very much the worse for wear for drink. Admitting he was an alcoholic he told us that he had tripped over and now his right leg hurt. While he was standing there I gave him a quick examination, he had no bony tenderness, and was able to bear his weight on his leg. he could feel his toes in wriggling in his shoe and there was no obvious deformity to the leg. So we helped him walk the few steps to the ambulance but he was unable to manage the stairs at the back of the ambulance so we put him in our carry chair and lifted him into the ambulance. A further examination showed little else of note – his pulse was a tad on the high side, but otherwise his blood pressure and other observations were well within normal limits.
We transported him to hospital, where the nurse gave him a quick examination, essentially repeating the exam I'd given him in the field, and she sent him out to the waiting room.
When we returned to the hospital a little later we were told that he had broken the neck of his femur, essentially he'd broken his hip.
He was so drunk he felt little pain, and for various reasons none of the normal signs of a broken hip were present. Luckily I'd documented that I'd examined for the possibility of this type of fracture and found negative signs all the way along, so should he complain (which I doubt he would do) both myself and the admitting nurse would be covered.
So don't drink, or you may find yourself walking around on a broken leg.
Now I'm off to sleep. Two very long night shifts and I'm ready to collapse.