Welcome Guest! The IOSH forums are a free resource to both members and non-members. Login or register to use them

Postings made by forum users are personal opinions. IOSH is not responsible for the content or accuracy of any of the information contained in forum postings. Please carefully consider any advice you receive.

Notification

Icon
Error

Options
Go to last post Go to first unread
Mersey  
#1 Posted : 20 January 2020 17:00:38(UTC)
Rank: Forum user
Mersey

People probably get sick of the constant RIDDOR questions on the forum so apologies in advance.

IP has slipped on a wet floor last Thursday and fallen heavily no witness to the actual incident and no CCTV.

No one is disputing the incident took place. 

Thursday IP attends A&E see the triage nurse then waits three hours to see  an unkown individual (whether it was a doctor or advanced qualified nurse) who uses a stethoscope to listen to breathing (I assume to listen out for a punctured lung which IP did not have) 

I believe the only way to determine if a rib(s) are broken is by an Xray. IP is back in work Monday on light duties. Do I have to take the IP's word that rib(s) are broken without this evidence? And therefore fill out a riddor report?

There is no written documentation or Xray to determine the rib(s) are broken. I don't know how you can tell that someones ribs are broken without an Xray to my knowledge its just not possible.

RIDDOR or not that is the question?

Roundtuit  
#2 Posted : 20 January 2020 17:21:35(UTC)
Rank: Super forum user
Roundtuit

https://www.hse.gov.uk/riddor/specified-injuries.htm

there may be no evidence of a fracture (e.g. if an x-ray is not taken), but the injury will still be reportable if a doctor considers it is likely there is a fracture.

So reportable

One way people can tell if they have a broken rib is pain when breathing, lifting or laughing - no x-ray required

Edited by user 20 January 2020 17:22:42(UTC)  | Reason: FFS

thanks 2 users thanked Roundtuit for this useful post.
Mersey on 20/01/2020(UTC), Mersey on 20/01/2020(UTC)
Roundtuit  
#3 Posted : 20 January 2020 17:21:35(UTC)
Rank: Super forum user
Roundtuit

https://www.hse.gov.uk/riddor/specified-injuries.htm

there may be no evidence of a fracture (e.g. if an x-ray is not taken), but the injury will still be reportable if a doctor considers it is likely there is a fracture.

So reportable

One way people can tell if they have a broken rib is pain when breathing, lifting or laughing - no x-ray required

Edited by user 20 January 2020 17:22:42(UTC)  | Reason: FFS

thanks 2 users thanked Roundtuit for this useful post.
Mersey on 20/01/2020(UTC), Mersey on 20/01/2020(UTC)
Mersey  
#4 Posted : 20 January 2020 17:50:07(UTC)
Rank: Forum user
Mersey

"but the injury will still be re portable if a doctor considers it is likely that there is a fracture"

Not sure whether it was a doctor? Say it wasn't a doctor and it was a nurse who suggested it, should that make a difference?

Thanks for the reply,

I'm not sure you can categorically say thats rib(s) are broken without an X-ray. I think an Xray is the only factual way to determine unless there is a puncture lung in which case you would get an Xray any way. I could be wrong I often am!

johnmurray  
#5 Posted : 20 January 2020 17:50:36(UTC)
Rank: Super forum user
johnmurray

Xrays cost money. They also expose people to ionising radiation. In the case of a fractured rib, it may not even show-up on an xray. Usually an xray will only be considered if there is some sign of internal injury, for instance haemotysis. The younger the patient, the more reluctant they will be to xray.

thanks 2 users thanked johnmurray for this useful post.
Mersey on 20/01/2020(UTC), ttxela on 21/01/2020(UTC)
Acorns  
#6 Posted : 20 January 2020 18:49:14(UTC)
Rank: Super forum user
Acorns

For most 'fractured' rib, its more a case of being torn muscle / ligaments etc rather than a broken boke in the sense of a broken arm/leg.  We all like the idea of an e-ray, but its just one means of diagnosis not the be all and end all.  Its important for an arm to know exactly where it is so as to set the plaster correctly.  For a rib, its usually just take rest and sometimes a bit of a wrap around support.  Sometimes it ends up with visible bruising and other times just great pain and discomfort the the patient and no visibil esymptoms.
I wouldn't be surprised at the diagnosis of a fractured rib, with no extenuating symptoms to be left at that without x-rays.  

thanks 1 user thanked Acorns for this useful post.
Mersey on 20/01/2020(UTC)
Roundtuit  
#7 Posted : 20 January 2020 19:14:55(UTC)
Rank: Super forum user
Roundtuit

Without going down the route of asking for the medical records of the visit it would be fairly safe to assume within the UK that if someone gets beyond the triage nurse in A&E a doctor will have been involved.

Then you have all the issues with patient confidentiallity and data protection to overcome should you choose to demand these documents be made available - let the true sceptics in insurance worry about this.

Unless you personally escorted the IP how sure are you they even attended A&E?

thanks 2 users thanked Roundtuit for this useful post.
Mersey on 20/01/2020(UTC), Mersey on 20/01/2020(UTC)
Roundtuit  
#8 Posted : 20 January 2020 19:14:55(UTC)
Rank: Super forum user
Roundtuit

Without going down the route of asking for the medical records of the visit it would be fairly safe to assume within the UK that if someone gets beyond the triage nurse in A&E a doctor will have been involved.

Then you have all the issues with patient confidentiallity and data protection to overcome should you choose to demand these documents be made available - let the true sceptics in insurance worry about this.

Unless you personally escorted the IP how sure are you they even attended A&E?

thanks 2 users thanked Roundtuit for this useful post.
Mersey on 20/01/2020(UTC), Mersey on 20/01/2020(UTC)
RayRapp  
#9 Posted : 20 January 2020 20:06:15(UTC)
Rank: Super forum user
RayRapp

I would be very surprised if a broken rib could be identified without an Xray. Some years back I had an unfortunate fall and went to the Dr, who said I may have a broken or bruised rib(s). Either way not much can be done about it but rest and pain killers. 

thanks 1 user thanked RayRapp for this useful post.
Mersey on 20/01/2020(UTC)
stevedm  
#10 Posted : 20 January 2020 20:09:49(UTC)
Rank: Super forum user
stevedm

there are occasions where you would not need to xray a suspect broken rib...you can do a chest examination (I do at the roadside etc) which will show some movement and coughing blood would identify the possibility of a punctured lung, liver or spleen...so no need for xray ...as you can't really splint anything...I personally would but that is just me I like to be 100%...what advice has he been given for his 'self treatement'...he may have just read the NHS website and not attended...?  Poss referral to occ health if available..?...not sure I would support a RIDDOR for this one...

thanks 1 user thanked stevedm for this useful post.
Mersey on 20/01/2020(UTC)
A Kurdziel  
#11 Posted : 21 January 2020 09:18:16(UTC)
Rank: Super forum user
A Kurdziel

“People probably get sick of the constant RIDDOR questions on the forum so apologies in advance”

YES

The reason is that people get hung up on whether this is a RIDDOR or not. I know why this is: the number of RIDDORS is used by many organisations as a metric for effective H&S performance.  Lots of RIDDORS = poor H&S is the equation. Of course RIDDOR of itself is not an admission of liability but many people see it as such.

What we should be asking is how could, the accident have been avoided in the first place. Why did the person slip in the first place, could something have been done to prevent this?

Instead we are trying to second guess a medical diagnosis!

As some has said RIDDOR is poor system for collecting data on work related accidents. Perhaps we should change this to either a self-reporting system for employees or make it a statutory duty on medical practitioners to report all work related accidents they come across.

YES I AM SICK OF RIDDOR

thanks 5 users thanked A Kurdziel for this useful post.
Mersey on 21/01/2020(UTC), CptBeaky on 21/01/2020(UTC), Gasman on 21/01/2020(UTC), ttxela on 21/01/2020(UTC), webstar on 23/01/2020(UTC)
Mersey  
#12 Posted : 21 January 2020 09:25:15(UTC)
Rank: Forum user
Mersey

Couldn't agree more.

I know what to do to prevent it happening again and thats the main thing thanks

Holliday42333  
#13 Posted : 21 January 2020 09:51:43(UTC)
Rank: Super forum user
Holliday42333

Whilst it wouldn't end up as RIDDOR, broken fingers and toes tend not to get x-rayed unless at a funny angle and obviously displaced.

The (unoffical rule) is; if it hurts for a week its bruised and it it hurts for more than a week its broken.  The treatment is exactly the same (strapping) for either option.

And yes; RIDDOR needs a revamp that won't happen under the current political desire for de-regulation.  If the Management Regs ACOP still hasn't been re-instated, what are the chances that RIDDOR will undergo a significant reform?

stevedm  
#14 Posted : 21 January 2020 10:01:31(UTC)
Rank: Super forum user
stevedm

...also one thing I forgot to add last night...the mechanism of injury..?  the IP would have to have fallen on thier side without thier arms as protection - possible......maybe just get the person to show you (without actually falling again) how it happened as part of the investigation? that will either confirm or deny the persons story...

Roundtuit  
#15 Posted : 21 January 2020 11:50:23(UTC)
Rank: Super forum user
Roundtuit

osteoporosis

Roundtuit  
#16 Posted : 21 January 2020 11:50:23(UTC)
Rank: Super forum user
Roundtuit

osteoporosis

CptBeaky  
#17 Posted : 21 January 2020 12:14:19(UTC)
Rank: Super forum user
CptBeaky

Fall at an angle that forces your elbow into your ribs....

Surely it is not our place to investigate the validity of an injury, just the circumstances that lead to it. In terms of RIDDOR, we have to go by the expert advice. If they say it is broken, we must assume it is broken (or seek a second opinion from another expert).

Basically we report. We investigate the cause. We rectify any flaws we discover to ensure the chance of it happening again is minimized. We then check to see if the original RA/SSOW etc needs updating. (not necessarily in that order).

The HSE then puts it into a big pile and forgets about it until it comes to statistic day again....

Mark-W  
#18 Posted : 21 January 2020 12:28:42(UTC)
Rank: Super forum user
Mark-W

Originally Posted by: CptBeaky Go to Quoted Post

Fall at an angle that forces your elbow into your ribs....

Surely it is not our place to investigate the validity of an injury, just the circumstances that lead to it. In terms of RIDDOR, we have to go by the expert advice. If they say it is broken, we must assume it is broken (or seek a second opinion from another expert).

Basically we report. We investigate the cause. We rectify any flaws we discover to ensure the chance of it happening again is minimized. We then check to see if the original RA/SSOW etc needs updating. (not necessarily in that order).

The HSE then puts it into a big pile and forgets about it until it comes to statistic day again....

I get the sentiment of investigating with the info we have but as there is no formal evidence of broken ribs we could be investigating down a rabbit hole. 

Theres no getting away from the incident, it happened but if the end result is just bruising rather than broken ribs the control measures that are implemented may not be proportionate?

Or am I being to cynical, like the OP

MrBrightside  
#19 Posted : 21 January 2020 12:35:01(UTC)
Rank: Forum user
MrBrightside

From RIDDOR: Bone fractures include a break, crack or chip. They are reportable when diagnosed or confirmed by a doctor, including when they are specified on a GP ‘fit note’. In some cases, there may be no definitive evidence of a fracture (eg if an X-ray is not taken), but the injury will still be reportable if a doctor considers it is likely that there is a fracture. Self-diagnosed ‘suspected fractures’ are not reportable.

Unless I have written confirmation, I will not report it as a Major RIDDOR. In the long run it doesn't really make much difference.

CptBeaky  
#20 Posted : 21 January 2020 12:54:30(UTC)
Rank: Super forum user
CptBeaky

Originally Posted by: Mark-W Go to Quoted Post

I get the sentiment of investigating with the info we have but as there is no formal evidence of broken ribs we could be investigating down a rabbit hole. 

Theres no getting away from the incident, it happened but if the end result is just bruising rather than broken ribs the control measures that are implemented may not be proportionate?

Or am I being to cynical, like the OP


I get your point, and am just as cynical as you are. But in this case we have a person that has slipped on a wet floor. Does it really matter what the injury was? Surely the potential injury is more important? Are there the right controls in place? etc. 

If there are, and this was just a "freak accident", then so be it. Log this and move on. If there was more that could have been done, great! Lets get down to improving H&S, and be thankful that the person was not injured more.

The RIDDOR question just seems to get in the way of letting us do our jobs. People need to get over the worry that the HSE is going to close them down the moment they report an accident. I do understand for some it is a bigger deal than this, but by trying to get out of reporting we run the risk of inaction. Remember not all businesses want to even acknowledge they have a safety issue.

It is all irrelevant I suspect anyway. I would assume the IP will be on light duties for the rest of the week, and as such it would still become reportable.

That being said, you are within your rights to ask for a medical report of the injury, it would be interesting if the IP would agree to that ;)

thanks 1 user thanked CptBeaky for this useful post.
A Kurdziel on 21/01/2020(UTC)
Mark-W  
#21 Posted : 21 January 2020 13:10:50(UTC)
Rank: Super forum user
Mark-W

Cpt Beaky

Fair point. I'm still confused to falling over and breaking ribs. I've never seen or heard of it before. Thats not to say it didn't happen but I'd of expected, broken coxis, hip, arm, clavicle before a rib. Unless he fell on something or was holding something close and that was between him and the ground when he impacted.

thanks 1 user thanked Mark-W for this useful post.
CptBeaky on 21/01/2020(UTC)
Roundtuit  
#22 Posted : 21 January 2020 19:29:59(UTC)
Rank: Super forum user
Roundtuit

Originally Posted by: Mark-W Go to Quoted Post
Theres no getting away from the incident, it happened but if the end result is just bruising rather than broken ribs the control measures that are implemented may not be proportionate?

There in lies the  joy of an accident investigation - twenty people have exactly the same fall under the exact same circumstances and we have twenty different outcomes ranging from a simple winding to a death.

The control measures are to prevent the fall occurring so how could they not be proprtionate?

Roundtuit  
#23 Posted : 21 January 2020 19:29:59(UTC)
Rank: Super forum user
Roundtuit

Originally Posted by: Mark-W Go to Quoted Post
Theres no getting away from the incident, it happened but if the end result is just bruising rather than broken ribs the control measures that are implemented may not be proportionate?

There in lies the  joy of an accident investigation - twenty people have exactly the same fall under the exact same circumstances and we have twenty different outcomes ranging from a simple winding to a death.

The control measures are to prevent the fall occurring so how could they not be proprtionate?

Elfin Davy 09  
#24 Posted : 22 January 2020 10:11:02(UTC)
Rank: Super forum user
Elfin Davy 09

Mersey

You say the accident happened last Thursday, and the IP is back Monday on "light duties".  I assume the light duties are going to continue until such time as the pain subsides so the incident is more than likely going to be RIDDOR reportable anyway as an over 7 day incident (because the person concerned isn't returning to their normal duties).  Therefore the question of whether or not the ribs are broken is academic really.

Edited by user 22 January 2020 10:14:09(UTC)  | Reason: Not specified

thanks 1 user thanked Elfin Davy 09 for this useful post.
jwk on 22/01/2020(UTC)
Roundtuit  
#25 Posted : 22 January 2020 10:29:05(UTC)
Rank: Super forum user
Roundtuit

Not academic really a broken bone is a specified injury and therefore an immediate report

Roundtuit  
#26 Posted : 22 January 2020 10:29:05(UTC)
Rank: Super forum user
Roundtuit

Not academic really a broken bone is a specified injury and therefore an immediate report

Elfin Davy 09  
#27 Posted : 22 January 2020 10:33:12(UTC)
Rank: Super forum user
Elfin Davy 09

Not strictly true - the HSE ask you to "notify without delay", but you still have 10 days to report a specified injury.  Only a death is an "immediate" report.

Edited by user 22 January 2020 10:35:49(UTC)  | Reason: Not specified

Users browsing this topic
Guest (7)
You cannot post new topics in this forum.
You cannot reply to topics in this forum.
You cannot delete your posts in this forum.
You cannot edit your posts in this forum.
You cannot create polls in this forum.
You cannot vote in polls in this forum.