To think the GP should have done a urine test

[Mimicat44]

My six month old dd had what we now know to be a febrile convulsion on Monday morning. I called 999 who sent a paramedic crew. It was terrifying, especially as the ambulance had to come from far away and so took a long time to get there. I thought she was going to die. I'm a single parent and she's my only child so was by myself and it was additionally stressful not to have anyone to go downstairs to meet the crew and show them where the flat is (it's top floor and not easy to find the door) so I had to watch helplessly out of the window while they tried to find us (they couldn't hear me banging on it to show them where we were)

They stayed about an hour doing various tests, monitoring her etc and trying to get her high temp down which it eventually did a bit until they were willing to leave and advised me to see my gp asap which I did, a couple of hours later.

Gp checked ears, throat, lymph nodes, temp and all were normal so she said it was probably a virus and no treatment was necessary. I was relieved and thought it was over as she seemed well again, and remained so all day until at 6pm it happened again. I called 999 again, had to go through all the questions all over again and again the ambulance was miles away so took ages to arrive. Had same situation where I could see them not being able to find us, going into wrong gate etc, it was like a nightmare.

They took us to a&e where we waited 7 hours until finally after seeing a&e doctor and paediatric doctors she was admitted to children's ward. They took a urine sample (which took me 5 hours of trying to get a wee from stark naked baby into plastic bowl in a&e finally managing to get one solitary drop after three wees and a poo landing on me) and dipstick showed possible UTI. They wanted to do lab test to confirm but not enough urine at that point.

Spent night on ward, poor baby connected to monitor that sounded an alarm every time her heart rate went over 170, which was every 5 mins, she was very hot and crying all night. In the morning managed to get a bigger urine sample and a few hours later they confirmed kidney infection and prescribed antibiotics and let us go.

AIBU to think that treatment was unnecessarily delayed by a urine test not being done sooner? If we hadn't gone to hospital then it wouldn't have been done and diagnosed at all and there could have been serious complications, even kidney failure.

I'm struggling to deal with it to be honest. Even though the worst is over and the outcome was good in the end (as long as the antibiotics work as expected) I still feel absolutely terrified, as though it's still happening. I can't relax and have to check her every five mins and I'm setting my alarm through the night to check her also. I feel so scared that something might happen again. Not necessarily this again but just something! And worse things happen, children get more ill than this! I don't know how people cope. I don't know what to do about how I'm feeling - do you think I should talk to the gp about this? Not necessarily in an accusatory way but maybe it will help somehow? Please be kind in your responses, I'm really feeling dreadful, just can't shake off this terrified feeling and keep crying.. of course I'm relieved that dd seems better but I still can't seem to feel better myself.

Tldr - dd got ill, could have been diagnosed and treated quicker, seems better now, I'm really not.

[mumbanator]

Was there a likely focus i.e. Source for the infection when you saw the GP? If she was full of cold, for example, I think it was reasonable not to look for a 2nd site of infection as that would be pretty unlikely. If, however, when you saw the GP you said there was no new cough/runny nose/sneezing etc then yes, the GP should have looked for the source of infection . Sorry you've had such a scary time and I think it does need to be fed back to the GP if the latter scenario is the case, either directly or via the practice manager x

[AuntieMay]

Sorry your baby is poorly, I've had to stay in hospital with mine and it is a horrible experience ( he's now 13 tho and absolutely fine).
It's quite unusual for a 6 mo th baby to have a kidney infection and even if the Gp thought about it, he would have sent you home to collect a sample to be dipsticked, this would then need to be sent to path lab tonne analysed for correct antibiotics to be prescribed. I don't think it could have happened within your timeline of baby getting ill again on the same day, even if he'd prescribed antibiotics, they would not have taken effect within just a few hours.
Horrible and scary experience but I would put it down to bad luck not a mistake on the Drs part.

[hanban89]

Oh OP how horrible. I really feel for you.
I think the GP should have thought of a urine test if everything else seemed fine. I'm surprised though that with such a fast heart rate the paramedics wouldn't take her first time. Especially as she hadn't fitted before and because she was so young.
You will need to watch in future with high temps but speak to your GP as they might say there is no need to phone an ambulance each time but I'm not sure.
Hope she is back to herself soon

[myreign]

Dipsticks shouldn't be used in children under 3 years old.

[Crunchymum]

Sorry you have had to deal with all this, especially on your own.

However I thought that if you call an ambulance for an under 2, they get taken to A&E regardless of being given the all clear by the paramedics (this was what happened to us and the reason given. Albeit it was 3 years ago and could vary by trust?)

[Bugsylugs]

Sorry your lo is poorly
Yes you are being unreasonable re GP, UTI or kidney infection is unusual in a child this age. I am more surprised paramedics didn't take lo to hospital after a first fit (febrile or otherwise) especially in this age with no obvious source of infection very odd.
Hope lo on the road to recovery

[DontTouchTheMoustache]

op I'm so sorry it sounds absolutely terrifying. I can empathise to some extent as a single parent to a young baby (who currently has a chest infection) and you must have been an absolute wreck. Sadly GP's sometimes miss things, last year I had a severe asthma attack and pneumonia which the GP missed as he didn't check my heart rate or blood pressure just thought I had the sniffles and a bit of a bad chest. 3 hours later I was in a&e and I was lucky to survive, I had to spend a few weeks in hospital fighting it off. I was furious at the time but in retrospect I can see that they can't necessarily check everything.
Is there anyone with you now? Do you have someone you can talk to?

[Chocolatecake12]

I do think it would be helpful for you to talk this through with someone. You actually sound like you're still in shock about the whole situation and are still trying to process the whole episode.
Try and focus on the positive, your dd is on the mend, her temperature is down, you know the signs to look out for in the future.
Be kind to yourself over the next few days and try to get some rest.

[Batwomanrisesagain]

Myreign whilst dipsticks may give a false negative result in under 3's and a MSU should always be sent in this age group, however a positive result would indicate a likely infection. Nice guidelines are quite clear about considering UTI in a febrile infant with no other focus. Similarly a temp of 39 or more in a baby age 3-6 months warrants consideration of admission and this group are at least intermediate risk for serious illness according to the NICE fever guidance in children.
OP I really empathise, my son had urosepsis that was missed in similar circumstances (I was accused of lying about his fever and symptoms) and 7 years on it stil haunts me. He recovered well by the way!

[Mimicat44]

Thanks for your kind words, I'm not really looking to blame the gp, or anyone, just trying to make sense of it all and not doing too well at that at the moment, seem to be stuck in hyper-anxiety mode!

[3littlemonkeys82]

As a ambulance dispatcher (8 years), the rule of conveying all under 2's hasn't stood for at least the last few years. As a mother of 3, with a baby who has fitted numerous times and stopped breathing the first time, I totally understand your position. As a pp said dip tests aren't routinely used on under 3's so the gp wouldn't have checked unless you mentioned reduced wet nappies or strong smells. Children who fit once are very unfortunately likely to fit again. If the fit lasts more than 5 mins, or if you feel it's unusual or seriously absolutely anything else please please please dial 999,...

I am that person that decides where to send the only ambulance I have, and regardless of being a mother, if I feel a child needs it, then that's where it goes... I make that decision lord knows how many times a day.

Children deteriorate fast, far faster than adults. Call us, we have very limited resources (particularly at present) but we will get there asap.

In the mean time I hope they've referred you to a paediatric consultant who can go through any worries or concerns. Pm me if you need to.

Btw my daughter turned 2 at xmas and hasn't fitted for 8 months now so touch wood we're through the worst.

[Mimicat44]

Batwoman so glad your son was ok!

[Mimicat44]

3littlemonkeys, thank you, I will pm you, they haven't referred us to anyone

[3littlemonkeys82]

I feel as though I'm still stuck in anxiety mode. My eldest is almost 14 and had meningitis as a baby, it's taken years to stop checking him yet I check on the 2 year old several times a night. My partner thank god is a ambulance tech and resussitated her first time she fitted because even though I knew what to do, watching YOUR baby stop breathing is an entirely different thing. I'd recommend checking and controlling temp as much as poss. If hers gets over 38 I give calpol to bring it down knowing I have ibuprofen to use if I need to, prevention is better than cure.

[Graceymac]

You poor thing, it is totally understandable you are still shaken and probably will be for a while. My 4 yr old dd has had many febrile seizures, they started at 14 months and I was away for the weekend in a rural area, it happened in the middle of the night and the ambulance took half an hour to arrive to an address that wasn't visible from the main road, I can still vividly remember how stressed I felt at that time and that feeling returns with each seizure that she has.
I am suprised that your ds wasn't taken in for assessment after the first seizure to rule out anything more serious. My dd ended up being on for a few days as she had several within a 24 hr period and had a CT scan despite having a raised temp just as a precaution.
As a nurse I am also suprised that the gp didn't take a urine sample to rule out a UTI printed with a young baby with a temperature.
I have young 3 dds and a urine sample has always been requested when they have presented with high temperatures. One of my dds had several UTIs as a baby. In saying this though I agree with a previous poster that even if a dipstick was performed and antibiotics were prescribed this wouldn't have prevented the second seizure from occurring as your ds would have only got one or two doses into him at that point.

[Bugsylugs]

How you are feeling is entirely natural its is very very frightening to watch especially if on your own and not seen before and you have had to endure this twice. Things will settle maybe talk to one of the nurses or doctors about this as lo is more at risk of further febrile fits and there is no evidence that bringing their temperature down prevents this however what to look for and what to do will empower you and give you confidence. Try and get some rest and know you did all the right things as a mum.

In your scenario you wouldn't have got a sample at the GP and really lo should have been seen in the hospital first time for many many reasons one being support and education.

[NeedsAsockamnesty]

My youngest had a kidney infection with no symptoms other than static weight.

It was terrifying especially given that all the midwives acted like I just wasn't feeding him.
He was 14 days old by the time someone listened to me and tested his wee.

[myreign]

It'a pretty much impossible for a GP to get a urine sample from a 6-month old though. If they thought the baby was septic and couldn't find a focus, they should have sent it to paeds. Presumably the GP didn't think the baby was septic.
I was answering the AIBU, I don't think it was unreasonable for the GP to have not done a "urine test".
I hope she gets better quickly OP.

[Mimicat44]

Graceymac that's awful, I can imagine how you felt. I will definitely ask for a urine test if she ever gets a fever with no obvious cause again.

[Mimicat44]

Thanks myreign. Yep it took me hours to get one drop of wee so I wouldn't have expected the gp to get one there and then, at all. Just maybe asked for me to collect one. But I know now to ask in future.

[Mimicat44]

Needasockamnesty that's awful, poor you. Im grateful that my dd was diagnosed and treated, it could have been a lot worse

[Graceymac]

What helped me was devising a plan with the paediatrician for future similar events. I have buccaneers midazolam at home, with my child minder and in Montessori, all have clear instructions on what they need to do. If my dd has one seizure, even if more than 5 minutes which responds to midazolam I only bring her to the go, identity or rule out clear of sources infection and manage at home. If she has a second one we call an ambulance and go to A&E as obviously it's not safe in the car if she is sedated from midazolam or likely to have another.
My dd has had more than 20 now and some have been prolonged so for episodes of illness with raised temp she is given Frisium for 3 days to reduce the chance of seizure.
Because I am very clear in what I have to do it does help me to cope better although of course it is traumatic when it happens.

[Graceymac]

Buccal not buccaneer! Sorry my auto corrector is going crazy this evening!

[Graceymac]

A urine sample is taken with a paediatric urine collection bag which adheres to the babies skin.

[nocoolnamesleft]

Okay, trying to comment on info online is never easy. But:

1)I would expect a 6 month old with a first febrile convulsion to have been taken straight to A&E by the ambulance the first time. I am very surprised that they did not. Certainly our local paramedics always do. And then we admit them to the kids' ward.

2)I am somewhat surprised that the GP didn't send them in to paediatrics if they couldn't find a focus...but do realise that they don't see that many of these, as most get taken straight to A&E. So they're probably much more used to seeing kids with a subsequent febrile fit, not a first one, and we usually worry much less about those (the first time you always think "yes but what made it happen when it's never happened before")

3)I'm a firm believer in urine tests, and would do one in febrile convulsion if no other source of the temperature found (and often even if it was!). Though in fairness should probably note that I'd be gobsmacked if the actual length of delay caused any problems. If I'd seen a kid following that pathway to admission, I'd be having a word with both the ambulance team, and the GP, to make sure they knew what to do if they saw that again, and also to stress to the GP that if they're ever not sure, paeds are pretty friendly and helpful, so they could always ring and ask.

Seeing a febrile convulsion in your child is terrifying. We tend to find that the children recover was faster than the poor sod of a parent that was looking after them at the time. It's one of the things I always say to our trainees: "Do you know what proportion of parents seeing their child having a first febrile fit think they're dying? Almost all of them. To us it's a common, routine, fairly simple problem. But to the parents it is horrifying". In fact, part of the reason we tend to observe them overnight the first time, as well as to make sure they don't do it again, is to let the parents stop shaking. So please don't feel that you're being daft for feeling so shell shocked. It's totally normal of you.