Any medical staff or doctors here who can advise please? Brain bleed

[RiftGibbon]

Not me.
Close friend who was out on Valentines night. Attacked from behind - struck over the head. Friend was found in the street unconscious and taken to hospital where a bleed on the brain was discovered. Medics were concerned that he could have seizures and/or could go blind.

For background, my friend has autism, lives alone and has chronic pain (several co-morbid autism related condistions). When at hospital they couldn't find a quiet space for him, nor an alternative to the chair he was in. They kept trying to find a bed but didn't have any. Eventually the stress broke him and he left, going home and went straight to bed.
I tried to phone him, hosptial tried to phone him, but nobody could get him to answer the phone. I'm not close enough to have been there with keys in the timeframe they needed, so they got police to do a welfare check, smashed their way in and terrified him, bringing about a meltdown.

After a lot of time on the phone with me, he went back to hospital - they had been advised by a specialist unit (not at their hosp) to keep him under obs for 48h - but ended up in another chair, essentially in what was a cupboard (this was apparenly an 'autism friendly' space as it wasn't in A&E, where he spent another 9 hours). Eventually they came back and said that they had no beds.

He discharged himself with their grudging consent and went home. I've spoken to him three times in 48 hours and he seems pretty much his usual self but is concerned that there has been no talk - and had been none - of a follow up scan to see what the bleed on the brain was doing.

He's tried phoning his GP but the receptionist has told him that he'll have to wait up to three days for the GP to phone him back to discuss, and 'after that' can see about making an appointment.

I've tried phoning the ward he was on, to speak with the consultant who saw him, but nobody has phoned me back.

Now I know that the NHS is pressured and underfunded but surely when they were so concerned that he'd died that they broke his door down, that they might have some sort of follow-up plan; that his GP might actually consider this an emergency?

I'm going to see about taking this to PALS with his consent, but really want to know what do we do to get him checked over again? I'm down as next of kin on his medical records.

[Egghead68]

I am very sorry to hear about your friend’s experience. Did the hospital give him any written head injury advice of red flags to look out for? If so, I’d follow that and take him back to A&E ASAP if he starts to show any of the red flags. Otherwise, resting and discussing the situation with his GP when he can get a phone appointment might be sensible.
The Headway website has factsheets about recovering from a brain injury which might be helpful.

[RiftGibbon]

I don't know that they gave him anything, Egg.
The hospital he was in doesn't specialise in brain injury so they had taken advice from one nearer to me which does. I think given his meltdown they were wary of trying to move him there, but it's not clear whether this was a possibility.
He's out of the 48 hour danger zone now but still concerned about the situation.
He knows he was hit but at what time and by whom, and how long he was unconscious are all unanswered.
He struggles with processing information at times, so anything that was said may have passed him by.
That said, they know he is autistic, and had an "autism nurse" helping him, but apparently she kept disappearing off to liaise with other staff rather than sitting with him and reassuring him.

Just want to make sure that all is as well as can be physically (head wise). His GP surgery is overstretched but I would expect them to see him as an emergency in the situation, which they don't seem to be able to.

I'll take a look at hlHeadway, thankyou for that.

[GEEpEe]

They wouldn't always rescan in this instance BUT because his care has been so fragmented, please call PALS and get them to establish whether they actually set an evidence based care plan.

[RiftGibbon]

Thanks GEE - he tried to call PALS yesterday but without success. I'll get into it.

[Egghead68]

Some possibly useful links and numbers here:

www.headway.org.uk/supporting-you/someone-i-know-has-a-brain-injury/

[RiftGibbon]

Thanks Egg spoke to the ward again today who were utterly useless. Have submitted a 'report' to PALS and I'm speaking to someone there tomorrow. They just keep saying "but he discharged himself against medical advice" and keep overlooking that he has autism, was in pain and that they had no bed for him. Really frustrating.
Hopefully PALS will be a bit more useful tomorrow.

[DonKeyshot]

I'm shocked by your account and the apparent lack of care given to your friend. Would it be possible for you to accompany him to a specialist unit? His GP should at least refer him for another urgent brain scan.

What are the police doing to find his attacker(s)? Are they checking for possible CCTV evidence on either street mounted units or cameras in shops/pubs/private houses where he was attacked?

As the victim of a violent crime your friend may be eligible to file a claim with the Criminal Injuries Compensation Authority.

[RiftGibbon]

Unfortunately not this week, DonKey and he is very frustrated and distressed (and afraid to go out). He does have some local friends who could go with him, but I don't know that he wants to put himself through any more interaction with medical people right now as they simply don't seem to understand autism.
Similarly he's not sure he wants to follow to with the police because of the stress. He already has PTSD from childhood trauma and also a previous assault a year or so ago.
He's managed to get a talk with his GP arranged for tomorrow and had asked me to hold off doing anything further until he's done that
I'm just finding it ridiculous that the hospital basically left him with no option but to go home if he didn't want to be unable to walk/didn't want to have a meltdown and now are essentially penalising him for this.