Where to get emergency prescription

[Vipi]

Not sure where to post this so trying here

Currently on a mini break with DH and DS. Two year old DS has a history of bronchiolitis and viral wheeze and is having an episode now as he has a bad cough.

We manage it by giving him several puffs of a salbutamol inhaler (4 to 10, depending on how bad it is) every few hours, and fortunately we have not crossed into the territory of needing hospital treatment. But it has been bad enough that he’s needed 8-10 puffs every few hours.

I brought four inhalers with me and three have run out. I have no idea how much is left in the last inhaler but I want to get another one in case this runs out too. Except, as we are not near home, I can’t simply ask my GP.

I did an online emergency prescription request from the NHS website, popped into a pharmacist, and despite insisting I had to pay a private fee even though it was obviously NHS, he checked the system and it wasn’t showing as I don’t think it’s on DS’s record as a repeat (we request it ad hoc).

Any idea what to do? Been on hold to 111 for the past hour to see if they can help.

Contact your gp and they can send a prescription through to the pharmacy wherever you are.

If you are in the UK why not ask a pharmacist?

Sorry ended that too quickly where the emergency Dr is I meant to add.

When I paid at a pharmacist it was incredibly cheap, something like £2 for a child's inhaler. However, if your child needs 8-10 puffs as frequently as you are saying then I really think they need to see a Dr for steroids or another course of treatment

I would be pushing for an emergency gp appointment or even a+e if he's gone through three inhalers in a couple of days - that's a lot of salbutamol and sounds like things are not under control.

Just to clarify, he hasn’t gone through 3 inhalers. Three have run out. They weren’t full to start with. One of them which I took out from my bag only gave out 2 puffs before it was done. I can never tell how much is left, which is why I carry so many in his changing bag.

I’ve tried a local GP and they won’t see me as I’m not a patient. For an emergency appointment, I have to send an email which they will review over the next three working days…

I’ll try my GP and see if they can send a request, but my GP is the sort to tell you everything must be through eConsult, and if something is urgent that it can’t wait the two working days, then I need to call 111, so not sure how helpful they will actually be.

Could you try a walk in centre?

What nhs site did you request the prescription on?
if it’s urgent and you’re away from home call 111, they can issue prescriptions. If you’re using lots of salbutamol it sounds like he needs to be seen. 111 can direct you to an appropriate service
pharmacists can make an emergency supply (chargeable) but only at times when you can’t obtain a prescription

Call 111, if a 2yr old is needing 4-10 puffs of salbutamol several times a day it may just be viral wheeze but someone needs to listen to his chest and check if he needs a nebulizer. I have asthma and so does DS and I wd call GP if either of us had a flare up that bad. Not a waste of NHS resources - if Dr thinks salbutamol is enough they can call you back and arrange for a script to collect at a pharmacy near you. But I am afraid they will definitely want to see you at a walk in.

Try your GP or if you have the money do a phone/zoom consult with a private one who can do you a digital prescription. I did this recently while on holiday in the UK. £120. Drug cost was cheaper than the NHS cost

You should also be counting the doses of salbutamol used. There’s still propellant left after you’ve used the 200 puffs- the inhaler will probably still ‘puff’ for a while but with no active drug in there. You can buy attacheable counters and get apps for this

@Pileofjeans children don't pay for prescriptions in the UK so the drugs will be free whatever it's just getting seen. Tbh he should have an action plan which says when to call 111 and needing to use this much salbutamol is definitely needs to see a doctor time. But with a wheezy 2 yr old that needs to be face to face so they can listen to his chest. Anything else might miss an infection needing antibiotics.

Children don't pay for private prescriptions?

That’s a good tip re counting. I will look at buying an attachable counter. We have several inhalers at home, but I’ve never known how to keep track.

I spoke to another pharmacist who was more helpful and he checked the system and said as we have only ever been prescribed two inhalers, it is not enough to justify it as an emergency repeat prescription so he simply can’t prescribe it (we usually get them from the hospital after each A&E visit).

Still on hold with 111 on phone and on hold with the GP on the other phone. He is settling with his breathing so seeing how the next couple of hours go before deciding whether he needs to go to A&E. I just have no idea how many puffs are left in our last remaining inhaler.

They do. We actually see a private GP as well as our NHS GP because our NHS GP is unhelpful for anything that isn’t routine, and we have always paid DS’s numerous antibiotics!

There is no prescription charge for NHS prescriptions. So the relative cost of the meds versus the NHS prescription charge is irrelevant to a British 2 yr old as they can always obtain a blue inhaler free on the NHS. The OP should definitely NOT pay £120 for a zoom call which will quite likely advise her to call 111 as they can't see the child in person. It will throw money away. OP does know her meds are free whatever. And blue inhalers cannot be bought OTC. 111 is the only sensible course of action, it's the non emergency number for health issues. They will know exactly what to advise.

Just to add re zoom calls, whenever I have had a zoom call for DS, they always send me to a GP / the hospital because DS is so young and they want him to be checked in person.

Hope you get through soon @Vipi. When home write to practice manager asking for an appt with the asthma nurse re an action plan for your child's viral wheeze, describing how you were placed in danger on holiday as a result of a failure to give proper guidance on this. I feel really cross that children with chronic wheezes get treated like this as it is so distressing for them. Hopefully he will grow out of it and not have asthma long term, though if he does it's a manageable condition. But ironically our asthma care for DS became massively better one summer when he suddenly got worse when visiting London and needed a trip to a&e. Pollution is a big trigger for him. Paediatrician who saw him wrote to our gp saying v obviously asthma, why hadn't it been investigated. We've had excellent care ever since and not troubled a hospital. Up till then this merry go round of hospital, GP saying oh it will clear up etc sounds v familiar.

As I expected, after waiting 45 minutes for an answer, my GP told me to put in an econsult and wait two clear working days. If I need it now, I need to call 111.

Still on hold for 111!

Our GP is useless. They’re good in person when you see them, but being able to see them is a challenge.

DS has had several hospital admissions, some severe, and even the consultant in the food allergy clinic wrote to the our GP saying he needs to be seen and managed with a brown inhaler, but our GP tells us to carry on as is with our plan. To be honest, we haven’t objected to this as we have seen a consultant privately who specialises in viral wheeze and told us the best thing to do is manage with the inhaler at home and we are having episodes of one a month, then consider montelukast instead of inhaler. Because of the side effects of montelukast, we haven’t gone down that route yet.

But yes, if we were unable to see someone privately, we really would have been stuck in limbo as so many doctors see it as a common childhood issue that they don’t realise how stressful it is living through it.

Wow I can't believe your GP did that. I work at a surgery and that would be a need to be seen/spoken to today app and they would send the prescription to a pharmacy local to you. I was told if my son needed to take between 8-10 puffs to go straight to a&e, I wouldn't bother with 111.

I agree I think if you still can't get through to 111 go to a&e. That's what both my asthma plan and my DS say if we've done the 10 puffs at home and it's not worked for more than a few hours.

Absolutely shocked at your GP. My dad was a GP and I had asthma as a child. Back then they were more cautious about brown inhalers with children because they were concerned about it having an impact on growth. Apparently the evidence is ita negligible so by now there's no reason not to use them in a symptomatic 2yr old. But I can imagine an old school GP might be more cautious for that reason. And there's no reason to diagnose asthma early. All three of mine had viral wheeze and had brown inhalers and oral steroids when small. Thankfully only one developed asthma and it's well controlled. Maybe try the Asthma UK helpline for advice on writing a letter of complaint if GP is ignoring advice of your hospital consultant?

Our plan is to go to A&E if 8-10 puffs doesn’t control it for 3-4 hours. We can also do 10 puffs, followed by another 10 puffs 10 minutes later, and if that doesn’t work then that’s also our trigger to go.

Or also when it’s really bad in terms of how hard he is working to breathe.

He hasn’t crossed any of those lines, hence why I haven’t taken him. He does seem to be calming down though, so we might be through the worst of it.

Yes our GP practice isn’t helpful. The doctors themselves are great but not the way it is run. Once they told me they are a general practice, not an emergency practice, and it is urgent, call 111 and if an emergency, go to A&E…

I think the problem with our GP is no one is knowledgeable enough to help with this. Only one GP who used to work in paediatrics knows about viral wheeze but the rest are very much “go to A&E”, but they never book me an appointment with her, even though I always request it.

111 sorted out a prescription for me so all ok on that front.

Ended up going to A&E as this thread encouraged me to (and I started to worry I had made the wrong decision!) and had quite an unpleasant experience. DS develops bronchiolitis or a wheeze whenever he has any type of respiratory illness - so when he has a cold or cough. So once a month since he was 8 months old. It’s not needed an A&E visit every time though.

This wasn’t our usual hospital so they didn’t have his medical records. As we were waiting to be triaged we had reached the point where DS needed his inhaler so I asked a doctor if I should give it to him or wait to be triaged. Doctor said I should give it to him.

About 5 minutes later, he gets called by the triage nurse. As he had just had his inhaler, his breathing was calm and he wasn’t tugging in that much around his ribcage. I explain the situation to the nurse and that we have been dealing with this
for over a year and she immediately asks me what I mean. I tell her that every time he gets a cold he develops bronchiolitis or a wheeze. Her response is that bronchial season only lasts a few months each year and we are the end of it now. I simply said well he gets a cold of some sort every month and he always ends up struggling to breathe and the hospital tell us it is either bronchiolitis or a wheeze. Her response “hmm that’s strange”. She then looks at him and said he seems ok right now. I tell her well he’s just had the inhaler.

Runs through the standard checks and then gets a doctor to listen to his chest. DS is crying and screaming as this happens and from experience I know they struggle to hear anything as I always have to try and calm him down to have a proper listen. Doctor listens and says he can’t hear anything. They look at his chest and say his tugging in is minimal (he had just had 8 puffs of the inhaler!), it’s just a cold. I’m welcome to stay if I wish but he just needs to see his GP if his cold doesn’t clear after a week… I also had a lecture about how inhalers don’t work with a cold and only work for a wheeze - I tried explaining yes, exactly, it’s helping him this time but the nurse was so dismissive.

Fortunately it meant we weren’t there for a long but I genuinely felt like they thought I was a fraud and panicking over just a cold. I wish I didn’t listen to that doctor who told me to give the inhaler. A couple of hours after we got home he was pulling in quite badly and I debated going back but gave him more of his inhaler which seemed to help.

DS is much better today and we are weaning him off the inhaler.