Is A and E where you are actually really efficient?

[Abitorangelooking]

DS fell and hurt his wrist yesterday at school. Ended up in A and E (no minor injuries where we are) wait time 0-1 hour sign up. We were seen, x-rayed, given painkillers, wrist splint fitted and back out the door in an hour and a half. Virtual fracture clinic called and advised follow up care this morning. There was a steady trickle of people coming in so wasn’t really quiet but no one was waiting ages either.

I have to admit I was expecting it to be the 7th circle of hell , given the news of late, but it was totally fine.

My elderly mum went in recently with heart attack symptoms - triaged and ECG etc done within 2-3 hours then a further 14 hour wait in a packed waiting room for the results.

I must say the last two times I've broken my foot it has been very efficient. I was advised I'd be waiting 5+ hours when I checked in but both times I was triaged then seen within the hour for X-ray and then realigned and fitted with my boot within 2 hours. I think they have set up a sort of separate broken bones but at our a&e whereas all the people with other stuff were still waiting. That said the fracture clinic were not so good and I ended up needing an op due to their poor advice and care.

Pretty good here, I had to go a few weeks back as I had an infection after major surgery. I was seen within a hour, bloods taken and told to wait a hour for the results, was then sent to the ward where I had my surgery, examined, given antibiotic. Probably at the hospital for 3 hours from start to finish which I don’t think is too bad. A&E was pretty busy and it was a bank holiday weekend.

Two elderly relatives went to a&e recently, first waited 8hrs in the ambulance to even get in a&e and then it took 2 days to get to a ward, just for basic rehydration and care etc. 2nd was waiting 10hrs in a chair in a&e.

@Abitorangelooking wishing your DC a
a speedy recovery!

Which part of the country are you in?

I've experienced two different pediatric A&E departments in the past few months and both were much longer waits than that.

I was at A&E yesterday with ds' girlfriend. No queue at reception, seen (triaged) by the nurse within half an hour. She talked with the doctor who said she didn't need to see her but gave her some stronger painkillers and advised her to talk to her GP today. An hour in total. (arrived about 5.15pm).

She rang the GP this morning and was seen in person (not a telephone appointment) at 11.20.

This was the QEUH A&E.

On the negative side, this is an ongoing issue for which she's already waiting an ultrasound. Timescale for an "urgent" ultrasound is 3 months She's been advised to ring daily to see if there's a cancellation. And the ultrasound will probably only eliminate an immediate issue and she is then going to have to fight for an MRI, which is what is needed to identify what she thinks the issue is (a recurrence of something she had before).

Our local one is (touch wood) okay. Have taken my chronically ill mum in due to falls and AFib episodes in the past- they were efficient, diligent and lovely with her.

We're in Scotland if that makes a difference

looking at your experience and all the others related here about elderly patients - I do strongly believe they're triaging the elderly to be seen later than everyone else.

Sorry - should have said the QEUH Glasgow A&E.

I'm an A&E doctor and this wouldn't be unusual for our paediatric A&E (though I'd say usually it's more like a 2 hour wait) but sadly very unusual for the adult side. DH broke his arm on Wednesday and had a five hour wait to be seen at the hospital where I work, which is pretty standard. There are just not enough doctors, or cubicles/ beds/ places to even see patients, compared to the volume coming through the doors. On recent shifts I've seen most of my majors patients on trolleys in the corridor, where they've often been waiting for 4+ hours already, because there is simply nowhere else. The cubicles are often taken up with patients who've already been 'admitted' to hospital but can't actually move out of the department as there are no free beds on the wards. I love working on the Paeds side partly because (except on very bad days) the volume of patients is much lower, plus most kids don't tend to come with a long list of complications and comorbidities, so there is a decent chance that you can assess and address a problem and get them sorted and home within a couple of hours. It's just soul destroying with adult patients knowing that before you even start they've probably been stuck for hours on a trolley or a plastic chair, often feeling increasingly rubbish.

We definitely aren't. If anything elderly/ frail people are usually higher priority or seen in a higher acuity area than young and healthy with same symptoms - it is literally just impossible to keep up with the volume of people coming in. And unfortunately the majority of people who attend A&E with serious problems are elderly.

I've never been in a children's A&E for longer than 3 hours
Adult A&E have been in 11 hours. That includes wait, X-ray and pot. The wait was the longest part though

I was taken there 2 weeks ago by ambulance after my fallopian tube ruptured at work due to an unknown ectopic pregnancy. Was in resus by 8pm worked on and in operating theatre by 9pm. Doctors/nurses very nice talking me through everything that was going on, what they were going to do etc.

On the ward the next morning though not so much. Wanted me up sitting in a chair at 8am after only getting into my bed post op at 1am, I had no clothes on, only a gown and was bleeding heavily with a catheter in that was on the right side of my bed and a blood transfusion going in on my left side. She was told where to go.

Also went to a different A&E in July with a broken ankle, triaged, xrayed, plastered up, xrayed again and home within 5hrs. That was at 1pm on a Monday.

I’m pretty rural but this was in Perth, no separate bit for kids. Interesting to see that my fellow Scots also are finding it ok.

We don’t have that sort of minor injuries unit. There is a an out of hours Gp place but it’s more of an antibiotics/ infections. They don’t have an x ray.

It varies.

It's the Children's side I'm more familiar with and in the past couple of years we've been for a couple of asthma attacks (999) concusion, suspected fracture and an issue that resulted in surgery.

The surgical issue was 8 hours from presenting there to operating theatre, and 2 hours from being seen by the surgical team with various tests and checks prior. He had to go back for anti-biotics over a weekend and that was only a couple of hours- we got in before Drunk O'Clock got going.

Asthma has been 30 mins and 7 hours to be seen by Urgent Care (the attacks had settled but needed medication reviews.

Other issues managed within 3-4 hours.

A 45min queue to even get into a car park was a low point though!

Absolutely not - its a shambles where I am in the south.

DS (2yo) cracked his head open. Bleeding, upset, quite a large open gash on his head etc. Got to A&E at 8pm.

The wait for general A&E triage alone was 4.5hours. Followed by a further 2 hours at the childrens' A&E waiting area before seeing a nurse who concluded it needed gluing back together, but wasn't allowed to do that until confirmed by a Pediatrician. Another 2.5 hours for the Pead to come and see DS, who immediately said "yep, glue it" to that same original nurse, who then glued the wound together in about 45 seconds.

I was at the point of wanting to glue the bastard thing shut myself at around 5 hours in!

Edit: We have no minor injuries centers in our area (or surrounding areas at all, for that matter) and no out of hours GP service anymore (stopped in covid and never returned!).

My experience varies. My DD (17 then) went to A&E on advice of 111 call. Big London hospital and the place was rammed. As she was 17 she was seen relatively quickly and sent to paediatric A&E. they booked her for tests (luckily a cancellation the next day). She was then admitted after her test.
On the other hand years ago we took my young son to A&E with suspected wrist fracture. After four hours my husband asked how much longer and they said 'he's already been seen'. Like I think he'd notice!
At another I took a violently vomiting visitor to an A&E department well outside London at 2am with just two others waiting. Two hours and even the receptionist, who could hear her vomiting in the loo down the hall, got anxious. The triage nurse was rude and dismissive saying we should have called an out of hours GP (there aren't any after midnight and they would have told her to go to A&E). So, hit or miss.

Yes I have some experience in triage and just to agree with @AveAtqueVale we definitely aren't triaging elderly people in a lower category. The younger people are more likely to be well enough to wait in the waiting room and have brought themselves in. Older people are more likely to come in by ambulance and unable to sit in a waiting room, hence them being on trollies while waiting to be seen or waiting for an inpatient bed. Obviously this is not ideal either. No one should be waiting in a corridor with not staff members to look after them, though. There are rules surrounding this and also how many patients can be looked after by each nurse. It's really difficult for patients (and staff) at the moment.
Maybe the general election will bring some hope 🙏

I'm in a small city, one hospital. Ds cut his mouth open, had a deep gash in his chin and bent four teeth. Bleeding profusely, very swollen We waited 8 hours to be seen, as did the child with the obviously broken ankle, a screaming baby under one and about 9 other kids. When we did get seen the dr was useless. Ds has scaring across his chin due to poor treatment.
I've been several times over the years and never been seen in less than 6 hours.

Luckily we live a 30 min drive from an excellent minor injuries and about 40 min from a very good children's hospital. When ds broke his wrist he was seen with in ten minutes at minor injuries. Unfortunately further treatment had to be through local hospital again a simple procedure and they butchered his arm. The scar looks like something out of a hammer horror film.

Our A&E is the main trauma hospital for most of the Midlands. And the next nearest is shut from 10pm to 8am. So our A&E is rammed. All the time. If you go with something you think is quite a big emergency, (we thought my dad had a stroke) they are really good at getting you seen and back out the door.

Any breaks etc, you need to go to the walk in, for anyone over 5. Unless they are like, really bad or a head injury. That's around 20 mins away

Where I am Urgent care is excellent - a&e appalling!! Where my parents live (no urgent care) a&e is appalling - they tried their best to kill my very able, active, cognitively completely intact 80yr old father when not only did 2 Gps fail to DX appendicitis but so did 1 x triage nurse and 2 x a&e doctors. By the time it was DX 3 days later by a sonographer looking at his liver but did a general ultrasound of everywhere to be thorough 🫣🙄 he had full blown peritonitis! Oh and he waited 7 hours to be seen in a&e after triage sitting on an ordinary chair.

Should probably add the GP had sent him to A&e as he was concerned about how ill he was and his blood test results.