What happens when rush into A&E with a life threatening illness?

[TrayBakers]

It seems silly to ask the question because presumably most people presenting at A&E are there because they feel they might have a life threatening problem, hence the word 'emergency' in the name of the department.

But I've always wondered how the reception staff deal with or spot genuinely time sensitive emergencies. I know it's not their job and that's what triage is for. But triage in my local hospital can take an hour, by which time anyone who is suffering a genuine medical emergency could be beyond help.

If someone were to run inside the department with a loved one and start calling out for help, would the reception staff immediately call for the doctors?

I remember one particular night that I found myself in A&E, a gentleman arrived crying out because of severe chest pain. They just asked him to wait in the waiting room. He continued crying out loudly whilst waiting to be triaged. He could've been in the throes of a heart attack.

Incidentally that same hospital has been named recently because someone died whilst waiting to be seen.

Does the TV version of bursting through the doors and being greeted by doctors thing ever happen? Or does that only really happen if you've called an ambulance to get there?

It's just something I've always wondered.

Of course not always but i presume that serious the ambulance staff would take them wherever

No it never happens being met at the A/E door by a bunch of doctors. Unless your arrive witth an ambulance with prior communication.

A nurse will most of the cases triage the arriving patient and sort a doctor appointment.

Yes sometimes when you arrive in an ambulance you are met at the majors entrance. The paramedics call through a courtesy call when there's something very complicated coming in. I accompanied my late DH on a few dramatic entrances that way.

But for walk ins, no. My DH walked in with a brain haemmorhage once and they ignored him for hours, which permanently disabled him, of course. It's very common to be completely ignored with very serious conditions in A&E. He was also almost died from retention and a heart attack, before he became quadriplegic and could no longer "walk in" as a walk in so started arriving by ambulance. When you get there by ambulance you also are often left for many many hours in terrible pain, bleeding etc, just on a trolley instead of a chair, so it's not magic or anything.

This was years ago so can't even blame the current state of the NHS. It's just how it's always worked.

I walked in with DS. The receptionist saw him and got a nurse straight away. He was then taken straight to resus.

I am so very sorry about your DH. Our NHS has been on its knees for so long and is only getting worse. It needs real change.

It seems to help if 111 or 999 contact ahead.

In my case although I just walked in my bloodwork was so haywire I was admitted immediately as they had no idea what was wrong for a few days.

Like Sirzy says, I ran in theough doors with a convulsing baby dc and doctor who was coming into waiting room to call a patient to be seen, grabbed him off me and took him straight through and also straight through to resus.

I'm surprised with chest pain he was left. Some things are triaged more quickly. When my dh went in with chest pain he was triaged and an ecg taken almost immediately to rule out heart attack.

It is absolutely dire where I am.
Dire.
Recentlyi went to A&E in severe pain. Agony. Thought I was dying.I can honestly say that I could have died right there in that waiting room and would not have been found for hours. No one gave a shit and no one did anything for me.

Similarly, a relative collapsed, was taken in by ambulance and was made to sit upright on a hard backed plastic chair for more than 48 hours.

Was given no food, no drink, didn’t use the toilet as it was smeared in shit all over the floor and toilet and blood all over the floor and on the door handle… for the whole 48 hours they were there. Kept going to check it every few hours and told the few people who walked past them… 48 hours!!!

Another elderly patient in a wheelchair next to them was seemingly unconscious but no one came near for many many hours.

Waiting room packed like a night club on a Saturday night with people standing taking up every inch of floor space, ambulances queuing outside and patients on trolleys lining the corridors.
Vomiting on floors, fighting, screaming, shouting.
Fucking dire.

My GP rang ahead and when I arrived reception was aware I was on way. I was taken straight back by nurse who appeared as soon as reception told her I was there.

This happened to us when DS1 was 7 months old. We arrived at reception and were taken straight through without even being checked in and triaged. They took his details whilst we were in the room and he was being treated by doctors.

When DS2 had the same symptoms and worse at 2 months old, we rushed him to the hospital, which was a different one to the one above as we had moved. We waited an hour to be triaged and as he was crying, the nurse didn’t examine him properly so we were put in the non urgent queue. I went up a few times crying saying that he’s seriously unwell and the nurse at the desk didn’t even glance at him. When they did routine obs two hours later, they finally saw how unwell he was and took us straight through.

Naturally I filed a complaint via PALS and the response was very much “sorry you had that experience, we will learn from it”. Even PALS didn’t think that was good enough and escalated it to a formal complaint. I then had a two hour phone call with a senior doctor who agreed what happened was unacceptable but whether they improved their procedures as a result, I don’t know.

I’ve been having an asthma attack a handful of times and been taken into a cubicle and put on a nebuliser immediately. I can’t remember exactly how but I assume they called for a nurse!

Generally those who are very unwell will arrive by ambulance. But this is not always the case, people do walk in who are extremely unwell. I can only talk for my hospital but you are triaged at the point of walking through the door, this includes a set of observations. This will catch those that are very unwell and need immediate attention.

Ps you presume too much to think most people go to A&E because they believe they have a life threatening problem 😆 people go because it's easy.

This is my fear and what's actually inspired this thread. I'm sitting here with DS2 who's only 8 weeks old, and post partum hormones have my mind racing about everything that could go wrong. The major one being serious illness and the hurdles I might face if he ever needed to be seen immediately. God forbid.

Ime the reception staff don’t give a shit and tell you to wait like everybody else.

i raced Dd back to a&e a week after being diagnosed with multiple clots in her lungs. So she was high risk for heart damage/heart attack. She had crippling chest pain and was sobbing/screaming in pain. I told them her background and we had to spend 20 plus minutes before being triaged with her screaming in pain.

and one of the reception staff at our a&e is a registered nurse and they make the decision about waiting, etc so it’s not like it was a non medical person who didn’t understand. Guess maybe if they have no free bed/trolley then they have no free bed/trolley no matter what’s happening?

Very interesting to see the range of experiences. How unfortunate that like everything else, it's the luck of the draw re how well your local hospital is run.

It really shouldn't be a lottery when it comes to health.

And my story happened a few months after someone at my hospital dropped dead of a cardiac arrest in reception after waiting over two hours without being seen with bad chest pain. Well actually he was just outside the front doors after arguing with reception staff about the wait and saying he was going to go home.

This must have been absolutely terrifying and frustrating in equal measure. I hope your DD is ok.

I had this with a head injury I didn't realise how ill I was and had gone in a taxi it turned out to be a bleed on my brain. But they called for help straight away within seconds I was in a wheel chair being wheeled into resus. Iv also seen it with a little boy carried in by his mum with an asthma attack taken straight into resus. The thing with chest pain 99% of the time it's not heart related and even if it is unless it's a cardiac arrest which the person wouldn't be breathing their is time

Sounds like Derriford in Plymouth!

I was met at the door when out of hours doctors called them to say I was coming in. That was with Quinsy.
Another time I went to by ambulance and then paramedics sat me by myself in the waiting room, the doctor went mad when he found me there, I had meningitis and was really unwell.

I've had this twice in 3 years.

First time was with my son, then 14. He'd had 3 weeks of worsening diarrhea, extreme weight loss and abdominal pain that the GP had been trying to get to the bottom of and he was waiting on an urgent gastro appointment when he took a turn for the (even) worse and I took him to a&e at our local children's hospital.

He was triaged within 30 min and given a check of his blood sugar levels to check for diabetes. Then a 6 hour wait (whilst every snotty toddler in the place was seen). Then finally saw a doctor, who examined him, ordered bloods after which he immediately put on a drip, sent for scans and admitted. He was in for 3 weeks and from the moment he saw that first doctor his care was exemplary.

Second time was last month. Me this time with an intestinal blockage. I was triaged within 10 min and sent for a preliminary set of examinations (blood pressure etc). Shortly thereafter I was given morphine for the pain and taken to the observation ward where I was seen by a doctor or two. Scan after 6 hours, treatment started 8 hours after I first got to hospital (other than the pain relief which was quick). I was in for a week.

Although a&e is under huge strain and can and does fail, our experiences show it can and does work sometimes (although my intestinal blockage only came about due to failures in other areas of the nhs).

Generally at ours if you arrive by ambulance with clear life threatening need you go straight to resus. If you walk in it's more problematic but we do try to triage ask fast as possible and keep an eye out for people.

I had this once I'd overdosed gone by ambulance who sat me in waiting room luckily the staff in a&e realised really quickly I wasn't ok and was taken straight into resus they wasn't happy with the paramedics and said I should of been taken straight through