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.

For me the most upsetting part was I felt completely helpless. I was where we needed to be, and we weren’t getting the help we needed. DS2 was 10 weeks old at the time and it was up to me to advocate for him, and I tried but I was being ignored. I know it wasn’t my fault but for a long time I felt like I didn’t do enough.

But once they did finally see how ill he was, he was taken through straight away. So sooner or later, they do spot it, it’s just a question of how long you wait.

This happened to me in the pandemic( not covid). I was immediately taken to a bed tested, put in ICU about four hours later, treated, recovered, survived.

Hospital had capacity then due to lockdowns. Now, I hope they would but who knows.

I was once in an A&E waiting room when a couple came in with a baby in a car seat. From the noise, I would guess the baby had whooping cough. Behind the desk was the receptionist and a nurse. They stood up, peered over to look at the baby who I presume was a bit blue - clearly looking very unwell anyway. The nurse said something to the receptionist, then bolted round the desk and through a door, and the receptionist said to the parents "follow her, through that door, right down to the end. Run."

This has given me goosebumps. It's good to hear that the baby was seen so quickly. I wonder what would have happened if the nurse wasn't at reception.

My 1year old had been flagged as red flag sepsis by the gp and gave me a note to that effect and had called ahead. We arrived at reception and they sent us straight up to paeds where a cot and nurse was waiting for us - didn’t hit the a&e waiting room at all.

I know everyone has different experiences and horror stories but iv always found with the nhs specifically a&e in true emergencies is when they really thrive. I'm sure we've all done the 14 hr+ waits and had a whinge but when it really matters they've stepped up and iv always been impressed with this side of things

I went into an extremely busy a&e with breathing difficulties and was immediately spotted by a nurse on triage & taken through to be seen. From arrival to being hooked up to machines to help me breathe was about 10 minutes and in that time they also managed to get me checked in, get a medical history etc.

I attended the hospital OP referred to in the last week as a walk-in with my adult DC who was seriously unwell. This was spotted by reception and he was triaged within minutes and seen by a dr almost immediately after.

A&E nurse here.

There is a system in place when the reception staff book you in. They are required to ask you certain questions that some answers trigger as a red flag and they escalate you to the nursing team to be seen quicker or send you straight through. You may not be aware you have been escalated though. This is an electronic system, so takes away the need for the receptionists judgement, as they are not clinical staff members.
The notion that you are seen quicker if 111 or 999 have 'called ahead' is nonsense. They don't have a direct line to a&e departments. The only time you are seen quicker is if you are brought in by ambulance and are in need of resus.

Years ago my father started to have a stroke at home, when I rang for an ambulance I was told there was a huge waiting time, so I rang a taxi , then my gp who rang the hospital and told them we were on the way and he was met at the door by someone with a wheelchair and taken straight into resus . If you're sick enough you will be taken straight in.

On the flip side, I have been in A&E with one of the kids and seen urgent people coming in and being prioritised. The fuss some of the waiting people and their families make about queue jumping. It's really not difficult to understand that something more urgent or life threatening should take priority.

At my local A&E there's usually an hour wait for triage, and a six hour wait to be seen by doctor - that's for non life threatening things like a stroke.

DS walked in looking absolutely fine - DH took him "for a check up". When DH explained what had happened the staff whisked DS through, and found he had a broken back and internal bleeding and wasn't at all fine. The nurse on the door should know who they need to prioritise but, as in any role, some seem to be better at their job than others.

I had a brain bleed, it was missed in A&E. Was sent home and told to come back the next day to ambulatory care to manage a hemiplegic migraine. Only after a CT scan and lumbar puncture the next day, I was rushed in for surgery. They found it was a ruptured aneurysm and I needed endovascular coiling. I was very lucky. The agony I was in wasn't believed at first.

Triage is normally very quick. Last time I hadn't sat down before I was taken through. But the wait afterwards can be very long. I was waiting 12 hours.
I went in with chest pain, which turned out to be pleurisy, so that's probably reasonable.

What probably doesn't help is the numpties who will rush into A&E screaming and crying with a papercut. In some cases, it is probably hard for the people on the reception desk to tell who us being a drama queen/king and who is genuinely in urgent need.

Or if the people with who need urgent help are being stoic about it, sometimes hospital staff think it can't be that bad when actually some people just have really high pain thresholds.

I was in the ambulance with my partner after a cycle accident. It was real life threatening. They knew, he was straight into the serious part to be stabilised before emergency op., I was taken to relatives room. They saved his life for sure.

Most of the time they get it bob on, they have to prioritise, can’t be easy.

I've only been in once with a broken ankle. They prioritised a few people before me (rightly so) including one man with a stab wound.

My two experiences with walk ( or parental carry in) childhood ( genuine) emergencies at a good children’s hospital A & E was that we were rushed through and seen immediately. I was so grateful to live near a children’s hospital- everything geared up for them.

Same. Five weeks ago. No ambulances, mistriaged as non-urgent, didn’t see a doctor for 6 hours. As soon as I did everything sprang into action but it’s not a surprise to me that more than 40% of patients with a ruptured aneurysm die.

I hope you are recovering well. It's been 2 years since my experience for me. I still have some crap days. Headaches are much better. Fatigue is one of the harder things to shake.
Remember to be kind to yourself, it's a hard process to go through but there is easier days ahead 💐

Our 2 local hospitals have separate children's A&E so on the occasions when DS8 has needed it over the years we have been triaged and seen very quickly.

As an adult, I've done my share of long waits but to be fair, I was always triaged quickly and sometimes the wait was longer than others depending on what I've been there for. I once had a broken arm which was very painful but accepted that someone who came in looking worse than me was likely to be seen first.

Triage took one look at me and pressed resus button and docs ran out. Taken in straight away. Reading these I now think I was very lucky.

I have Addisons disease and we discuss this a lot in the Addisons forum I’m in. Addisons is a rare disorder that can result in a potentially fatal adrenal crisis if were suddenly unwell or have another health issue that causes a sudden need for IV steroids over and above the oral steroids we take daily - we can’t produce cortisol so we need an urgent and immediate steroid injection to prevent a fatal coma. It’s literally that serious - and relatively easy to treat. We all wear medical alert bracelets and carry cards which state very clearly we can’t wait for medical help or it could be fatal - we do also have our own steroid injection kits but for various reasons sometimes we’re not able to administer these ourselves (they’re not like an epi pen, you have to assemble them, not always possible if you’re acutely unwell). It’s a common rant on the forums that we are routinely triaged and left to wait for hours without medical help. This is completely wrong and is so frustrating when all we need is a very quick steroid injection and we can then be reasonably safely left for a few hours depending on the cause behind the crisis. Staff just often ignore the steroid dependency cards / life threatening medical alert cards we carry. It is really traumatic and frightening for us to be in that situation and people think because we often appear “ok” we are time wasters - but we can crash within minutes and our bodies can start shutting down.

My GP phoned ahead and told them I was coming, id been in A&E the day before and was discharged same day with a 'virus' GP was v unhappy and sent me back due to clear severely high infection markers. Sat in A&E For hours and hours till I was seen. I had sepsis. To make matters worse when I later made a formal complaint I was told they were too short staffed to investigate and after chasing every month for a YEAR I was told they had closed the complaint due to not being able to speak to involved members of staff. I have zero faith in the NHS.

My an and e has a nurse literally on the door to do immediate triage.

Anyone very ill he will triage to see a doctor asap.

Anyone else goes into the normal triage process.

I have walked in with chest pain and was triaged quite quickly.

A friend of mine died after waiting hours in a and e. He had sepsis. He'd been turned away from an and e two days previously.