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.

Very recent experience at major teaching hospital in London.
Long wait to book in at reception.
Signs saying wait to be called to reception.
Nurses at the door ??? No chance.
Wait to see triaging nurse
Then several hours to see HP.
Fine, apart from wait to see intial reception.
But ... We were non urgent and sent to A&E via booked community physio appt and again by physio when attending a hospital appt.
First was for an x-ray , second for blood tests.
So we were clogging up A&E for what should ,IMO, have been dealt with by walk in out patient services.
Very frustrating.

I had severe chest pain a few years ago and wasn't triaged for four hours. I ended up being there for 18 hours in total, but if it had been a heart attack I likely would have died. On that same trip someone was lying on the floor with a bleeding head wound, barely moving and people kept telling reception, but they weren't triaged either. That was Plymouth.

A couple of years ago I attended with chest pains, which were not an actual heart attack in the end but was a cardiac issue although not immediately life threatening. However they did treat it as a suspected heart attack.

At our unit you can't directly visit A&E, everyone presents at the urgent care centre where they are booked in and triaged. It's London, it's busy and waits are generally dreadful.

In my case, I must have looked awful on arrival, as at the door a security guard bought over a wheelchair, took me to the desk and I queue skipped into triage, straight to A&E and straight into a cubical.

I presume there are certain symptoms that trigger a process for the wonderful reception staff to just get the triage nurse straight to you.

I'm not in A&E but a similar triaging area and the last time I had a patients with ?Addisons crisis it had been phoned in through the med reg (wasn't the normal process) and he came through to make sure there was a resus bed waiting for the patient and we had to bleep the med reg as soon as they arrived.

That’s good. I’ve had Addisons since 2017 and I’m now on my 3rd formal complaint about my local (large university) hospital because they just do not get it. At all. It is just luck I haven’t died yet to be honest!

My mum has been removed from the car at a&e on a state of seizure and taken into the hospital this year, but only because my dad had been talking to the neurology and oncology teams before setting off and they were expecting him to arrive with her.

Hah! You reckon ambulance cases get seen first? Wrong.

Taken by ambulance to A&E with chest pain (chronic heart condition) and was unceremoniously dumped in the waiting room and sat there for 4 hours before being seen. The ambulance men were deemed to have triaged me so not seen by anyone for 4 hours. This is the state of our local hospital. Had I been picked up when it was closed (overnight) I would have gone to nearest city and at least they keep a bloody eye on you!

I went to our local minor injuries/out of hours GP service on a Saturday feeling awful with what turned out to be shingles in my eye. They normally assign people to a nurse but, unbeknownst to me, I was assigned to a doctor - I think it was due to a combination of having phoned 111 and looking like death warmed up. It didn't get me in particularly quickly, but it did mean I saw the right person without unnecessary delay.

We’ve been in a&e a few times. Twice for me, kidney stones literally in agony so that was fun, the first time I was really unwell and the triage nurse was just lovely all the staff were, second time not so much but care was good and fairly fast, my son was under a year so 13 years ago.

With same son, asthmatic we came via home due to exacerbation and they were great then ambulance the next time and he was totally mis managed to the point they made him worse and he ended up on infusions and nearly ended up in picu, the fact I am a paeds nurse and was saying he needs more nebs, paeds review etc they were just saying I was an anxious parent, I went to ask a nurse for them to check him and she was like just give him his inhaler, I was so angry, I just said if the inhaler was working we wouldn’t be here, really was a farce also sending in a clinical support worker to do Obs on him when he arrived which were all incorrect. It’s our closest a&e but am praying we don’t need it this winter ❄️

I've had to do 2 A&E arrivals with very unwell children.
First time I took my 6 week old in, he was grey, floppy, massive fever and making strange grunting breaths (we lived minutes from the hospital so rushed over). When I arrived there was a huge queue to even get to the reception desk and security told me it was about an hour queue. I showed the security guard my son and the guard told me no-one gets "special treatment".

I massively froze up in panic and some Saint of a woman noticed us and made everyone in the queue stand aside to let us go to the front. We were checked in (where I said I didn't think he was breathing properly) and we then had to sit in a waiting room for about 15 minutes for triage while I was sobbing hysterically (on my own because of a&e rules). We were in triage for 10 seconds before going to resus - he had meningitis and encephalitis.

2nd time with other child we had to sit in the waiting room for around 10 minutes, then triage and straight to resus as her spo2 was in the high 80s.

Honestly I would ring an ambulance now for anything serious despite the fact I could walk to A&E in minutes.

I can't speak for other hospitals. Where I work (I don't work in A+E), I saw two incidents where they saw a person (who had not come in by ambulance) straight away. I'm sure that there are many other occasions where they just whisk them through.

• a friend of mine. She messaged me one morning, telling me the symptoms she had (first thing that went through my mind was cauda equina). I bundled her into car and took her straight to hospital (quicker than waiting ambulance). They saw her immediately (as they were worried about cauda equina), did the tests and scans needed. Thank God it wasn't this.
• I was at the A+E reception desk, registering my DD (she'd had another fracture that needed checking out). A lady came running in saying that her husband was having an anaphylaxis reaction (he was in car just outside the front door. The reception lady froze (she was unsure what to do) but I told her to pull the arrest bell, yell for help and put out a resus call immediately. The poor guy was attended to straight away, and whisked into resus. I looked after the poor lady until the resus people let her through to see him.

It makes me so sad hearing about people who have been left waiting. Slightly different situation, but I remember when I was a student nurse, an elderly lady had been dropped off in A+E one Friday afternoon. She had a small bag with her. She wasn't poorly so no one thought too much of it, until a while later when someone approached her. It turned out that her family left her there as they wanted to go away for the weekend. I wasn't on placement there (one of my friends was), but I cried when I heard the story.

My mum very nearly died in an A&E waiting room. Arrived in a taxi but she quickly got worse, flopping down in the chair, couldn't sit properly, asking if she could possibly lie down. I repeatedly begged for help, told to sit down. I got her a wheelchair for her to sit in which she again was collapsing out of. Eventually a passing HCA who I asked for help took her obs discretely around a corner and immediately called a nurse. I saw panic in that nurse's face. Suddenly more staff and a trolley. She was cannulated in a side room and then rushed into resus. Turned out to be sepsis.

I assume if she hasn't had someone advocating for her she would have died there in the waiting room. She just looked like a sleepy, slightly floppy old lady.

I ran into A&E once with my son (about 5 at the time) in my arms. A nurse did rush over as he was obviously not fully conscious and got him triaged straight away.

That happened to me with my DC. Waiting room full of people but they grabbed DC who was also a baby and took them straight through. This wasn’t A&E but it the out of hours emergency doctors. It’s horrific when it’s you’re child 😢 thank god the took them straight in.

I went to A&E after calling 111 because I was menstrual bleeding significantly. I was in no pain but you know you’re own body and I know I couldn’t keep loosing the amount I was hourly and be ok. TBF I explained to the receptionist and within a five mins I was called for and they had called the gynaecologist down to see me.

I rushed into A&E once with my son who was fitting. I got into re-sus (sp?) immediately.

I presented at A&E with a DVT in my pregnancy and got sent straight to the ward.

Other than that, the other times I (or one of my children) had life threatening issues we called an ambulance and got blue lighted in. You miss the whole waiting room experience then.

Our reception do the first triage, I went to A&E, honestly I thought I was wasting their time. Within 10 minutes I was on a trolley, blood cultures were sent and IV antibiotics started for sepsis.

They saved my life that day, from the minute I walked through the door.

When I took my son in an emergency, a doctor passing the entrance took one look at him, grabbed out my arms and we were in resus before I spoke to anyone.

Last year I had a life threatening episode which resulted in my husband rushing me in as quicker than ambulance coming out to our tiny village. I managed to get to reception after collapsing twice in parking lot. Husband got shouted at to move car so by a miracle alone I made it to reception. Receptionist immediately realised I was in dire straights and I could barely speak and was slumped over reception desk. A nurse in passing got me into a chair and took me straight past everyone to resus. Staff kept asking who my paramedic was and which ambulance I came in on and was gobsmacked that we drove. Next several in resus was a blur. Got stabilised about 6 hours in, stayed in resus for 24 hours and then in hospital for a week. It was extremely scary and I didn't at the time realise how quickly I deteriorated and how close I was to death. Nhs worked beautifully in what was a life threatening episode.

Some of these experiences are awful.

I was seen to very fast when I walked into a London A&E with a ruptured appendix (and was way too ill to make very much fuss at the time - someone must have "spotted" something about me). My DH had a very long wait for an actual ward/bed with an awful infection/diverticulitis at the same hospital, but they were aware of him and very kind.

The pressure NHS staff are under is terrible. Mistakes are inevitable. And things must change.

oh actually got sent by the GP to A&E for my DVT and another time for cellulitis which was creeping up my leg (in both cases I was clueless as to the seriousness of the illnesses so went to the GP in a very laid back way). In both cases I got to avoid the waiting room and got straight in.

When I went into big city a&e last month there was a triage nurse who you spoke to first then an admin person who checked details.
I was directed straight through as it was an emergency other patients were directed to another triage nurse.
The there was a 2 stage triage which seemed to work well.

I had a mild stroke recently. Symptoms were being unable to use arm and leg on one side.

Saturday so went to out of hours GP who sent me straight to a&e. Took 1 hour to see triage. I'd already waited an hour for GP (walk in centre).

Another 4h then a doctor gave me aspirin and sent me for a head scan. 2h later I was admitted.

Every time I see stroke advice saying you need to act fast (within an hour) it makes me want to cry

Another incident was my 3 month old who stopped breathing. I started CPR and we were blue lighted into town (still took 20 minutes). Upon arrival the resus team were waiting and worked on him immediately. Never seen so many people in one room. When eventually stabilised he was transferred to hdu and had emergency surgery a couple of hours later. He spent a day in icu and then several in hdu before going home. Again NHS worked well in life or death emergency.

One time I called an ambulance for my mum because I went over to visit her and found her lying on the couch with a blanket round her. She was a funny colour, her breathing sounded really strange and when I tried to wake her, I couldn’t. I dived for the phone, rang an ambulance and when we got to the hospital, we were met at the door and they wheeled her off to work on her. They put me in the family room to wait. A few hours later a doctor came and told me that she had severe pneumonia and abscesses on her lungs but she was stable and being moved to icu.
Obviously if someone arrives unconscious, it’s different to walking in. I’ve brought my mum to a&e a good number of times, a few times she has gone straight through, but she has mostly been unconscious when that happened.

Last time I was waiting in a&e (to be called through to DM in resus) a guy carried his mate in who had a screwdriver stuck in the side of his abdomen - blood everywhere. He'd apparently fallen on it at work. The sea of people in a&e waiting area parted in shock and a&e reception called through to resus and he was whisked through in seconds whilst his mate went and parked the car he'd brought him in and abandoned in the ambulance bay.
DM sadly died a few days later, but I often wonder what happened to the screwdriver guy

I broke my arm in 2002 - it turned out to be quite a serious break; humerus fracture falling off a horse. Dad came and picked me up, and took me to A&E, and they took me straight through as I was in a lot of pain, feeling dizzy etc. They were shocked at the location of the fracture and how serious it was, but luckily it healed without any surgery required.