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.

With my baby many years ago I went to the Gp and was told to go to an and e with him via car as it would be faster than waiting for an ambulance. Hospital was around the corner. The GP had called the hospital and we were taken straight in to a room and were greeted by a number of doctors and nurses (he was obviously very unwell!)
I don’t think the same would happen at an and e. Witnessing it first hand is actually know it wouldn’t. Unless you were obviously bleeding out maybe then they would take it seriously. There are just no beds and no capacity at my local hospital. Even in resus / majors.

I also had to take my husband to A&E by a non emergency ambulance during one of the doctors strikes last year

A&E was horrendous. We got there at 4am people had been there since 5pm and not been treated, was standing room only and the nurses were doing their best but with lack of doctors couldnt really do much and some were still in the waiting room 8 hours later when we finally were able to go

I went to a walk in centre with a strange allergic reaction, I could barely stand up and despite the waiting room being packed, the receptionist took one look and called a doctor. I was then surrounded by nurses, doctors and a blue light ambulance ordered to take me straight to A&E. I was rushed through and spent a week in ITU with sepsis. I did not realise how seriously ill I was.

I went in with a fractured dislocation. By car as no ambulances. They took my details and sat me down. I was seen within 5 mins as obviously the pain was terrible.

I was queuing in A&E when a very elderly man staggered past and lent on the reception area. I was shocked how long the staff took to notice he was stood there never mind the fact he was clearly very ill. The rest of us got a wheelchair and got the staffs attention. Really disappointed and worried me. Once other staff realised help did come quickly, and a few hands.

At ours there are a few ways in. One is by ambulance round the back. The second is to wait and be triaged, which is up to 20 min. The third is if the person looks very ill or collapses, they have a big red button and press that! If that goes off there's an alarm and lots and lots of staff run into the room to attend the person. You can ask the person on the desk to press the button if someone deteriorates. I've seen them do it for a head injury. The problem is with quiet people who are silently having a heart attack or stroke or can't advocate for themselves.

No; not in our experience!

My then 15 year old daughter was met at the door by doctors and nurses as the paramedics had rang her through as extremely urgent. Taken straight to resus and was in theatre within 4 hours having brain surgery.

A few years back I had chronic Diarrhoea that in itself was worrying as it went on for weeks went to my GP twice first told it was side effects of antibiotics then a virus when my DH found me half unconscious he took me to A&E but made then mistake of asking the triage nurse if I could see a gastroenterologist, that was it she accused me of trying to see a specialist and more or less threw us out. Next day I managed to get an appointment with a practise nurse who called my GP in the one who said I had a virus 4 days before I will never forget his face he looked totally shocked, he sent me back to A&E turns out I had SEPSIS and I was very ill, the hospital are fantastic when I was in there, I was in for 12 days 11 of which were in isolation.

What scares me is that if this happened now and I couldn't actually have a face to face with a GP only a telephone or email consultation if that GP would not have seen for himself how much I had deteriorated in just 4 days and I could have died.

Asthma attack is life threatening. Hence immediate response. There are surprisingly few situations that merit immediate response.
And it’s generally the quieter patient that is of more concern. If someone is yelling and screaming at staff for attention their pain is likely to be mild to moderate. When someone has severe pain they are likely to be very quiet and unwilling to give more than one word answers. Any activity just triggers the pain. They will be very pale/pasty and sweaty, staff look for physical signs of pain level, heart rate, facial expression, parlour and posture are all indicators.
Our perception of pain is very subjective, a 10 to one person may be a 1 to someone else. When you have severe pain even the smallest movement makes it worse so you are often very still. The only indicator may be facial grimace or very low grade moaning.

I have just spent the last 3 weeks with my DSis who was end of life pathway. Towards the end her pain was severe, the primal nature of her moans and silent screams was gut wrenching. Sometimes the pain was so severe that she was having top ups hourly. She was a runner and very active, used to pushing her body to limits. Her pain threshold was high and managed on paracetamol and ibuprofen until the last week.

If you are in an A&E waiting room you are generally not an emergency. Although triage is cursory it does generally pick up the emergencies.
My DH had a stroke a couple of years ago, he was seen rapidly, scanned and treated for hypertension so that they could give him the anticoagulant treatment that effectively reversed his stroke within 4 hours. He was admitted to the stroke ward 4.5 hrs after he arrived.
Im afraid that I would rather wait for minor stuff if it means that seriously acutely ill patients receive life saving treatment. My sprained ankle or cut finger will wait. If I’ve spent two or three days deliberating over a health condition only to roll into A&E at midnight then I only have myself to blame. Hospitals are not fully staffed at night, only the staff needed for inpatients are needed. The rest of the staff that make a fully operational hospital work 9-5 so it is absolutely pointless expecting first class diagnostic treatment from A&E when you haven’t even tried your GP.

I was in A&E around midnight, not life threatening but needed a blood test asap, it couldn’t wait until morning ( long story short, GP had told me to take incorrect medication dose) A mum came in, said her husband was carrying their teenage daughter in, her symptoms were xxxxx and my head whipped up—- sepsis symptoms. Receptionist, HCA and nurse jumped into action. Poor girl who looked so ill was rushed through, I heard HCA and nurse say following sepsis protocol and she was moved immediately through to the inner treatment area. It was fast, calm & everyone seemed to know their part to play.

In my expirence they sent my dad home 4 times after making him wait hours.

Triage spotted me waiting and said I looked grey, then gave me morphine and I said I've got cauda equina, it feels different and wrong
Examined and MRI shortly after then surgery

My mum was taken into a&e, they checked her vital signs, and she went straight into intensive care. She nearly died but luckily survived. The people in the hospital thought she wouldn't make it. I would hope this would aways be the case.

My mum had a haemorrhagic stroke while out. No ambulance came, waited for over an hour then I got a call from the place she was at. I picked her up and drove her to the hospital. I parked where the ambulance bay is right by the doors and shouted at the paramedic to get their attention. They helped get her out the car and transferred her inside. They promptly took her by ambulance to the specialist stroke unit at a different hospital for treatment. As per the protocol here.

I do wonder what would happen if it happens again though. Would I / should I just pull up at the ambulance bay and get their help or should I take her in if I can, as we now have a wheelchair. But I'd be taking her through the urgent care triage where they queue out the door. Would they realise? Strokes are time sensitive.

I once drove my dad to A&E with a suspected stroke as it was quicker than an ambulance. By the time we got there, he was slurring and could hardly walk. He was having a stroke. No triage and yes, doctors running out of the dept to treat him.

Edited to say he was fine and I was eight and a half months pregnant and the doctors were almost as concerned about me 🙈

Odd cross post with @XioXio there x

Think it depends whether you’re taken in by ambulance. As PPs have said, if the paramedics phone ahead they have doctors waiting. I had that when I had sepsis.

My friend drove me to A&E when I had a serious head injury and, although I walked in, I was clearly away with the fairies and had an open wound on my head. I was seen really quickly, despite the waiting room being packed (it was New Year's Day). I remember at the time I thought everyone was being over dramatic, but it turns out I had a brain bleed, so I'm very grateful I was seen as an emergency otherwise my outcome would've been a lot worse.

DD went to A&E with some mega-infection. After a while she collapsed when standing in Q to ask about how long was remaining wait time. She said people swarmed around her as she became an emergency case and got very quick treatment.

I walked in struggling to breath after falling off a horse and I was rushed through, and x rayed straight away. 4 broken ribs and a broken collar bone

I arrived with a very poorly baby with a letter from the out of hours, one look from the receptionist and we were in resus. She had sepsis.

I have also arrived with my DC in respiratory distress and had to wait for triage, I think receptionist's experience and parents behaviour will dictate a lot.

My child projectile vomited blood at the reception desk, a nurse in the waiting room took us straight to resus and within 5 minutes there was a full paediatric crash team in there with intubation kits just in case. The NHS does work well sometimes!

I don’t know how but I arrived with a poorly baby via ambulance and was greeted by a triage of staff immediately. My DH once took my DSS and just shouted “we need help” and someone came to his aid immediately. I guess the staff can tell, to a degree, what’s genuinely a crisis and what’s a self perceived crisis (maybe like the man above having a heart attack).

Also OP they always err on the side of caution with babies.