a&e bad experience

[cucumberpeach]

Just having a little moan as feeling a bit sorry for myself. I know people go through worse things.

I woke up with agonising abdominal pain which worsened all day, vomiting and everything and not keeping anything down. DM called the GP for me and they sent for an ambulance which took several hours to come (not complaining, it's not their fault, obvs there will have been more serious cases to attend to).

Eventually they came and I've now been in the hospital for hours in agony. They didn't give me pain relief, had to beg for it several times. It helped but then wore off and they ignored my polite requests for more. They actually shouted at me when I tried to lie on the floor as it brought relief. They told off a kind lady who went to ask if I could be seen as I was in a lot of pain for misleading them as they thought she was asking for her own mother and asking on behalf of someone else is apparently 'against the rules'.

After asking at the desk four times over the course of an hour they gave me a codeine pill but I'm dreading it wearing off.

Just a bad experience and still haven't seen the dr. Upside is seeing how kind the patients are to eachother, we're all sticking up for eachother! One women was stroking my hair as I lay on the floor in pain.

I realise nurses and medics have a really hard job btw. Just quite miserable at this point.

Sorry you're having to deal with so many idiots OP. Severe abdominal pain such as yours isn't something that can be dealt with by a GP. It was entirely appropriate for them to call you an ambulance.

I'm not an idiot if you're referring to me thanks.

GPs can and do deal with abdominal pain they are trained to check for signs of serious issues that may require hospital care and further tests as opposed to say utis, viruses or constipation. They do this thing called an examination to see if the abdomin is soft or rigid and they also check vital signs to see if they are raised to check for signs of infection.

Look, we can all agree many gps are rubbish but if we expect them to send everyone to a&e without even seeing them then there is your answer why a&e is always backed up and folk are waiting ages to be then sent home.

Wow. Don’t engage with whatever awfulness is there on last posts!

Thank you. It's been quite insulting to hear it described as a 'tummy ache'. Like a gust of wind is to a hurricane!

@DameM Perhaps you should go into public health policy so they can have the benefit of your expertise

@cucumberpeach I'm so sorry you had the experience you did in A and E. ❤ I'm even sorrier at you having to defend yourself to people who clearly have no experience or empathy for what it feels like to be in agony. I've been despairing reading some of the comments.

For what it's worth, sending you lots of well wishes and I hope you don't need to venture near A and E anytime soon xxx

Good idea. First thing I'd implement is GPs actually see their patients before passing the buck to A&E, unless of course they are breathless or haemorrhaging then an immediate a&e dash is required but for abdominal issues they are actually trained to spot an acute abdomen versus constipation/viral pain whatever. It what they are paid for.

Secondly I'd get paramedics better trained.

I'll get applying for that nhs boss now..

There's some very overinvested people on this thread that seem determined to catch you out.

You absolutely did the right thing.

Thank you. Lord grant me the confidence of a MN poster who thinks they know better than three ambulance call centre workers, one GP, two paramedics and a doctor 😅

But you were seen and sent home so clearly your gp was at fault?

I'm sorry if you think I'm a dimwit, conversely a know it all, bullying you or whatever but the problem is the system, not you.

Someone with non specific abdo pain should not have been sent to a&e. GPs are paid to assess and triage people and only send the sick ones to a&e. It sounded like a horrible time for you and all completely avoidable. Meanwhile everyone is waiting ages because gps cba to examine their patients. Good luck anyway.

The point is it could have been serious. It really is a very simple point to comprehend. Also, why are you so obsessed with my trip to hospital?!

Because a quick examination by a gp and a check of your vital signs would have have shown it was viral pain or whatever. An acute abdomen or severe illness are relatively actually easy to spot. Not so easy over a phone with a third party describing symptoms.

Anything could be anything that is why we have gps to sort out what needs urgent investigation and what doesn't.

I'm obsessed with your trip to hospital because it is a national thing, gps using a&e as their own private referral place so those who are very sick tend to have to wait longer.

Your trip to hospital is a snapshot of what is going on everywhere. Gps and dispatch staff need to do better.

Because a quick examination by a gp and a check of your vital signs would have have shown it was viral pain or whatever

It’s not that simple in all cases @DameM

You mentioned upthread that DVT which I used in my example can be identified by red skin and swelling.

What you failed to realise is that I’ve already stated that in my case there was no red skin or swelling.

My blood pressure was also normal the warning sign for me was the pain in my leg. I am glad I was not discouraged from going to a&e because it’s “just a sore leg”.

What ended up being a bilateral pulmonary embolism was ONLY identified because an ambulance took me to A&E where the doctors acted fasted and took a blood test and sent me for a CT scan of my lungs which confirmed it. This was all done within 4 hours of arriving in A&E.

ETA:

“No because a sudden sharp pain in the calf with redness and swelling is indicative of a dvt. Mind, again I'd expect a GP to see you, start you on anti coags and send you to an assessment unit to have a scan and further treatment.
Gps seem to be using A&E as their own personal overflow facility.”

Nah, you don’t mess around with a blood clot. Waiting for a GP to see me would’ve wasted precious time.

Blood clots in the lung are bad enough but you need to act not only fast but carefully so they don’t dislodge and move to eg. Heart or brain.

In my case as soon as I was diagnosed I was immediately moved to bedrest where I stayed for a week and was told NOT to move from my bed.

I was actually abroad but even if I was in the Uk I’m glad I didn’t try and walk over to my GPs or to a walk-in clinic.

That would’ve been putting myself in further risk even if I had been able to get a last minute same day appointment which is massively unlikely considering it was around 4pm when I first rang the ambulance.

GPs do not administer anticoagulant injections as far as I know. They do prescribe the pill form though of course.

The injection is more effective and what was urgently needed in my case during that first week I was hospitalised. I was able to go onto the pill form once discharged.

I am not sure what “assessment unit” you’re referring to, but the best place to be assessed for DVT/ PE is a&e due to the obvious urgency involved with these conditions.

So a responsible GP would have told me on the phone to go straight to A&E for diagnosis/treatment.

That's just not the case though - if these issues are so easy to spot, why are severe abdominal pain cases invariably scanned? Surely there's no need for a scan if it's all so obvious.

There's also the fact that medicine really isn't an exact science. It works on averages so that the average case of DVT, appendicitis, pneumonia or whatever displays a specific set of symptoms, but all human bodies are different and there are too many variables to only rely upon textbook lists of symptoms. We all know of cases where people have been misdiagnosed or simply sent away because doctors of various kinds have not used their intuition, or maybe their common sense or maybe just been bored. I have all too many just of my own.

This is why things like scans exist, also second opinions, and it's why it's not worth the doctor or the patient taking the chance and assuming it's nothing serious. Too often it is.

When it comes to emotional intelligence it's a fair assessment.

Severe abdominal pain is an a&e issue because serious time critical issues like heart attack (which can feel like abdominal pain, especially in women) need to be ruled out first so waiting for a GP appointment is not appropriate (nor is waiting hours in a&e tbh - I'm abroad and went to my local emergency department with abdominal pain and they did an ecg immediately on arrival to rule out heart attack, before they were happy to let me wait)

Course they prescribe sub cut anticoagulant injections like enoxaparin or whatever and the patient (or nurse if unable to do it themselves) administers it. My df was assessed in an mau when he had a pe, they don't all go via A&E. That's what I mean by an 'assessment unit'. Some hospitals call them mau, some cdu. It varies.

'Severe abdominal pain is an a&e issue because serious time critical issues like heart attack (which can feel like abdominal pain, especially in women) need to be ruled out first so waiting for a GP appointment is not appropriate'

She waited hours for an ambulance. In that time a GP could have prodded her abdo, dipped her wee, taken her temp and at least had some idea what they were sending her to an emergency department with.

The GPs are the problem not the patients.

If she could have got an appointment with the GP that day, which from what I hear from the UK, can be very difficult to get. Plus the ecg needs to be done, can that be done at the GP? (I don't know if it can in the UK so asking) If not, then going to the GP first would delay matters even more than they were already delayed.

She shouldn't have had to wait hours for the ambulance either with those symptoms, another problem with the UK.

No idea what an MAU etc is but as I said I was exactly where I was supposed to be which was A&E as that was the place (in that country) where I’d have got seen to the quickest.
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Not all blood clots are equal so I can’t speak for everyone but in my case I was told it was very good I had come straight there and in an ambulance where I was strapped in.

I was admitted onto a hospital ward after one night in urgent care ward.

So going to a clinic first would have just delayed things as well as been more unnecessary moving around which could have put me at greater risk for dislodging the clots.

Even in my recent experience in the UK a&e there was a poster that showed 3 different tiers of emergency and blood clots was on the “red” most urgent. You should absolutely go to A&E for suspected blood clots.

In my town A&E is where you go for urgent CT scans which is what you need if you have a suspected blood clot. There is nowhere else they send people to get those.

And as I’ve already said, for most people getting a last minute same day appointment with a GP especially if you call after a certain time is very unlikely. For my surgery you need to call before 9am and even then it’s not guaranteed.

Exactly, it’s unnecessary delay in many cases, even on the off chance someone is able to get an immediate same day GP appointment -which is unlikely .

All the health professionals told me I did exactly the right thing by coming straight to A&E. Even if it hadn’t been what I thought it was I’d still have done the right thing based on the info I had.

I’m no apologist of GPs as I’ve had my issues with many, but I’m not sure why this poster is so keen to insist their advice is right against the actual clinical advice which tells people to head straight to a&e in the situations myself,OP and others have outlined.

Course they prescribe sub cut anticoagulant injections like enoxaparin or whatever and the patient (or nurse if unable to do it themselves) administers it.

What world are you living in? It’s absolutely not normal for patients who have never had a PE before to be injecting themselves with anticoagulants. Like most people I’ve never injected myself with anything in my life. Had never even been in a hospital overnight before this incident.

You don’t seem to be getting that I needed to be injected by a medic asap and then was placed on a hospital bed for over a week and told not to move until they done the second lot of scans after several days to check the clot had reduced enough/gone.

The GP surgery would absolutely not have been the right place for this even if there was a nurse who would do the initial injection.

And there’s the not so small matter of they shouldn’t really be injecting you with an anti-coagulant BEFORE the scan if you’re someone with no history of blood clots and they don’t know for certain you have.

Hence they are meant to direct you to A&E to diagnosis you before they begin treatment.

It is absolutely normal to have sub cutaneous anti coags in this 'world I live in'. I had a query dvt once, it was negative after scan but my on the ball gp prescribed it I administered it then popped to the hospital to be scanned.

I'm not talking about performing major surgery on oneself but anti coags whilst awaiting scan are absolutely routine.

Anyway, I digress. As I say some gps are great and actually see and review their patients before sending to hospital, some aren't. It is a postcode lottery and shouldn't be they should do a very basic assessment so a&e at least know what their concerns are rather than a very vague 'abdo pain' which can be anything from a urine infection to a lifetime threatening <and actually requiring a&e> aneurysm.