Why do parents take children to A&E when it's not an accident or an emergency

[MigGirl]

So spent Tuesday evening/early morning Wed in A&E with DS as he was having an asthma attack which we couldn't control at home. I would have preferred an out of hours appointment but 111 sent us to A&E.

It's been a few years since we have had to do this, as his asthma has been very well controlled. I wasn't to happy with the number of children there who only had viral colds, at lest three went home with just eye drops for conjunctivitis. Yes we could hear everything that was going on, not ideal either.

We where there till 3am who takes their small child to A&E after 10pm at night when they just have a cold and sticky eye. Surely you wait until the morning and ring the GP, I know GP services can be stretched but ours will always see ill children the same day.

I'm annoyed now as DS has come down with a cold and we probably caught it there, he'll be lucky if we don't end up with another vist for his asthma as colds are often a trigger.

Is 111 sending to many people to A&E when they should really have an out of hours appointment? No wonder the waiting times are so long if they are having to deal with so many minor aliments.

Also people don't learn first aid and don't have confidence in paediatric first aid to treat illnesses at home. We're bombarded by campaigns "is it meningitis?", "is it sepsis?", etc but without the training to develop the skills to determine when a situation is an emergency. Personally I think neonatal first aid should be offered to every parent as part of standard antenatal care, then paediatric classes provided for parents in schools annually.

I once took dd (18 months at the time) to a&e as she banged her head on a toy, vomitted and was pretty out of it (not responding to anything). 111 sent us (understandably in this situation). After the 20 minute drive to the hospital, she was charging around the a&e waiting room living her best life and I could feel people rolling their eyes at her being there. Anyone who’d been there for the first hour of our waiting room stay would wonder why the hell we were there. Anyone after that point would have seen her vomiting and the drs rushing her to get checked. (Fortunatly she was ok).

You may overhear some conversations but that doesn’t necessarily show you the whole picture. I’m sure there were people sent there for non essential things by overly cautious 111 people but just saying it’s not always that obvious.

Completely agree, I know we talk about not wanting to waste resources and to reduce pressure etc, but the reality is that the public are not doctors or trained in healthcare so there will always be a wide capacity range for people to decide appropriately what's the best place to get themselves or their child seen. I don't know anyone who'd willingly sign up for a 6 hr wait in a and e with a toddler. They're obviously worried enough to feel its worth that trip. And definitely better to get seen and not need it than not get seen and miss something serious. I remember in the 'good old days' my mum refusing to take me to a and e for a sore foot because she was so worried about wasting the Dr's time and the embarrassment of it being a wasted appointment. In the meantime I actually had a broken foot.

Everyone is at A&E for the same reason as you. They couldn't get a GP/out of hours appointment. You answered your own question.

Many reasons - they can’t get to see their GP, 111 triages into ED, urgent care and ED are in the same building - different function and they may have been sent there but you wouldn’t know that, they’re scared and don’t know where else to go, their child has an underlying health condition, it’s more convenient, they are of another culture where that would be the right path. It’s not as simple as you think at all and it will always be the default until we sort out primary care (which we will probably never do as it’s expensive and controversial as GPs sit outside the NHS)

I think you’re being a bit harsh. My DC had a cold. Managed it for a couple of days at home with usual OTC advice but temp wasn’t coming down. One day he was lethargic, eyes were rolling backwards and his temp was 39.9. We took him to A&E where they triaged and his heart rate was off the charts. They took bloods via IV as they were concerned but that returned nothing. They double dosed him on everything (which you can only do on advice of a doctor), HR was up because of his high fever and he was discharged same night with “just a viral something”. But that could have ended differently if we just rode it out or waited for a GP.

Not at our hospital, its A&E only. Out of hours have separate buildings on a different site. So everyone in A&E at our local hospital are just there for A&E.

For those talking about advice for sick children, I've always looked on 111 website first when they where ill before ringing. I know not everyone has that ability but I'm sure most do now. They even tell you to do this when you ring them.

There's also a reasonable amount of adults who go in when they don't need to. Recently had eight hours in A&E while hospital discussed DH's results with a specialist hospital. We were in a quiet waiting area with four others that came and went, but you could hear everything that was being said. One lady clearly did not need to be there, another asking questions about treatment in a foreign hospital - he didn't take the paperwork with him and as he didn't feel ill, nothing was done.

I’m in a small market town.

no out of hours gp in my town.
minor injuries the next town over six miles away but they are only open 8-6.

a and e is pretty much your only option outside working hours.

I used to live in a city that had loads of other options.

We never go to our local hospital, total horror show...average wait can be over 20 hours now, entire families with a picnic, whole families outside smoking and chucking junk food containers around...fights, drunks, addicts...If we need to go, then its a slightly longer trip to another hospital which seems much better in turning away the time wasters.

I believe that SS follow up if you decline care where it's advised?

I called a private GP about my son when he had an awful cough because our nursery thought it ought to be seen and we're sniffy about the pharmacy's assessment that it didn't need to be seen by a doctor.

The online GP couldn't do any real assessment of him so they did recommend waking up the sleeping 18m old and taking him to out of hours.

We didn't go, because it was just a bad cough. He was better in a couple of days of rest and fluids.

I don't agree with it, but I do see it differently. The majority that gravitate to A&E at night are usually there because it's the place with the lights on. A huge amount present because of MH issues, the need to talk and offload. A&E that has a social prescriber function can clear the waiting room massively, the issue is lack of other services,as services have decreased and closed, A & E numbers have gone up.

because they called to get a gp appoinment in the morning - no apps left. called 111 waited 40 min for nurse triage and then the dr called back at 9pm who told them to go to a&e as examination and dr only prescription is need.
and then they need to wait another hour or 2 for hospital pharmacy...

GP's need to be better funded so that they can actually see someone with a minor-but-need-acute-attention issue.

In my experience 111 send people to A and E for anything which might conceivably be serious. It's a terrible system.

My friend took her perfectly well 6 year old to A&E on a Saturday evening recently because he’d been complaining his hearing was a bit muffled for a couple of days. No pain at all, just didn’t fancy waiting for the GP to open on Monday. Got sent home after triage with a diagnosis of “ear wax and a bit of a cold” which might have blocked his ears up a bit.

DS2 is an advanced nurse practitioner in A&E. Last week he had a child brought in who had a verruca on their foot. He, also, had an adult who had a self limiting illness who had seen a pharmacist and 3 GPs, including the out of hours, but wasn’t happy with what they’d said.

If you are on the verge of losing your job for it then an evening A&E dash may seem the better option. The fear of losing a job, as a single parent, is immense.

Instant gratification. People who have no education are also not good at pre-planning or focusing on preventative measures. This would include stocking up on OTC medications, learning how to use them, getting all the required vaccines that could prevent serious illness (flu, covid, chicken pox etc). They also have no understanding of hygiene and allow their children to do things that get them sick more often (spending all day in soft plays, taking them in public when sick, touching or eating things that have been on the floor etc).

These parents simply live their life assuming that bad things will never happen to them. They're the same parents who never follow safety rules, sleep guidelines, nutrition guidelines, vaccine guidelines, ignore their kids in public, leave them home alone etc because they just assume the worst case scenario will never befall them.

However in the event something bad does happen, they panic and opt for the instant solution which is A&E or 111. It's very easy to convince 111 into triaging a child for hospital because they would also always err on the side of safety. Everyone knows what to say to make a situation sound potentially life threatening. The whole point of A&E is that a lot (not all obviously) of cases could easily be prevented with enough education, planning and preparation on part of the parents. The fact that NHS is entirely free is probably a factor too. In many other countries, misuse of the ambulance system comes with a hefty fee so people have more incentive to learn how to manage basic medical situations themselves.

I have a close friend who worked in A&E and that is literally exactly how he described his time there. 95% of patients didn't have any sort of life-threatening emergency but decided to show up at crazy hours for their own convenience. Obviously a lot symptoms were serious, but they were also reasonably preventable ones, especially if related to an existing condition. They were often pain related but not life-threatening, which is the purpose of A&E.

Not taking medication correctly or not visiting a specialist are things that can easily lead a pre-existing condition to worsen to the point of A&E. Similarly for children's things...ignoring an infection or not knowing how to treat mild symptoms can easily cause it escalate into something more serious. MH also plays a huge role. Hypochondria, panic attacks, bipolar are things that are not life threatening at all but can trick the patient into thinking they might be dying and need A&E immediately.

My DC is one of the bouncing around like a nutter ones. We’re usually being held in A&E because they’re unhappy about her heart rate or breathing and are waiting for her to stabilise a bit after medication so they can send us home OR see if she needs to go up to paeds. She can still be acting pretty normal with a silent chest and retractions/tugging. So often she’s had a fucktonne of Salamol - which makes her cray cray - and she’s waiting half an hour or so for some more obs. But she looks like she’s fine, even when she’s actually really quite poorly.

The problem is, you don’t know These peoples backgrounds. Yes, some people may misjudge a situation, but it is better to be safe than sorry.

As an adult i delayed seeking help for what I thought it was a panic attack (couldn’t get GP appt). Whilst I walked into a&e, i quickly ended up in reaus as I actually had a dangerous arrhythmia.

Going back to the children, my Kids may have a condition whereby temperature could trigger an arrhythmia that can result in a cardiac arrest (happened to my husband). Guidance from their team at Gt Ormond St Is that I take them in immediately if they have a temperature that does not respond to Calpol and Nurofen
Within 30 to 35 minutes.

Last week had to take my daughter in she had a temperature that was not responding to medication. I have no doubt that I was judged By other parents, as she does not have a flashing neon sign above her head explaining relevant background. Also to the untrained eye she seemed ok (she presents well) save for the fact that she seemed to just have a cold. We ended up being admitted for 2 nights and have an urgent outpatient follow up at GOSH tomorrow.

Watching and posting too much shit online is mulching some peoples brains -if they had any to start with. Some probably need an app for breath to remind them to breathe, eat, sleep and fart.
What happened to common sense and how did we manage before bloody mobiles?

Fear mostly. Or a lack of understanding of the system… some people don’t have a GP and are used to countries having walk in clinics instead so they assume A&E is the same.

111 is a nightmare with kids. It seems 9/10 they send you to A&E

Once they tried to send an ambulance because my son had hit his head and I was just calling for advice as it was the multiple fall that weekend and I was worried about what concussion is and what signs are important - reading between the lines they wanted to send ambulance in case it was child abuse.

In those circumstances you don’t usually argue with professionals (it looks like you have something to hide); but our local ambulance takes you to the worst hospital in the country. So I was like hell flipping no. If you want me to take him then I will but I am going to x hospital (same distance but out of our CCG).

So I had to then!

I once had an overnight wait with DS following an asthma attack (ambulanced in). We were in the paediatric waiting room and the Dr said there was a minimum 6 hour wait.

The room cleared significantly within 5 mins.

A major issue is lack of timely access to GP services, particularly for younger children who can deteriorate quickly.

Although there are still the "need anti-biotics for a cold" people still around.