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.

We took DS2 (14) to A&E recently without calling 111 or visiting a pharmacist. It was the weekend, so GP was closed & he was delirious, although no temperature etc. He has epilepsy & we knew that if we called 111 they would say A&E, so we just cut out the middle man 🤷‍♀️ He was kept in overnight then they discharged him saying he shouldn't be there! So we can't win.

When my baby has a cold, I always find his breathing sounds alarming. I’ve been told by an A&E doctor that I don’t need to be the judge whether something is wrong or not, and that my only job is to call 111 and let the experts decide. They had sent me to A&E before and then it turned out that DS’ stats where ok and we were sent home again, but it’s a ‘better safe than sorry’ situation and I think 111 is doing the right thing sending small children to A&E because it’s just hard to know whether they’d be ok at home or not.

But it's not about winning. In this case, the care sounds appropriate. Your son, who has a neurological condition, was experiencing a change in his neurological state. He was admitted for monitoring overnight, but no reason for a continuing stay was observed. Presumably you're familiar with his epilepsy presentation and care plan, so he's best at home where he's in a familiar, comfortable environment with people who can provide appropriate first aid and escalate his care if necessary.

Being in hospital can lower some people's seizure threshold (the lights, the sleep disturbance, the noises, etc) and that's a risk that has to be balanced when admitting people with epilepsy.

Patients under our mental health trust are told to go to A & E, as a place of safety, out of hours in a crisis, such as feeling suicidal. If they don’t go, the suicidal feelings are not taken seriously and they can be discharged from the mental health services for “not engaging with services”! So, if you don’t do, as they tell you, no more mental health treatment for you!

Taking kids to A and E for a day out has been going on far longer than the current NHS crisis.

DD2 was a dispenser in a pharmacy. Eye drops are not usually licensed for use on children under 2. A doctor can prescribe them for a child under 2. DD used to get mothers coming in, having been told by the GP to go buy eye drops for a 6 month old baby; and they got annoyed when she told them, she couldn’t sell them to them, saying

“But the GP said…”

It’s not the pharmacy’s fault; it’s to protect young children!

I would of been 100% in agreement OP and thought this was outrageous until I tried to get an appointment for my sick child with the GP a few weeks ago, genuinely hours trying to get through on the phone before even getting to speak to a receptionist (our surgery has put a no walk in policy) as in don't go in to speak to the receptionist just call. After finally getting through, I waited another 2 hours for the Dr to call me back to then be told there were no appointments left that day go to A&E. It's very scary when your child is sick and if you can't see a GP what else can you do

There’s a new pharmacy prescribing scheme and some can fit babies over 1. It’s called pharmacy first. But not in my area for eye drops.

I just don’t really think it’s anyone else’s business, I highly doubt people are taking their children to A&E for fun or for what they genuinely believe to be a simple cold.

We took DS to A&E once at around 20months as he fell in the garden, he was screaming in pain and refusing to weight bare, for the next couple of hours we decided to monitor, he was fine when off his leg and as soon as he tried to stand or walk he would fall to the floor and scream in pain, weekend so gp shut, local walk in won’t see children under 2 so we had no choice but to go to A&E. Within 5 mins of getting there he was running about and playing with the toys as if nothing had happened 🙄, we very clearly didn’t need to be there at that point but the nurse recommended we stay just to get him checked over so that’s what we did. He was just being dramatic but at the time it was really frightening.

It’s a great scheme and would take a lot of pressure off GP’s but the downside at least where we are is that the pharmacies running it are just not keen to say anything on kids. We took my daughter to one when she was about 18 months old for suspected ear infection having been told this was absolutely something the pharmacy could do, we went, we waited, they had a little look and told us they weren’t prepared to say anything or prescribe anything and to see a GP or present at A&E!

Are you at all familiar with bi-polar @User9767475 ?

It's very common for people with it to lack insight into the fact that they are unwell. You don't think you're dying, as you expressed it, you can feel on top of the world and able to achieve anything.

So unless you are taken there on a 136, it's highly unlikely you will rock up for a bit of "attention seeking".

It's a far cry from hypochondria.

I get that lots of people are told by 111 to go there but I don’t get why so many people are calling 111 for standard viruses and upset tummies in the first place. A lot of parents don’t realise a medic isn’t actually needed. Yes I understand sometimes the illness isn’t ‘just’ a virus, but at the same time taking your child to see a doctor every time they have a cold or a cough is ridiculous.

I called 111 for advice and was told I may have to take DS to a&e - I explained I didn't want to take him there unnecessarily and checked whether it really was necessary to bring him. Then they said that they'd get a GP to call me back. The GP called, explained what to look out for and said not to bring him to a&e. The next week I got a call from the children's services to check why I hadn't followed medical advice and whether DS was OK.

Another time, I called 111 for DS and was given an emergency out of hours GP appt at a&e. Brought him there and the GP gave out to me for coming to the appt and said that 111 should have told me to stay at home and that DS was fine.

Mixed messages and anxious parents mean that people will attend inappropriately!

Because parents aren't trained medical professionals. How do you know when something is a standard virus/stomach bug etc or something worse?

Every time they have a sniffle is obviously ridiculous but sometimes it is genuinely difficult to tell and I do think it's better to be safe than sorry, especially with young children who can go downhill fast.

Well, I have just been told by a GP (yes, an actual GP, I’m serious) that there is no such thing as an urgent paediatric blood test where we are so if I can’t secure a cancellation and am concerned it needs expediting, I should just go to A&E. Literally couldn’t believe it. The choice is wait 7 weeks or A&E - no option to just turn up, take a ticket and wait, or be given a number to call to get something in maybe 2 weeks’ time. God knows what they do with the kids who genuinely need an urgent blood test as opposed to “not urgent but don’t feel I can wait 7 weeks”…

I do agree about 111. The last time I spent the night in paediatric A&E was for a head wound which might have needed gluing (after 9 hours, they decided it didn’t….). We were the only “accident” in the waiting room. Almost everyone else, being candid, appeared to need an out of hours GP and had been sent by 111. I do understand their caution but it feels as though it reflects the lack of adequate out of hours service rather than 111 or parents making the wrong call.

I have one child who never presents as unwell even when he is very unwell, so I’ve been told by our GP to take a cautious approach with him (that said, we’ve not been to A&E with him in years and years), and I have another child with a very rare and serious underlying condition, so if he’s unwell and we’re at all concerned we go to the A&E at the hospital where his paediatric team and surgeons are based so he’s seen by people who know him and his condition well. If we went to the GP he’d send us to A&E anyway so there really is no point. I would find it really difficult to judge others not knowing their back story.

I was in A&E last week as I suffer with cysts most clear up and about 1 in 4 turn into abscesses I know I just need some antibiotics in first instance, but getting a GP appointment is difficult so then it worsens and I have to ring 111 who send me to urgent care, when in actual fact I probably just need a GP to prescribe some antibiotics.

I really do think this is where the healthcare system fails, sometimes it lacks common sense and I think pharmacists should be able to prescribe antibiotics for some things.

But also GPs used to treat a lot more my boomer and gen-x colleagues tell me about GPs doing minor surgeries stuff like verucca removal etc

Walk-in centres need to be brought back.

There was a lot of kids in when I was in A&E/UC and I did think is this because parents are more worried now? I think as a child I went maybe like 5/6 times to A&E

I took our DD to the hospital with what 3 gp visits diagnosed as tonsillitis.
When she was unable to swallow water and had a temperature of 40.1 degrees me and DH decided that it was the only option.
She had sepsis.

Yes, Pharmacy First can treat 7 common conditions, but eye drops for under 2s are not included:

https://www.hwehealthiertogether.nhs.uk/parentscarers/worried-your-child-unwell/pharmacy-first

Well A&E, or the GP for that matter, are not going to be running any tests during an early stage ‘appears’ to be run of the mill illness. They are going to advise pain meds if needed, push fluids etc. Then they are going to let you go home. The vast majority of cases don’t develop into something more, but if that is happening it’s not diagnosed immediately. No Doctor is going to be running blood tests at that stage or sending a child for further investigation if they present as having a basic viral infection. Far too many parents have huge expectations of the NHS and think that a doctors visit will help to cure a virus or that they will get treatment for a stomach bug when that truth is there things are, in the main, very manageable at home without any examination.

The vast majority of cases don't turn into something more but sometimes they do and if you aren't a medical professional, it can be hard to tell the difference. Even plenty of medical professionals can't tell the difference and sometimes send poorly children home who simply end up coming back in or sometimes, even end up dying as a result of serious medical issues getting missed.

I took my son in with a stomach bug because he was dehydrated. He actually didn't have a stomach bug at all, he had cancer. Even the medical professionals didn't see that coming so how are parents supposed to?

Yes, in the vast majority of cases, it isn't going to be something as serious as cancer but if I hadn't had taken him in that day? I'm confident he wouldn't be with us right now as his condition ended up getting much worse and thankfully it happened in hospital, not at home. He didn't look seriously unwell whilst waiting to be triaged and was sat in the waiting room on his ipad, some people may have even thought he didn't belong there.

Im sorry that happened to your son.

There must have been something that led to further tests that found out he had cancer though as ordinarily children with a bug are not tested for cancer. Children who show up presenting with a basic bug/virus are sent home with NFA, just advice.

I really don’t want you to think I’m being argumentative here as I feel awful even replying as I have but I do think far too many parents race to A&E they don’t need to. You needed to have your son seen.

He wasn't sent home because he was dehydrated so the initial diagnosis was gastroenteritis, overnight on fluids and home the next day. He seemingly improved with fluids and anti sickness meds but then went downhill fast because his stomach bug was actually a bowel obstruction caused by cancer which had then caused sepsis.

He started the day in A&E quietly playing on on his ipad and ended the day having a cardiac arrest in the children's assessment ward. He was transferred to a different hospital for emergency surgery and it was the biopsy that came back a week later which diagnosed cancer.

The 'playing with toys' test fails miserably with some children. DD2 has been admitted multiple times with breathing difficulties - the only A&E trip where she didn't play in the waiting room was the ambulance arrival where we were in triage in minutes and in resus immediately after that. Similarly, on the ward, she can be the illest child in the room and the most active.

That said, DD1 recently fell in the 'urgent but not emergency' gap. We had attended with an injury and been told to come back for further checks if she was still in pain a week later. She was, minor injuries wouldn't take her (111 asked them), and so we had a long day in A&E. (And yes, I brought food, as I expected it to be long and the vending machine is expensive - does that count as 'a picnic'?) It would be better for everyone if cases like that could be scheduled attendances.