for being really fecked off with GPs

[banana87]

I understand that antibiotics do not work when you have a viral infection.

However, last week DD2 (15m) was clearly not right. I called GP and told them her symptoms (sleeping 17+ hours, bad cough, high fever, not eating). They told me (over the phone) that it was a virus. Wait it out. I waited 2 days and took her to see a private GP who immediately diagnosed her with a chest infection and prescribed antibiotics.

My SIL has been sick since end of last week. She is getting progressively worse (same symptoms as above other than sleeping!). She phoned GP Monday. He told her (over the phone) it was a virus, take paracetemol and wait it out. It got to the point that she felt her chest tightening and heavy so went in the next day (yesterday). He acknowledged that she was quite ill, but gave her an inhaler and said it wasn't an infection. She's worse today than she was yesterday and is now going to see a private GP.

Last winter my DD1 had persistent high fevers that did not respond to calpol or neurofen. We were in A&E twice and dr twice. Every time, "it's just a virus". After 6 weeks I had enough and took her in and said I wanted her to have blood tests as I was convinced she had cancer. Funnily, they gave me antibiotics even though "there is no sign of infection" and within 3 days the fevers were gone and have never returned.

Also last winter my then 5 week old baby had a high temp. I took her to the GP. "Just a virus". Next day, same thing and on call dr had us go straight to A&E where I was told "it's just a virus". Luckily a very good consultant was on call and thought it would be wise to do a chest x-ray "just in case". She had PNEUMONIA.

I understand that there are worries about antibiotic resistance. But what is the point in withholding antibiotics until one is so sick that there is no other option? In all of the above examples, antibiotics were or are currently being withheld needlessly. Why?

[RoseandVioletCreams]

ok dikker,

I have called out of hours - I think her chest needs listening too anyway, but no other symptons in terms of the laboured breathing etc.

you poor thing, so sorry to read about your DD, its terribly worrying when you cant trust the system to help you.

what i dont understand though, is gp's being budget driven, if they let a problem fester it will cost them more in the long run anyway?

[RoseandVioletCreams]

Landrover, so so so sorry to hear of your daughter.

[crashdoll]

what i dont understand though, is gp's being budget driven, if they let a problem fester it will cost them more in the long run anyway?

It will fester if it's a virus and there's not a lot anyone can do about it.

[dikkertjedap]

to World Health Organisation accepted respiratory rates in children by age group - you basically need to count the number of exhalations during exactly 1 minute (I tend to repeat it a few times to make sure I get it correct)

Other check is the capillary refill test (also known as nailbed test)

However, Rose if unsure it is best to take your dc to A&E at least there will be paediatricians there, better than OOH in my experience.

[dikkertjedap]

Of course it is not true that nothing can be done if it is a virus. There are anti virals available for people in at risk groups. Also, GPs could be much more pro-active in positively excluding bacterial infections rather than just having the default stance that everything is a virus unless proven otherwise.

[FasterStronger]

but you dont go to A&E unless there is an Accident or an Emergency.

because otherwise you will cause delays for people who have had an accident or an emergency.

[Sirzy]

Faster - if your child is having enough trouble with their chest you suspect pnumonia then of course your right to take them to A and E.

A child with chest problems is very much an emergency

[banana87]

but you dont go to A&E unless there is an Accident or an Emergency.

because otherwise you will cause delays for people who have had an accident or an emergency.

Very ignorant comment here. If a child has a high temp that is not coming down with medication, you DO go to A&E. High fevers are very dangerous, especially if they are not responding to treatment. Comments like this are careless.

[FasterStronger]

Sirzy - I don't read what the poster is saying in the same way as you do.

on a different note: has your DC been tested for a propensity for pneumonia? i cannot remember the details but there is a test for it - i think it runs in families. i recall flu jab is recommended.

banana87 could you show me a medical reference for you assertion?

[banana87]

Read "when to call the dr".

[banana87]

www.cpnonline.org/CRS/CRS/pa_fever_hhg.htm

[banana87]

Forgot to add: in both instances that we went to a&e, it was out of hours and NHS direct told us to.

[crashdoll]

Of course it is not true that nothing can be done if it is a virus. There are anti virals available for people in at risk groups. Also, GPs could be much more pro-active in positively excluding bacterial infections rather than just having the default stance that everything is a virus unless proven otherwise.

1.) But unless OP says otherwise, the child is not at risk. What else is there that a GP can prescribe?

2.) By the time the GP has swabbed and got results, it will be about a week. Will people like the OP be happy to wait? Anyway, the NHS cannot afford this.

Again, not excusing GPs fobbing patients off but there are a lot of people who cannot grasp that ABs will not help a virus. It will only leave them with side effects.

[saintlyjimjams]

Anti virals aren't given very often though. DS1 has been given them once, but he was at risk of death without them.

[Sirzy]

Faster DS has his flu jab anyway, from his x rays/blood tests they have identified the strain he gets and why.

[silverstaresatnight]

I agree with you , a lot of GPs are way too laissez faire especially with kids, can be dangerous.

[silverstaresatnight]

And I am a hospital dr

[Zavi]

Can't believe the number of people on here - including OP - who have sick children and phone the GP for advice

GPs do not have crystal balls. They can ONLY make a diagnosis based on clinical history, to include past medical history, AND a clinical examination.

If you are concerned enough about your child to phone the GP then you should be taking them to the surgery where they can be examined properly.

Where are your priorities in this scenario?????

[thebitchdoctor]

Well silverstaresatnight I'm a GP and I can tell you there are PLENTY of GPs who aren't laissez faire with kids at all.

[silverstaresatnight]

I do think there is a prevailing attitude among some, obviously not all , GPs of feeling that either all illness is a virus or that parents / mothers are being over anxious.
It always strikes me there is a reluctance to think it could be a serious pathology or some difficulty in distinguishing the serious from the trivial, and not enough info given to parents about when to come back and what to actually do, ie a plan if things don't get better.

Then as soon as hey go to AE every single child with a fever is referred to paeds!

[landrover]

Thankyou RoseandViolet xxxx Have a lovely daughter called Gabrielle now, she is a huge comfort x

[saintlyjimjams]

Zavi - I didn't phone my GP I rang the eye A&E as that is what you have to do. I rang them because my ds1 is severely autistic, very hard to examine and because you only get a quick glimpse you need an expert. You are not allowed to just turn up at the eye A&E, - they won't see you - the procedure is to ring and they decide whether you will be seen.

A lot of GP's now operate telephone triage as well - so you ring, and either talk to a doctor or nurse and they decide whether you get an appointment.

[thebitchdoctor]

Utter codswallop. What kind of hospital dr are you?

I'm not denying there are many terrible GPs (just as there are terrible doctors in every speciality) but there are many, MANY good GPs who screen for red flags, who don't dismiss anxious parents out of hand and most importantly they SAFETY NET for if things don't improve, they follow up with appointments or phonecalls if they are worried about the patient but don't think they warrant admission. Its the basis on which our practice is built on. You probably don't know about these many good GPs because you don't see many of their patients as they are managed at home.

And yes, if a child is in A&E I would bloody hope they would be referred to paeds if necessary.

I find there is a tendency for some hospital doctors to forget that GPs have only 10 minutes in which to take a history, to do a competent examination and form a management plan without the comfort blanket of on-site bloods, ECGs, X rays and the like. We have to rely purely on our clinical skills and sometimes our intuition to decide the best form of action.

[thebitchdoctor]

And land rover I'm so very sorry about your loss.

[silverstaresatnight]

It's not, honestly.
Not suggesting you are not a good dr obviously wouldn't dream of being so rude but the ops experience does happen.