AIBU - 2 year old I’ll for over a week. A&E?

[IAmADancer]

I have two year old twins who came down with chickenpox on NYE. 1 twin had a few spots and hardly any symptoms and is now fine whereas twins 2 has been ill for nearly 10 days.

He had a temp of over 39 for 5 days and I took him to the gp on Friday who said it was chickenpox and not too worry. By Saturday night I was getting concerned as he wasn’t eating, barely drinking, high temp and sleeping constantly. Rang 111 and they decided to send ambulance. Paramedics checked him out and said it’s just chickenpox but I could be referred for out of hours doctor at hospital which I agreed too. Took him to out of hours on the Sunday at 12pm as this was earliest appointment I could get. GP saw him and straight away said he has an infection on top of the chickenpox and also an ear infection and put him on antibiotics. His temperature has now come down and he is starting to eat a little bit more but he is still sleeping quite a bit, 6 hours today, not eating very much and just generally not himself. I still feel concerned but don’t know what to do. He has also had diahrrea and has had some nose bleeds. I did tell the doctor all of this.

So I suppose I’m asking if I it would be unreasonable to take him to a&e and get him checked or is he just recovering from a nasty infection? Advice please.

OP you have done all the right things.

Keep us posted on your appt.

Hi all

Been to doctors and they have said that the ear infection isn’t healing and it should be by now as he is on day four of antibiotics. They are putting him on stronger antibiotics and I have to bring him back on Friday if he is still off colour. He’s asleep on me at the moment so he obviously still feels a bit crap.

Oh the poor little thing.

They should have taken a swab to establish the infection.

Dancer glad you've been seen and sounds like there is a plan in place. Hopefully the stronger dose works. Poor little poppet, must be in agony.

I know what you mean about being a worried parent but we are all the same. They can't tell you how they feel so you have to go by their behaviour and your gut.

Agree it's ridiculous you couldn't get an ooh app for so long!

callme I'm sorry to hear about your baby. I can only imagine how threads like this make you feel, you're doing such a good thing by sharing your story to help others.

So glad you've been finally seen. It's appalling the NHS has been allowed to get to this state.

To be fair though, ear infections move very fast. I remember developing a slightly itchy inner ear one evening. Next morning, at 5am, I woke up, screaming with pain. Got seen at about 12.30pm that afternoon, and the kind doctor listened to my description of the pain, took one look at my ear, and said, "I'm not surprised- you've got a bad infection" and then told me to take cocodamol. I went from totally normal pain-free, itch-free ears to that, in less than 18 hours.

They should have taken a swab to establish the infection.

For what? To identify whether it was antibiotic-resistant or something? That wouldn't be very efficient. They'd probably only be getting the results of culturing the sample about now. Unless you're proposing leaving patients hanging without a prescription (inhumane, imo) until the results come back, it's quicker to prescribe first line antibiotics for a first ear infection, and see if they work.

I think swabs are taken for persistant, repeated ear infections, aren't they?

ODFOD

Barny you’re right, there is misinformation.

They absolutely can and do swab, especially after an infection that hasn’t cleared up with the first lost of antibiotics.

And antibiotics absolutely do differ in strength, are you telling me that 200mg and 400mg of metronidazole are they same strength? Of course they aren’t.

Swab to establish the bacteria!

I had 8 weeks of infection once and 4 types of antibiotics. I wonder what cost the NHS more, all of the antibiotics and appointments or the swab that they should have done after the first antibiotics didn’t work?

The GP who I saw finally swabbed and said it should have been done weeks ago.

Barny unsure if it's intended but you're coming across aggressive. The OP is worried about her child people are just trying to reassure her.

I don't claim to be a dr at all so if they're aren't such things as stronger antibiotics I apologise, I have heard that term used before however.

What is your suggestion other than antibiotics?

I don't think people suggesting that a sick child be given a quicker gp app means we deserve for the NHS to collapse. The NHS is collapsing because we have an ageing population and a huge social care issue. People using the nhs for medical reasons is nothing new

Barnyforever

Can I just ask if you’re a nurse or a doctor? Do you have a full understanding of how antibiotics work and how they are used to treat illness? If so then I would be more than happy to listen to what you have to say.

I think it’s a bit of sweeping statement in relation to the UK getting what it deserves in relation to the NHS. There was a really interesting thread on here a week or so ago asking NHS professionals what was causing the issues we are currently facing and it was fascinating to read. Yes funding is a huge problem but so is a growing population with a large elderly majority, drug and alcohol problems, mental health issues and obesity.
I have not demanded swabs or any preferential treatment but Indonwant to be taken seriously when I go to the NHS with valid concerns.

As I said upthread I would happily put my hand in my pocket and pay for the service if it was needed. If I went to the doctors today and they had said you need to pay for this appointment/medication etc then I would have done without question. If he needed swabs and I had to pay for them, then I would. I have absolutely no problem with that at all.

Oh and I should add that he has been given a combination of antibiotics that make it stronger. Happy to take a picture of the bottle and you can explain it to me in greater detail.

Glad you have been seen!
Hope the combo of antibiotics do the trick.

And hope you can both get some rest today.
You must be exhausted

I am glad your baby has been seen and sorted.

OOH will have offered the appointment based on their clinical assessment - ie your child needed to be seen within 24 hours but it was not life threatening based on the answers you gave to questions. If this is not the case then you need to complain as they should have resource to see a patient if this is what is determined is required. You can actually ask for a copy of the OOH report which will tell you the recommended timescale to be seen and it will also detail the answers you gave to the questions asked.

Clinicians are humans and they will make mistakes and we fellow humans we need to appreciate this can happen. BUT, mistakes need to be explored so learning and change can happen and improvement evidenced.

I am happy to read posts about how awful the NHS is after something bad has happened but reading a post where unqualified people are giving advice on what a mum with a poorly baby should do is dangerous and could have led to the OP not doing anything had people said, "oh they'll be ok"

Equally, there were people saying go to A&E for what ended up being an ear infection.

I just wish people would call 111 or their GP about health concerns at the time so they get the right advice. at the right time.

No negativity intended - just concerned about future posts on this type of matter. It ended ok this time, but what about the future when it could be a child where the extra 1 hour would have made a difference?

Barnyforever

I do understand your frustration as healthcare professional and how you must feel constantly demonised. I am probably a bit jaded as in the last 12 months my step sisters husband has been told he has terminal lung cancer, he’s 45, and they turned him away 4 times before it was picked up, my mums best friend was told there was nothing wrong with her and after numerous visits to gp etc they finally told her it was pancreatic cancer. She didn’t last very long.

I know the pressure the NHS is under, I can’t begin to imagine how hard it is especially at the moment. But I am allowed an opinion as to how I have been treated by various people as we have gone along. I have said that OOH GP and 111 were fantastic, others not so much. I’m sure that’s the case in any job.

He has been put on co-amoxiclav. I haven’t hear of it before?

Tistheseason17

I feel as if you have just decided to read bits of my posts and not all of it. I already New he had an ear infection, and the reason I was asking for advice was because in the last few days all the HCP I’d spoken with bar one person, who actually picked up the virus’s he had, had pretty much dismissed my concerns.

I would ask the question what would you have done differently but that would be pointless as I’m sure your superior judgement would have been far better than mine.

Equally, there were people saying go to A&E for what ended up being an ear infection.

Ear infections can be very serious in young children.

@IAmADancer
Have RTFT
Only the first part of my post was specific to you. Sorry if not clear - it was specific to your wait for an OOH appointment and trying to be helpful to you should you wish to get further information to understand why it had taken so long to get an appointment and support you if you need to make a complaint.

The rest of my post is general and not specific to you.

I do still think 111 is better than MN for health advice and the call to 111 should be first, then get the support from MN posters about how you are feeling, which I support fully.

barny I didn’t suggest the GP swabbed the child the first time. I know that a GP wouldn’t do that.

You’re reading things on this thread that aren’t there.

I assume today is your day off from being a HCP? Go and get a cup of tea, meditate, chill out.

barny you've every right to be grumpy. My neighbour is a practice nurse and is exhausted from how busy they are. I think anyone who works in the nhs, especially at this time of year, are wonderful.

My mums GP missed her cancer for three months despite her going pretty much every week to see him. In the end I took her to a&e , she was diagnosed the next morning with cancer. She died 6 weeks later. Whilst I could be angry at the GP I am not. They're under immense pressure and are only human. I accept dying is just part of life and there is only so much we can do. That said the a&e staff were terrific so if anyone is having issues with GPs I can see why they go to a&e.

Anyway I feel like we're all getting off topic here and I hate it when things start to get a bit nasty on here.

OP keep us posted and hopefully you're little one feels better soon.

I agree, there are always some misinformed posts on MN where health related topics are concerned!
My daughter has been hospitalised with an ear infection that had spread to the mastoid area, so yes they can be serious in those who are vulnerable in some way. And she routinely has her ear infections swabbed at the hospital, because she has been on prophylactic antibiotics for a few years, and takes many treatment courses on top, resistance has been a huge problem for her, and she has often required next line IVs to clear them. Even a simple eColi Uti became a big problem last year.
GPs don't routinely swab ears, because for most children, the first line is usually sufficient, and as somebody already posted, the majority of ear related infections, are of viral origin, and don't necessarily need antibiotics at all.
It is indeed often difficult for doctors to identify the patients that need more than reassurance. In the case of cancer, both my parents passed away quite young, and getting their diagnosis was a minefield. And I know many people who have had similar stories. But I can understand that GPs have to follow some form of referral protocol, otherwise there would be mayhem! If initial tests don't reveal anything untoward, then the pathway seems to be put on hold, unfortunately with detrimental outcomes for some.
As for assessing a sick child however, I do think GPs can and should do more. A cursory glance based on professional experience, is just not always sufficient. Some children do not present in a typical way, and my child certainly hasn't on every ocassion. A&E triage patients with a simple, heart rate, temp, sats score etc, and yet our GP has never done this. It takes a mere couple of minutes, so why is it so often overlooked. When I stressed to my GP that I was concerned about my daughter's HR, she dismissed it as simply fever related, and perfectly normal. She didn't check it herself, she simply dismissed my concerns. So I took her straight to A&E, and as soon as she was triaged, (HR was almost 200 (high for an 8 yr old!) and her BP had started to drop dangerously low), she was admitted as an emergency. Blood cultures revealed she had invasive scepticaemia. But our very experienced GP, did not think she LOOKED ill.
It's just not acceptable sometimes, and for every how ever many thousand kids that may be fine, there will be one that warranted more.
Yes the NHS is struggling to do the best it can, and we as a family are hugely grateful and have huge respect for the many people who give it their all, but it's over stretched and under funded, and I think it's high time that people started contributing in some way.