To think they shouldn't have called an ambulance

[Andyetanothernamechange]

DD, aged 2, was having breathing difficulties. This is the third time in 2 months. I took her to the local urgent care centre where she was seen quickly and put on a nebuliser. Half way through the nebuliser she perked up massively and started singing! After the neb her sats were fine, but by that point the doctor had called 999 for her to be blue lighted to A&E. When the paramedics arrived, DD was singing baa baa black sheep. At this point the doctor said she had previously suspected sepsis but not anymore and the blue light wasn't needed. DD sang for the entire journey in the ambulance. At A&E we waited a while, gave her her inhaler (which I had already) and were given a course of steroids. I know that breathing problems are not to be dismissed, but after one nebuliser she was markedly better and UCC could have prescribed the steroids without needing to use an ambulance or A&E time. Of course it's better to be cautious with small children, but it just seemed as though they made an initial decision and then couldn't go back on it. Ultimately, I felt like it was a waste of resources for her to be sent my ambulance to another hospital when she could have been treated where she was.

And I suppose what I'm asking is, not should an ambulance have been called? But, can an ambulance be cancelled if it is no longer warranted.

The doctors know more than you, and though she might have appeared fine, they might have been concerned about something or she could go downhill fast. Now they have to err on the side of caution, and cover themselves too. If they did not and something happened suddenly to your dd, you probably would sue the Hospital Trust.

But, can an ambulance be cancelled if it is no longer warranted.

It was still warranted. The medical personnel on this thread are saying themselves that if a child has been ill enough to require a nebuliser, the worry is that when it wears off they will be back to being very ill! And that they should be observed in hospital as they can crash very quickly indeed.

Also, just to add, the UCC was in a hospital, just one without an A&E. There are rooms, bays, oxygen from the wall rather than a tank. It is in effect a mini-A&E.

But, can an ambulance be cancelled if it is no longer warranted.

Yes. They absolutely can be. Add to that the paramedics make a judgement as to whether or not the patient they are attending actually needs to go to hospital. In this case the decision was yes, the patient needs to go.

They don't just rock up and take people who have fully recovered to hospital. Your DD was clearly still in the danger zone.

It is in effect a mini-A&E.

A 'mini A&E' without expert paediatricians that have experience in intubating and ventilating a young child if the situation arose.

They are the experts and know the limits of their competence as well as warning signs. They were acting in the best interest of your child and this post is the most ridiculous I've seen - and I am a paediatrician

The Urgent Care Centre is just that. It doesn't become a 'mini A&E' because you decide

I don’t think OP is being ungrateful. I’ve seen hundreds of posts along the lines of ‘why are you wasting valuable NHS resources going to a&e/calling 999/calling OOH?’ and it makes one feel guilty about accessing emergency services if the child turns out to be fine, even if it was an appropriate course of action.

One of my babies breath holds and passes out when angry and the first time it happened my GP made me take her to a&e (she would have called an ambulance if I wasn’t able to take a taxi). I spent the whole time in a&e taking up a bed in majors with the most well looking baby you have ever seen, whose obs were perfect and felt so guilty, but it could have been something more serious so it was appropriate.

So in the nicest possible way, YABU OP, and you shouldn’t feel guilty but I get why you do. I wish the NHS was better funded so we weren’t hesitant about accessing emergency care for potentially very sick children.

I'm not a doctor, no, but my other child has spent many months in hospital previously with breathing problems. I do know what to look for which is exactly why I took my youngest to UCC. But I also know, based on all of signs following the neb - good sats, no signs of respiratory distress - that at that point she wasn't an emergency

You base this insight on your observation of one child. The Dr and paramedics luckily have more in depth medical training and experience. I understand mums on this forum using such anecdotal evidence to argue with each other over who is right (however misguided that might be), but it certainly isn’t a basis for challenging the professional opinion of several medics.

After riddles26 post, I don’t think anything else can be said. Straight from the horse mouth so to speak!

(By the way, I’m not calling you a horse riddles26 lol)

I once called an ambulance for my DS thinking he had the beginning symptoms of anaphylaxis.(I wasn't sure if he had eaten nuts) It turned out that he didn't it was severe hay-fever. I apologised to the hospital for calling the ambulance and was told that if you call an ambulance because you think there is a life threatening situation and there isn't that is OK. It's the people who call ambulances for things that are obviously not emergencys that they don't want.

@Gunpowder You've explained my position better than I have!

I realise that I ABU now. I also fear that I may have become somewhat complacent about breathing problems as I've seen my other daughter very ill and, comparatively, my youngest was infinitely better. But, as others have said, I shouldn't judge that based on one child and children do present differently.

I'm sorry for any offence this thread has caused. It absolutely wasn't my intention. I just felt guilty at the thought that someone else might be waiting for an ambulance while one was being used to transfer a singing child.

I also just want to clarify that I don't think she should have been discharged at that point, I was under the impression that she could have been monitored at the UCC as I know others have been before. But yes, you're right, there aren't paediatric specialists there and that might have been what she needed.

Sorry again.

My grandson suffers horrendously with croup. My poor DD has been told to always phone for an ambulance as he's gone from being a bit wheezy to his chest almost collapsing within 10 minutes. His worst attack was when he was 3 - the call handler heard him gasping and they sent out a 1st responder and 2 ambulances. They had to give him adrenaline, nebulise him and he was blue lit to hospital with 2 paramedics in the back and the 1st responder. He was dreadfully unwell for nearly 4 days in hospital. I didn't sleep for days afterwards - all I could hear was him gasping for breath.

They don't mess about with kids in respiratory distress for good reason. So glad your LO is better.

Of course it can be cancelled. But the Dr didn't. Based on all stats etc. So that should tell you everything you need to know

The downside of all the sepsis awareness is that there will be more false positives. It is completely impossible for every medical professional to spot sepsis every single time, without missing a case, and never err in the side of caution (which happened here).

If you are saying that you'd rather they moved the bar back towards less false positives then there will be cases missed. These are important decisions but "it should be completely accurate every time," is not a valid position, just a stupid one.

Never feel bad about using an ambulance for breathing & bleeding.

Yes, if it wasn’t for all the ‘sepsis awareness’ (I could see the nurse reading the poster over my head while she was assessing me) I probably wouldn’t be here.

Sepsis had been ruled out by the time the ambulance arrived. Again, my original question wasn't clear. If they suspected sepsis I completely agree that an ambulance should have been called. My question was more based around the fact that things had changed by the time the paramedics arrived.

Ah apologies, I thought your thread title was ‘AIBU to think they shouldn’t have called an ambulance’.

We had the same situation once, would have been quicker to drive there as I know the cheeky back routes to the hospital. Once the adrenaline wore off and I was looking at things more clearly I realised they’d insisted on ambulance transport in case he crashed in the ambulance.

We, as reasonably healthy adults, have the view that we should always avoid using a&e / other urgent services - but as parents I think we have to retrain ourselves to see children (and old people) as inherently more vulnerable (even if generally healthy). So the reason WE don’t abuse the system is so it it there for THEM. (And other emergencies / vulnerable people!)

I'm glad your child perked up after the neb. I do not think they were unreasonable to call an ambulance. At the age of 2 kids don't have the reserves of energy to cope with the stress of breathing difficulties for long. I tell you this from experience. When my son was 2 he developed asthma symptoms following viral upper RT infection. We phone out of hours doctor and as soon as she heard him over the phone she sent an ambulance. By the time we got to hospital he was much better following treatment in the ambulance. The consultant decided to keep an eye on him overnight. Thank god he did, he went downhill again rapidly and ended up in high dependency for 2 nights. I just thank god they didn't send us home.

AvoidingDM I didn’t realise how serious asthma was either. Then last year I had an acute episode and I’m lucky to be here.

OP YABU. Don’t think of asthma as a trivial illness.

I'm stunned that your first reaction to this incident is to worry about the strain on NHS resources.
This kind of incident is why we put the NHS in place.

I was sent to A&E 4 times in 3 days by my GP who was trying his hardest to listen to me. Each time I was laughed at by consultants. I went to MIU instead and UCC because I was desperate and I was told I was a hypochondriac and an overly paranoid new first time young mother.

Two days later my daughter nearly died of Septicaemia and it was only because I did CPR on her in the car that she is alive now. Even when I got to A&E with my blue lifeless baby I was told to take a seat and wait my turn. Had it not been for me screaming like a lunatic until someone listened to me she would be dead now. Be grateful people were listening to you and being cautious for your child's sake some of us could only have wished for the same.

Zebra & Loubluee so sorry for your loss

A severe wheeze (more.serious than it sounds)
Thats what this thread has taugh me in a nutshell. Wheeze makes it sound trivial. Sounds like I should be adding another lucky star or two to my NHS thank-yous