What exactly is A&E for?

[AccidentallyOnPurpose]

Inspired by a current thread , but this has been bugging me for a while.

No matter how serious the situation or symptoms, there are always plenty of people telling OP she's a time waster, she's fine,her kid is fine etc. To stop being so silly and just wait for the GP or ask a pharmacist. If they're feeling particularly generous maybe ring 111 but God forbid they take it seriously and send an ambulance. Then you're the reason an old person is lying on the floor for hours waiting for help and a father of 4 died of a heart attack.

Fainting, bleeding, high fevers, sudden or continuous increased pain etc none of them are good enough. I'm surprised no one suggested to put a wet paper towel on it. It works in schools.

So what exactly is the A&E department for ?

If it was down to me, I’d beef up A&E and base GPs there too, if an emergency appointment was needed. Make it a massive triage centre, which may include an outcome of making an appointment for a few days time.
Many EDs have minors departments, which doesn’t sound exactly life threatening. It’s annoying that the patients are forced to make the decision, you basically just want to see someone trustworthy, quickly rather than faffing around figuring out if you’re worthy enough, especially if it concerns a child. Definitely more emergency mental health support needed too.

I was watching BBC1 Ambulance on catch up last night - quite a few of the patients were apologising as they got on the ambulance for 'being a pain' 'wasting their time' etc. One of them died in the end, so as serious as it gets, but still was very sorry for calling them out

It made me think what a blinder the government has played. They've run the NHS down so much that people actually feel guilty for dying!!

@BoredZelda

OP you’re being a bit silly imo, I’ve seen loads of threads where the poster is advised to go to a&e.

But those threads are always also full of people saying anything less than 20 seconds from death makes you an A&E timewaster.

It's those replies I based my thread on. They're in significant numbers too,

@LIZS

Minor injuries can do straightforwards breaks, cuts and infections. A and E for potentially life threatening conditions, acute medical care, serious accidents, complicated fractures, head injuries etc

Ours can't. Any potential fractures, dislocations - including where it's come out and gone back in again but still hurts like buggery - or bad sprains are told to go straight to A&E as they're the only ones with x-ray facilities.

Other than that, A&E for cuts that might need stitching (gaping, even if it only ends up with a bunch of steristrips), cuts to the scalp, burns over a joint, over the fingers or larger than about the size of an inch or are white or don't hurt, all electric shocks, breathing difficulties, chest pain, bleeding that won't stop, abdominal pain, head injuries, eye injuries and sudden eye pain, loss of consciousness, shoulder pain particularly when somebody could theoretically be pregnant - anything where it's going to be necessary to see inside the body to know for certain what's going on - plus symptoms suggesting sepsis, babies and children with very high temperatures, seizures, severe back pain with numbness or loss of bladder or bowel sensation or control, sudden onset headaches, loss of control or sensation on one side of the body or drooping of one side of the face, etc.

Minor injuries here is largely for the odd cat bite and splinters.

@ssd

I think if you need to go to A&E you don't ask mumsnet.

If you are in a lot of pain it’s difficult to make a decision. I once told and OOH GP over the phone that I didn’t think it was necessary for me to go to A and E because a GP I had seen earlier in the day said I was fine. I was actually really ill and was admitted to hospital a day later and I couldn’t be fully assessed until they gave me morphine. Pain easily confuses people.

Life or limb. If you are in danger of losing either ED is the place to go. 999 is for emergency ambulance for the same reason. Not for a problem you have had for 2 years that you now decide needs attention at 0200hrs on a Saturday! Not because your acrylic nails are coming off! Not because you have run out of meds or want the covid vaccine!!!!

I dunno, mostly I think we've got it right as a family over the years. Broken bones (requiring surgery and plastering and more treatment). Facial cut that needed maxillofacial surgery, bog standard stitches, 2x blue lighted from GP's and an inpatient stay...Only two times I was less sure, one was (what turned out to be a calf tear) an injury that a GP friend urged me to get checked out for risk of snapped Achilles (and I probably would have riced and then seen a physio for) and the other some broken ribs (which actually are not treatable so don't need X raying) ... But the associated abdominal distension convinced 111 that internal injuries needed to be rulled out...(I was a bit less sure would have done watchful waiting)....

When DS2 was a staff nurse in A&E he got fed up with people bringing their kids in with minor ailments between 5.30am and 6.30am. They did it to make sure they were well enough for nursery/school and so the parents could go to work. It was a complete waste of resources.

He’s left A&E now. One of the reasons was because unless he was in resus or majors there were so many people there who didn’t need to be there so they’d have a long wait which would make quite a few of them become abusive.

I can’t remember the last time I went to A&E for me or DH. I’ve got a cardiac problem atm that a lot of people would go to A&E for but in reality there’s nothing they can do, I just need to wait for my cardiology appointment.

The last time either of the kids needed emergency treatment was when DS2 dislocated and broke his shoulder playing rugby at school. The A&E department had closed its doors to patients because it was over capacity so he was taken to the minor injuries unit, they put it back in and we went to the fracture clinic the next day.

We have had ambulances to him over the years because he’s asthmatic and needed putting on the nebuliser so they gave us one to save us having to do that.

I've only been three times in nearly 40 years.

Once when I was hit by someone and lost consciousness and my friends took me. I still don't remember any of it.

Once with DD, which in all fairness it could've waited for GP but she was only 9 months old and I freaked out even if it was minor. She did get antibiotics prescribed.

Once when I broke my ankle.

I avoid the GP if I can , I'm definitely not going to A&E for a jolly.

I was in paediatric A&E earlier this week (GP sent us as X-ray was required). I didn’t see any child where I would have queried whether they needed to be there. Two kids vomiting profusely (one baby, one toddler whose mother was worried she’d vomited blood). One baby who might have swallowed a triple A battery (not on the X-ray so clearly hadn’t). And DC2 who couldn’t walk following an accident (minor fracture).

Now I am absolutely sure adults A&E is a different matter. But paediatric A&E, in the middle of the day - I didn’t see anyone I would have considered to be a timewaster.

Though I was probably labelled a time waster last summer when I took DC2 in. He’d been ill for a couple of days and it had come on very suddenly. Running a high temperature. Had spent most of the day trying to get some sense out of 111. And failing. By the evening he was showing several signs of possible sepsis and wasn’t responding to Calpol. I decided “fuck it” and took him to A&E.

He made a Lazarus-like recovery within minutes of arrival and I felt like a complete fraud. If I had a pound for every time I said “I promise he wasn’t acting like this when we left the house”….

@Whenigrowupiwanttobea

Life or limb. If you are in danger of losing either ED is the place to go. 999 is for emergency ambulance for the same reason. Not for a problem you have had for 2 years that you now decide needs attention at 0200hrs on a Saturday! Not because your acrylic nails are coming off! Not because you have run out of meds or want the covid vaccine!!!!

That is an unfair thing to say. You jump from life/death situation to acrylic nails coming off

What people want to know is the in between!!! What if they suddenly have, for example, horrible severe pain? Are they going to die? Probably not! But it might be worrying enough to want to see a doctor ASAP! Even if it means (like another poster said) waiting hours in AandE.

I've been to A&E for myself twice, once when I had a pot of boiling tea spilt on my leg and had second degree burns. And once as a teenager when I had a severe mental health crisis.

Been sent by GP twice for DCs for severe croup and DS' hydrocele (doctor couldn't tell if it was that or a hernia)

Called an ambulance once for DD when she had severe pneumonia (sent away from FOUR GPs in the 10 days prior to her admission telling us it was a virus). She went very limp and blue and was drifting in and out of consciousness. Was terrifying.

Bizarre that people think you only go to A&E for “life threatening emergencies” !! There are plenty of situations requiring emergency care that aren’t necessarily life threatening. Also you don’t always know. Some things need to be urgently assessed by a professional to judge how serious they are .
A&E is for accidents (minor and major) and when you require emergency care (for whatever reason).

Personally I don't go to A&E with straightforward breaks (e.g. my broken foot).

I go to minor injuries the next morning - it's much quicker to be seen there.

I'd go to A&E with a serious break (e.g. main leg bones) or a complicated fracture.

@MrsTulipTattsyrup

This is what the NHS says on its website. Pretty clear, really. Accidents and emergencies.

The fact that it says "such as" followed by a list implies, to me, that the list isn't all-inclusive. Severe pain or high fever, for instance, could very well be an emergency situation, but how would you know unless you went and got it checked out? I would try to treat at home first with Tylenol or Advil but if those didn't help then I would consider going to the emergency room. If it was a weekend and my doctor's office wasn't open. My doctor can always get me in on the same day.

@Bizawit

Bizarre that people think you only go to A&E for “life threatening emergencies” !! There are plenty of situations requiring emergency care that aren’t necessarily life threatening. Also you don’t always know. Some things need to be urgently assessed by a professional to judge how serious they are . A&E is for accidents (minor and major) and when you require emergency care (for whatever reason).

I went to the emergency room last year for the first time ever. I started having pain on a Friday, and it worsened until Sunday morning I couldn't stand it anymore. That, along with a high fever that didn't respond to meds made me concerned I had appendicitis. It turned out to be diverticulitis, which I had never heard of. My white blood cell count was 4x what it should have been, so I had to stay while they gave me a bag of intravenous antibiotics.

I have two hospitals within a 10 minute drive from my house. They have their emergency room wait times up on their website so you can usually check ahead to see how long you're going to have to wait before you go.

@BurntTheFuckOut

Things I’ve been to A&E for

-DD2, multiple times for stitches, head wounds. She is fearless and clumsy, fantastic combination.

-I woke up, confused, agitated, talking nonsense and with a raging fever. ExDP called 111, who sent an ambulance when he mentioned I’d started a new medication a few days prior. I was in resus for a while as my BP was high, HR all over the place. Serotonin Syndrome. Spent a few nights in hospital with that.

-Swine Flu. 3 days in ICU. I was 22 with no pre existing conditions.

-

@BurntTheFuckOut you’re the only person I’ve ever come across who has also had serotonin syndrome!

I've been for a broken ankle, had to dual 999 as I was stuck on the floor, then dh had heard a bone snap & I was shivering & sweating. Told to go by 111 during a gallstones attack. When I had fallen & smashed my face on the pavement, split from lip to nose & damaged my knees.

I have taken ds when he fell on the ice & broke his wrist. When we were sent direct from the GP as ds was in so much pain I couldn't touch him. When ds had been sick 30 times in 6 hours. When ds had popped his calf muscle.

Our walk in (currently starts with a call due to covid) is pretty good, every day 10am-10pm can see:

• Minor ear, nose and throat problems
• Sprains and strains
• Wound infections
• Minor burns and scalds
• Minor head injuries (only in over 2 year olds and under 65 year olds)
• Skin conditions
• Minor respiratory conditions such as cough
• Mild abdominal pain or discomfort
• Insect and animal bites and stings
• Minor eye problems
• Minor injuries to the back, shoulder and chest
• Wound dressings
• Emergency contraception

No X-ray
In theory this really should mean A&E is accident and emergency.

@LIZS

Minor injuries can do straightforwards breaks, cuts and infections. A and E for potentially life threatening conditions, acute medical care, serious accidents, complicated fractures, head injuries etc

We don't have a minor injuries unit at all. You can't get a GP appointment for love nor money either. So people have to go to A&E for breaks, cuts, minor burns, nosebleeds that won't stop, sprains, infected bites turning septic etc, because there's nowhere else available.

@wheresmymojo

Personally I don't go to A&E with straightforward breaks (e.g. my broken foot).

I go to minor injuries the next morning - it's much quicker to be seen there.

I'd go to A&E with a serious break (e.g. main leg bones) or a complicated fracture.

But how do you know it's a complex fracture? Just curious?

@blackheartsgirl Im so sorry for what happened but i feel i must say it would still have been inhumane to speak to someone with gallstones like that. It IS incredibly painful and can be life threatening.

www.dailymail.co.uk/news/article-2365464/Man-41-died-gallstones-begging-999-operator-GP-ambulance-told-bath.html

There's no walk in clinic or see and treat around here, there's a minor injuries hospital unit and the major trauma centre a&e, ooh will direct you to the miu for anything non life threatening, unless it's between 11pm and 8am when you get sent to the major a&e because you need to be treated in a timely fashion (suspected breaks, stitches needed etc) and there's no other alternative.

I'm fortunate that I've not been to A and E for over 49 years. But the lack of frontline services sends people there who shouldn't be there.
A few years ago I had an allergic exemca type rash on the palm of my hand. Painful and raw. I treated it at home with things like savlon, antihistamines, lanacane and oatmeal. When it was getting unbearable I rang for a drs appointment. 3 week wait. I went to the pharmacy to see if they had anything different to what I was using. The pharmacist took one look, said he wouldn't sell me anything, I needed to see a Dr. Rang the Dr and explained I had an appt booked but the pharmacy said to see one now. No joy there.
So I went to the walk in centre and was prescribed a high dose of penicillin. That walk in centre has since closed. If this happened now I'd be at A and E.