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 ?

Right wingers talk about the deserving/non deserving poor
Left wingers talk about the deserving/ non deserving NHS patient!!!!!

A&E Accident and emergency. I think deep down you know when something is really wrong. I've gone to A&E twice (walked in, not called 111 before hand and not blue lighted) and both times it's turned out to be life threatening. One of those was after my GP telling me there was nothing wrong. Always follow your instinct.

OP you are taking MN too seriously. It is clear what A and E are for. You are simply listening to people who talk rubbish on social medai.

2 years ago I was suffering from extreme diarrhoea not an A&E matter I am sure people on here would say, I had been to the GP twice, first time I was told it was due to antibiotics I was taking, second time a week later I was told it was a virus, by the Wednesday of the next week my DH found me collapsed on the sofa so took my to A&E, he made the mistake of asking the Triage Nurse if I could see a specialist, that was it she wouldn't even let me see a doctor, accused me of trying to see a specialist through A&E and told me to go back to my GP

Got an emergency appt next day with the Nurse, she took one look at me and called the GP in the same one who told me a few days before I had a virus, he was visibly shocked to see how ill I looked an the fact that I had lost a lot of weight since he last saw me, gave me a letter for A&E and I was admitted to hospital with SEPSIS, I was in for 12 days 11 of which were in isolation I was very seriously ill.

I wont be fobbed off next time I nearly died all because a nurse thought I was trying to 'pull a fast one'

@ssd

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

It’s attitudes like this which means many people put off seeking medical care until they are at a crisis point.

In a lot of cases the earlier you seek medical help the better.

Do all hospitals have an acute / minor injuries unit?

I'm the 80s / 90s it was literally an accident ie dropped a sack of potatoes on my foot, got bit by a dog, dropped a vase and got glass stuck in knee, fell and hit head and big lump / lots of blood, sprained wrists and broken legs from coming off bikes OR an emergency - loss of consciousness, chest pains etc.

It seems really it should just be EMERGENCY now and the use of the word accident confuses people.

Our local A&E is pretty good at triaging at first point of contact but I did find it confusing when DS was little they they wouldn't see us for an accident (toddler hitting head on kerb for example, massive lump) and instead we had to walk halfway across the hospital to be seen by minor injuries.

I think it's hard for people in distress to separate minor and major in the momwnt

Accident is for serious accidents.
But if in doubt ring 111, it is why it was set up.

My father went to the doctor as he had chest pains, he didn't think it was worth going to A&E, they weren't "that" bad.

My father died in the doctors surgery.

My father should've gone to A&E, my mother deeply regrets not calling an ambulance.

@bigbluebus

Lost count of how many times I dialled 999 when my DD was alive and she was admitted to resus in A&E each time. She had her first seizure just before her 2nd birthday and lived until she was 22. Sadly medication failed to control her epileptic seizures. But then we never had to queue up and wait as it was an emergency.

I'm so sorry for your loss.

@Offmyfence I am so sorry to hear this.
I suspect he is not the only one. My GP now has a recorded message before the receptionist answers - it says something like, if you are experiencing chest pain please hang up now and dial 999.

Clue is in the name!

I've been once when took DD to gp and he said go straight to a and e.

Some neighbours, friends. And one work mate in particular. Seem to spend their lives there.

Some is luck. Some is silly. Workmate there are jokes about him having chair with name on etc.

Having said that. Cuts shortages etc mean in some areas seeing a GP or even a nurse at GP is weeks wait. So things get worse and worse and then. A and e seems only place to go.

It's shitty.

(I do think some people freak out over nothing a lot though).

[quote julieca]@Offmyfence I am so sorry to hear this.
I suspect he is not the only one. My GP now has a recorded message before the receptionist answers - it says something like, if you are experiencing chest pain please hang up now and dial 999.[/quote]
Thank you.

@cowburp

If it's something or you aren't sure if it's something that could kill you but isn't a pre existing condition.

By your logic I should not take my asthmatic kid to emergency because she can’t breath following treatment at home. Because it is a pre-existing condition.

And that when she had double sided unresolved pneumonia as a baby we shouldn’t have gone back when she could not breath?

Or what about a cancer patient getting chemo with fever? Or someone with a heart condition having chest pain?

Seriously only if it might kill you but isn’t pre-existing just isn’t the the criteria

But if in doubt ring 111, it is why it was set up.

If in doubt & something doesn't seem right go to A&E imo.
Family member was ill, covid symptoms phoned 111 & they said yes all sound like covid. Took them for test & it came back negative, phoned 111 again & they said likely still covid & see what happens over the next few days. I called an ambulance later that day as something wasn't right. It was sepsis & if I waited they would have died.

I've also gone to a&e myself for not feeling right. I wasn't right I had appendicitis & then severe pneumonia whilst 6 months pregnant.

Where we live the out of hours GP has a clinic next to A&E. if you rock up with a non emergency you get punted over there to be seen and it gives a clear message to the time wasters.
On the flip side an elderly relative recently called an ambulance with chest pains after a recent operation. Waiting time for an ambulance was over an hour. They give up waiting and his wife drove him in. He had clots on his lungs. The treatment once there was great but you’ve got to get through the doors first.

@julieca

Accident is for serious accidents. But if in doubt ring 111, it is why it was set up.

I rand 111 the other day. 45 minute wait fir the call to be answered. Was told a doctor would ring me back within sox hours. Four hours later I got a call from a non-medic saying they wouldn’t be able to call back for several more hours, so after 4am. It’s very frightening, the state of our healthcare system.

I think the confusion comes because there is A&E, Urgent Care, Minor Injuries, and Walk In Centers.

Where I live we have A&E (for adults only) and a walk in Center in the same place. same registration desk, tri-age by the same nurse.

I've been there when I've cut my hand, it's no longer bleeding heavily, but I needed more first aid than I could provide myself at home. I've also been there with my DC with various injuries over the years - only once were we sent over to the A&E in the next city, and that wasn't something that was an accident or an emergency, but DC was admitted to hospital. DS friend once took him after he had a nasty accident- personally I'd have taken him to the the A&E in the next city to avoid having to be transferred, but friend was panicking slightly and just wanted medical help. It turned out a specialist just happened to be at our very small A&E, and DS got very, very lucky.

So I think it's all too confusing and could do with some clarity. I also think the ambulance service needs an overhaul. There are too many elderly people lying on the floor for hours on end because no body can help them up - so poor women spent the entire day (7 hours) lying in the middle of our town center the other day waiting for help. She's still alive, but it must have been absolutely bloody awful for her. The whole town knows about it, yet there are no protests, no marches, no one demanding the government sort this out. There is more fuss locally when someone doesn't get a correct delivery form the Chinese takeaway, or the town car park price increases than when it take hours for an ambulance to arrive.

Exercising judgement about whether a medical issue is likely to be serious, particularly if you're expected to err on the side of not going to A&E, is quite a skilled task. We shouldn't expect people with no medical training to be able to do that. The normal thing would be that if you thought you needed medical attention but you weren't sure, you would phone your GP for less urgent stuff and get an appointment at your convenience, or if it was more urgent or out of hours you would pop along to a&E where the triage nurse would make a preliminary assessment of your likelihood of pegging it in the next 20 minutes and prioritise you accordingly. And if you had something nobody thought was very serious but you had a bad feeling or some other reason to want it done straight away, you accept the long wait in A&E, if it turns out you were sicker than the triage assessment suggested then you're in the right place if your condition worsens. None of this is unreasonable to expect. There are plenty of places in Europe for example where this 8s exactly how the system works, and by and large it worked like that in the UK as well in the past. But now you have this situation where GPs are overstretched, mental health services have been cut to the bone, and so A&E as the carer of last resort is getting absolutely hammered. And people are hearing that message and paying attention, so they don't seek medical treatment, and then they either get better or they get worse.
I was watching Ambulance last week and one of the call handlers remarked "they call us when they shouldn't, and they don't call us when they do" - but actually I think that's two different groups of people, both making bad judgement calls but different judgements and in different situations. And I wish people would stop with the "don't overburden the NHS" message because I don't think it reaches the people whose lives are so chaotic that they end up frequent flyers at A&E, I think it reaches the diligent, worried types who are actually properly ill but don't want to be a bother.

In my hospital (and I suspect many others) Urgent Care issues in the same physical space as A&E so people call it A&E regardless if they're actually treated there or UC.

You are triaged my a Nurse and then directed to Reception who book you in for the relevant service.

We do have 3 out of hours GP hubs and minor injuries too, which from my extensive experience with sickly and injury prone children and very good and removing gravel from and treating wounds but cannot x-ray or prescribe antibiotics so don't cover most of the things we need. Hence rocking up at hospital.

Very long winded way of saying may just be a case of semantics, people saying they're going to A&E when they don't mean it cos it's the same place

Things I’ve been to A&E for:

• Waking up in the night with my heart racing in my chest and not being able to slow it down, feeling short of breath. That happened in the middle of the night, turned out it was the start of my nocturnal panic attacks.

• Lots of blood in my urine. Which turned out to be a nasty UTI, I was sent home with antibiotics.

• When I woke up in the morning once and my face was swollen, turns out I had mumps (was vaccinated as a child but immunity obviously wears off.

• With my nan when she walked into a wooden shoe rack and it took a huge chunk out of her leg.

• With my mum who was bleeding extremely heavily during the menopause and it turned out she had polyps.

I once went to A&E because if a v heavy period, and felt ridiculous about it - but no idea what else to do.
Was admitted to a ward within a couple of hours of arrival & kept in for three days.

GPs can give x-ray forms where you go straight to the x-ray dept rather than waiting in A&E, assuming you can get to speak to GP. Having watched Ambulance, I think people should be more considerate about when to call an ambulance and try to get to hospital themselves if possible (e.g. baby has temperature, toddler had fall)

I wonder if part of the confusion for some is because some hospitals only have A&E, no separate walk in/ minor injuries.

I know our closest A&E didn't until recently. There was a minor injuries at a different hospital (just minor injuries and out of hours GP, no A&E) but it closed at 11pm so when DS was a baby and we needed an out of hours doctor we had to go to A&E, for what turned out to be a very nasty throat infection.

The hospital we took DD to when she had cracked her head open and needed it gluing was the same. They triage according to need once inside of course but everyone went in the same doors- those who arrived by ambulance, those with major A&E worthy issues, and those who just needed sticking back together.

It's not always easy to know, though.

A couple of years ago, I had the most intense abdominal pain I've ever experienced — couldn't move normally, and so much pain I had tears flowing constantly from my eyes. I was in a public place and had no idea what to do, and everyone around me diplomatically ignored it. I was frightened by the level of pain (worse than passing a kidney stone, which is pretty bad) and scared it was something serious, so managed to get myself to A&E something like 40 minutes into the attack. As luck would have it, the pain had started easing slightly just as I arrived, so when I told the nurse guarding the doorway what was wrong, she told me "A&E isn't for tummy aches, go to the GP clinic over there". I was mortified but I really had thought I might have something horribly wrong

It was probably something to do with the then-undiagnosed coeliac disease, and definitely wasn't a life-threatening emergency, but I didn't know that at the time…