To have refused to take DD to A & E

[Polarbearstar]

‘Refused’ sounds more aggressive than it actually was, but DD has not really been quite right for a while now with a perforated ear drum, high temperatures, cold, streaming nose.

Doctor keeps saying to take to A and E and I am unclear what A and E can do that they can’t?

You have clearly misunderstood the GP. No GP will tell you to use A and E as your GP for routine childhood illness. I don't believe your GP told you to never return and just use A and E for every minor issue.

Within routine childhood illnesses, there can be symptoms that mean a visit to A and E is warranted and that is likely what your GP was conveying. Your GP was tryin gto establish when it is appropriate to see the GP and when an A and E assessment is warranted due to a need for a more indepth assessment than a GP can provide. Going to A and E for that deeper assessment doesn't always mean the finding will be more serious - it is to rule out more serious issues.

So you mean that your GP told you that if the symptoms of this ear infection persist, you should go to A and E? Presumably not that you should always go to A and E if your child is unwell.

At the end of those five hours we were told ‘calpol and fluids.
After your child had been examined to confirm that more was not required, right? And if more had been required, then she might e.g. have been kept in overnight, given further treatment? You were lucky that no further treatment was required for the moment. But that wasn't the only possible outcome.

Let's say you lock your door when you go out. Then when you come back, you check your Ring doorbell and see that no-one tried to break in. Does that mean it was a waste of time locking the door?

@CremeEggThief

OP what is the point in your post? You've clearly decided you're going to do what you want/think is best anyway. Do you just want to annoy people with your bad attitude?

YABU

I really don’t feel I have displayed a bad attitude at all. Please do point out where I have and I’ll gladly apologise.

What I wanted from this post is to try to understand the system as I’ll be honest and say I don’t. On the occasions we have had to go to the walk in centre, phone 11, go to A and E we are always always told to see someone else, usually the GP. Now the GP is also sending us somewhere else.

YANBU. This is not appropriate advice, they should only be telling you to go to A&E in an emergency when it wouldn’t be safe to wait to see the GP. Otherwise the GP should see her and then refer you to the ENT or Paediatric on call teams if they think more specialist input and/or hospital admission is required.

If A&E is swamped with every child who has an ear infection or tonsillitis then it will delay care for the ones who really need to be there.

That’s certainly not what was said, @ravenmum. And I did ask for clarification. We do not go to A and E if the infection worsens, we go to A and E when she is ill.

No one is saying that going to A and E is a waste of time, it is best to be sure, but I do think some common sense and some judgement can be used as well. Going straight to A and E for absolutely everything is neither sensible or conducive, surely?

My DD is now a teen but has suffered with her ears since a baby.

Is your DD getting repeated burst ear drums? I think one of the problems is that it takes around 6 weeks for the hole to heal (it's been a while might not be exactly 6 weeks). During this time, bacteria can get in more easily for infections like mastoiditis and meningitis. In this case you may be better advised to get urgent medical attention rather than waiting for office hours to see GP. If she is getting repeated ear infections, perhaps request referral to ENT and/or audiology, unless GP thinks A&E should arrange this?!

Earache is so painful and distressing for babies. I hope she feels better soon.

16 months?!
My DD was checked at just over 2 for hearing damage after a winter of ear infections that recurred but that got antibiotics. We had no indications there had been damage, she seemed to be speaking ok. We were only referred as a precaution because the doctor had been unable to do the full examination they wanted to on one occasion.

The ear that was most troublesome had moderate (step on from mild) hearing impairment and it was drained in hospital, then she had a grommets op. Her speaking and sleep really improved and she was much better able to say when her hearing was disturbed - like listening to a TV or radio constantly, especially when lying down). She had been travel sick; that then stopped, because the ear wasn't messing her balance around. It was a huge improvement but the impairment did get worse on the basis of the hospital tests and she needed grommets 2 more times (and may still, into her teens).

Yes, A&E may not do much more than the GP, but honestly, the referral around that age was a shock to us in terms of the 'one ear is quite damaged' proof, and your child could really be in pain and discomfort that antibiotics can't clear up entirely, if it's down to damage.

Are you saying your child has had the same infection for three weeks and that the antibiotics aren’t helping and the GP has told you to go to A&E if it flares up again but you want to keep returning to the same GP for more antibiotics that aren’t helping? Or have I misunderstood?

I'm sorry OP but there's very clearly been some misunderstanding somewhere along the line here.

At a time when A&E waiting times are through the roof and beds are a premium, there's no way the GP should be advising you to Take your child to A&E for any and all medical concerns. Maybe the GP misunderstood or maybe you did but either way, isn't it worth calling the GP surgery to confirm?

I would bet my house that you'll be told the GP is the first port of call for routine illnesses and not to go to A&E unless there's been an accident or emergency

No GP would tell you to always take your child to A and E every time she is ill. Maybe try clarifying it again. For example, did she mean "if your child is seriously ill"?

I would imagine because of the giant backlog for ENT referrals ( currently waiting 17 months) he's trying to guide you to getting help quicker. My lil one had to have a low dosage of long term antibiotics that could only be prescribed via ENT or pediatrics after being seen by someone in ent.

@Polarbearstar

I think you would do well to try and clarify with the GP what they meant. Maybe they didn't want your child in pain over a weekend and as you say it usually happens then they meant "if this happens again on a Sunday just take her to A&E instead of waiting til Monday to see the GP"?

If this is a recurrent issue for your DD then you need to ask the GP for a referral to ENT. This may take months though depending on area and waiting lists, so in some cases A&E would be better to deal with an acute problem or be able to refer directly to ENT casualty?

Are people really this stupid?

OP if it helps both my dc, and they are grown up now, had repeated ear infections as babies. 11 for one, 8 for the other. It was unspeakably horrid. They had antibiotic course after antibiotic. At that time we were advised antibiotics every time. When an ear infection started on a Friday night the only option was to get abs from A&E. We tried everything, including a low dose ab for six weeks to try and clear it.

Generally the gp was dismissive and refused an NHS referral to ENT or grommets as both dc had well developed speech.

Privately we asked for an ENT referral. DC were grommeted at 15 and 20 months respectively. Once that was done the ear infections stopped.

At about 9 DS had another ear infection and the GP wasn't remotely interested despite the leaking yellow fluid for days. Went back a few times.

The next time this happened he was in Austria. There the standard is urgent review by GP, immediate referral to ENT where he was examined, the ear was toiletted and he was given ABs.

When he got home we went to the GP. Not remotely interested. Had him referred privately. The ear- drum was healing at an angle because ds had an inherited condition called choleastaysis (might be wrong) that caused excess bone to form in the inner ear - eventually this gets worse and worse so hearing is lost (DS's great grandad, paternal was stone deaf by the age of 30). A grommet was required to ensure the drum healed straight. If it hadn't been sorted much more serious surgery would have been required.

I think I said NHS GP wasn't interested and refused to refer on NHS.

OP I would suggest you insist on an ENT referral and if this is refused you may have to pay for it.

Both DC recovered as soon as they had grommets.

I think what you are saying is that GP is fobbing you off and you want to be able to get urgent treatment and appointments for her as needed from your own GP. If so, YANBU and it’s frustrating. Try 111 for an out of hours appointment. It’s awful but I’ve been known to wait until 6pm to call 111 because my own GP was so impossible and out of hours service was better.

And to add, in case this may be something that applies to you, swimming, at all, with a perforated drum was a fast track to the next infection. DC had plugs and a band to protect the ears, but once again, the infection had to be gone, and grommets in, before it was any use to be protecting in water.

That’s certainly not what was said, @ravenmum. And I did ask for clarification. We do not go to A and E if the infection worsens, we go to A and E when she is ill.

I understand you asked for clarification, but this doesn't make sense. I can't see a GP suggesting you go to A+E whenever a child is ill. There must have been some misunderstanding, and they meant if the ear infection persits or comes back again.

what I’m really about here is trying to understand why we are being sent to A and E.

Surely this is what you probe the GP

A GP tell me to take my child to the doctors

I’d be out the door and in the car with said child before you could blink

@Polarbearstar

That’s certainly not what was said, *@ravenmum*. And I did ask for clarification. We do not go to A and E if the infection worsens, we go to A and E when she is ill.

No one is saying that going to A and E is a waste of time, it is best to be sure, but I do think some common sense and some judgement can be used as well. Going straight to A and E for absolutely everything is neither sensible or conducive, surely?

She obviously didn’t mean that OP I think you need to apply a “some common sense”

A&E can do all the baseline tests that your GP cannot do; your daughter will see a specialist and treatment will be expedited. As GP advised it, do please take her to A&E. Ears are important and not just for hearing.

@SleepWhenAmDead - thank you. That does make sense. It hasn’t been a repeated case but it doesn’t seem to have cleared up at all, which is the worry. I definitely agree urgent medical attention is sometimes appropriate but the problem is when you end up on the carousel of the GP telling you to go to A and E and A and E telling you to go to the GP it’s very frustrating and you get nowhere.

@ColgateGirl I did ask for clarification and she did say to go to A and E whenever she is unwell. I agree it sounds bizarre which is why I posted on here - I am lost myself - but you can’t keep saying ‘is this what you mean’ and being told ‘yes.’

@HistoricGreenBox yes, you have misunderstood I think. Of course it’s nonsensical to keep trying treatment that doesn’t work. However, I would expect the GP to be making appropriate referrals to ENT or to the paediatric unit. Waiting for her to be unwell then going to A and E is surely not the right way of going about it.

At any rate I am calling BUPA now so hopefully we can get something sorted.

The GP is saying that because if you go to A&E again with a v young child who is persistently unwell & isn't responding to their treatment ( and you convey that history to them ) then they can do blood tests to see if it's something else causing or underlying those symptoms & you can get her seen by a specialist paediatric Consultant asap. This is way quicker than the GP doing a written referral to get her seen by a specialist. That could take months & months if the GP went the 'formal' referal route . You need to be very clear she's not getting better & you want a paediatric specialist to see her. The GP is obviously trying to help you get a quicker route to a Specialist. Please, please take your child, the GP won't refer you to A&E for no good reason!

My DP works as an A&E locum doctor. He's seeing lots of patients (adults and children) with minor ailments and illnesses who are saying they were told to attend A&E for what in his opinion are GP matters and not much he can do in an A&E department. He's having to refer on to ENT or wherever but mostly just tells them they need to see their GP. So I can completely believe OP was told to go to A&E for recurring ear infections.
I'm still moaning to any and all that my GP is still insisting on phone appointments and not seeing me in person. I've on going autoimmune problems, and need regular checkups and changes to my meds.
If antibiotics aren't work I'd be calling the GP and insisting on ENT referral.

Sounds like a severe case of crossed wires.