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?

Also, the GP did put her hands on and around the bad ear and DD didn’t wince or show any signs of discomfort so the GP does not think she is in pain. I’ll agree it’s unpleasant and that’s why I am spending money to sort it!

This is what it's like now.

The whole point of the gp is surely to prevent things getting to the point it becomes an a&e job. But you cant get in.

Then you cant get seen at a&e fir hours and hours because its full of people who should be at the drs

OP - you've got your work cut out either way with ENT for children. My DD's audiologist said that she needed to see ENT. The waiting list for NHS ENT is really long. The COVID really impacted on ENT.

I then also tried to get a private ENT appt and in my COUNTY they will only see adults and had no suggestions for me.

In the end my DD showed symptoms of mastoiditis and I took her to the GP who said to go to A&E where we did get to see an ENT Consultant. (mastoidisits is not recommended though).

I think you need to be persistent and prepared to travel if you can xx

OP is there a language difference between you and the GP or is there a reason why the communication was so poor? As I said in my earlier post, I think you misunderstood them.
It's important to have clear communication channels with dealing with medical staff. If the problem is with the GP, then perhaps you need to change GPs. If you need extra support then ask the surgery what is available. Or try to ensure someone else comes with you if possible or ask the GP to write their advice down. It can be easy to miss nuance if you're worried about your DC

They would recommend A&E in my area because A&E can refer you on to the ENT Emergencies clinic. GP's can't do that round here.

Many GP's say this as a way of bypassing the referraly system.

If your DD was referred by tge GP, they would enter the ENT waiting list and could be waiting months for an intial appointment especially in the current NHS climate.
By going through A&E - they will do an intial assessment there and then and in general will be transferred to a specialist quicker.

If im honest (hospital worker) its an absolute nightmare that they do this and it one of the reasons hospitals are struggling with A&E waits - A&E is life or death, not a quick route for a referral but the GP's are happy to give this advice as they are under so much pressure it easens their burden.

Its a bit of a loophole, you technically can do it - but knowing the system makes it a bit morally wrong for me. Obviosuly you know your DD better than anyone and can best assess their need for A&E or to return to GP and ask for a proper referal to a ENT specialist

@Whinge

Another one saying YABU. Doctors / GPs don't say go to A+E for no reason. If they're suggesting it (and it seems like they've suggested it more than once) then you should listen.

Actually I disagree, it doesn't sound like the GP is concerned, it sounds like they are washing their hands of her. If they are concerned they should be referring her to audiology, or ent or whatever the right consultant is.

@IDidntKnowItWasAParty

Wtf is wrong with you OP - your baby is ill, Gp tells you to take them to A&E, yet instead you come on here?! Jesus wept, your poor child. Go to A&E.

^ x 1,000,000 times

Your poor child, why do you think you know better than your GP?

For a perforated ear drum if antibiotics don’t dry it up, will need to be swabbed to determine what type of infection it is, either bacterial or fungal, then different medication can be given. My DH has a perforated ear drum, which perforated about 15 years ago. The operation to close the perforation, he was only given a 50% success rate then, although now, the success rate is way higher and you should consider this going forward, if you want her be able to go swimming.

One good way to understand better would be to... Take her to a and e like the Dr said.

I agree, it doesn’t sounds like A&E is the most appropriate route. I would be asking the GP to discuss with paeds and seeing if you can be seen on the assessment unit or in hot clinic. Sitting for hours in A&E benefits no one

A few people have confirmed that GPs do do this, so I really don’t think I misunderstood her, in fact I know I didn’t.

@SleepWhenAmDead thanks - it is a bit of a headache. I’ve asked for a referral so we can go through BUPA but even privately it’s looking like it’s difficult.

As an A&E nurse you aren’t being unreasonable. The GP is getting out of seeing a patient & by telling you to go to A&E is ultimately passing you on the the hospital system instead of being treated in the community. A&E stands for ACCIDENT & EMERGENCY, can your baby breathe? Is she otherwise fairly well? Eating & drinking? Peeing & pooing? If yes to the above then this is neither an accident or an emergency & the GP should be providing you with care. This is the reason that hospitals are overwhelmed & ambulances are stuck at A&E departments & unable to attend calls, GPs must go back to seeing patients in the community

@LittleSnakes

• Antibiotics make little difference to the number of children whose symptoms improve • Antibiotics make little difference to the number of children with recurrent infections, short-term hearing loss or perforated eardrum

From NICE guidelines. Every time I’ve been to GP for something similar, they say ‘come back and see me if it doesn’t go away’. Not ‘go to A&E if it doe my go away’ Unless there’s concerns about sepsis obvs.

So my father, in the days before antibiotics, had to have all his inner ear removed as a small child because of an ear infection. If he had antibiotics he would have been able to hear in both ears, not just one. The NICE guidelines are very risky.

Well, it’s definitely not something we can arse about with, that much is clear.

I'd probably try 111 or out of hours services if they exist in your area before A&E as waits can be extreme.

I've had similar - well before covid - woke up with red swollen itchy eye - washed it out it was getting steadily worse itched like hell took anti histomes - didn't think chemist would be able to offer more than we had in so rang GP in morning - explained got an appointment with health care practitioner - she was vile gave me perscription drops told me off for not going at eye A&E in next city - that I didn't know even existed and said next time I shouldn't waste their time.

We were fairly new to area and they werent' enough GPs but it was an early sign they were worst GP we'd ever had. Had to learn to be very peristant and frequently print off and go in with NICE guidelines.

So anyway.... you'll call the GP again and get the swab...?

A lot of people aren't reading this thread correctly.

The doctor didn't say go to a&e right away shes said next time take her straight to A&E.

I see your point OP and my gp has also advised me to take DC to a&e for things such as viral cold, water infection etc and it really feels like they are trying to palm you off when you know a&e just means a long wait to receive the same treatment as gp would prescribe.

Obviously If your child is very poorly and your worried you would take her to a&e but in this case how can doctor recommend it for the future without seeing your child

FFS. YANBU @Polarbearstar

If either I or my child had a reoccurring infection I would expect the GP to prescribe antibiotics. If this didn’t work I would expect them to swab and find out why it wasn’t healing. If they still couldn’t figure out the issue I would expect a referral to a specialist, not to be fobbed off to A&E.

Accident and emergency is for that alone. Your DC has had a diagnosis but isn’t responding to treatment. She needs a referral to ENT.

Oh, it thought your DD is much older, in that case I’d definitely be going to A&e just to be on a safe side.

I would be requesting additional checks with the audiologist department.

Perforated eardrums can heal, but not always, which would then result in a hearing loss.

A&E should be able to offer the additional checks (even if it's based on being seen and then referred) to better understand the cause of it and to check that the inner ear workings are not damaged beyond repair.

I have hearing loss, and my LB (5weeks) has been diagnosed. It's really important to push for these hearing checks or you may find that it gets worse and causes permanent damage.

Hope this helps!

A perforated eardrum can turn serious if not dealt with, why would you just not listen and go. Is it really worth risking your child's hearing because you cant be bothered sitting in A&E for a few hours

likewise I feel REALLY confused about the GP's response as this doesn't appear an A&E criteria. I likewise have had a lifetime of ear problems(hearing is impaired now) following recurrent ear infections and 2 perforations (the membrane can grow back when you are a child but once you are an adult it doesn't). If she is getting recurrent temps and discharge that suggests possibly a persistent ear infection; as the GP has previously prescribed antibiotics then they should be swabbing to check if they are prescribing the appropriate antibiotic. if this is a recurrent problem that they cant get to the bottom of they should be referring for specialist advice/ENT. I personally would put my concerns in writing and also ask to see her medical records ,something is being lost in the communication here and I can understand how frustrated you may be. if you want to try an alternative in the meanwhiel,garlic/horseradish is very good for recurrent ear and sinus infections and dairy can also exacerbate problems (though obv. a challenge to go dairy free in this age group)

[quote Polarbearstar]@Calmdown14 no, it isn’t. It’s completely the opposite, it is one ear infection.[/quote]
An ear infection can lead to other things; the ears are a portal to the brain, ear infection can lead to balance disorders.

If your daughter goes to A&E she will be seen by an ENT doctor, there is always one on call. You won't be taking up time that other patients need, they won't all have ear problems!

Just go.

Doctors don’t recommend A&E unless necessary. The fact that you are refusing to take her is ridiculous and irresponsible.