To think my husband is gravely ill at the wrong time?

[MyOtherCarIsAPorsche]

Masses of confusion.

Husband spoke to GP yesterday morning and described his chest pain. He was advised to call an ambulance. My husband refused because he didn't think he needed one - thought he had chest infection or torn muscle.

He went to A&E - was sat in a corridor from 10.30am - he had ecg, x ray and blood test. He continued to sit on a chair in the corridor all day.

He was told he was waiting for blood test results. These came back at 6pm. Then he had to wait for a CT scan - then rushed to resus.

Dissected aorta from heart level to naval level.

I was called to be allowed to sit with him because I wasn't allowed to be in A&E. Was then told he was being blue lighted to another hospital an hour away for immediate surgery. I asked is this time critical? The answer was - yes life saving.

Paramedics arrived and told me to set off to this other hospital. There were three paramedics. One said 'I'm not taking him because I can't use that bit of kit, I'll lose my job if something goes wrong'. No advanced paramedics available and no doctor available to go in the transfer.

I was 15 min into the journey and then called back to the hospital.

No surgery.

Trying all day today to get him transferred. Nothing available.

He's critically ill.

I'm out of my mind with worry.

There's a saying about not being ill on the weekend. The standard of care is not the same. The 24hr cover appears to not exist.

I feel like we're being fobbed off with poor excuses big style.

@Youally

Senior NHS manager

• consistent on call now. Not this afternoon, not later, now. Not a foundation doctor or a SHO or a registrar you tell everyone who comes near you you want the con on call NOW

• Twitter. Tweet the hospital, the CEO the chair of the board - tag them in the tweet

• Phone switchboard and ask for the site matron

• Make sure everything is documented. Ask them very clearly what time your husband is being transferred and write it down in front of them. With the doctors name and grade and specialty

It is very true that the squeaky wheel gets the oil when it comes to the NHS. Make some noise

This is good advice. There has to be a consultant on call. Demand to speak to them and refuse to be fobbed off.

That is shocking. I hope you can shake them up and he gets the treatment he needs.

I feel for you, I really do.
It's a potentially life-threatening condition, but if it's not leaking outside of the aorta yet, then it's not necessarily time desperate, if you see what I mean.
However, the dissection has the potential to rupture at any time, and then it absolutely IS time essential to get him into surgery.

People can live with aortic dissection for some time, and have elective surgery to repair it, which most will survive.

If his dissection/aneurysm had ruptured, I'm sure he'd be straight into surgery, so I think you can take some comfort that you still have some time, but he will need surgery as soon as it can be arranged, to repair the aortic wall.

Another nhs manager here. I agree. You need to speak to the consultant and the manager on call. Stay calm, stay polite but be clear you were told he's critically ill. Something needs to happen now.

Lots of people are advising to try email - this isn't going to work. Emails are not a useful method of communication in a genuine emergency.

At every Trust, there will be a general manager on call, and a consultant on call - those are the people who the OP needs to be speaking to. And the nurses she is dealing with will have those phone numbers.

Ask very sternly to speak to the site practitioner there is always one on and the consultant on call (again there is always one on). Then demand answers, there is also always anaesthetists on call asking as there are theatres at the hospital meaning they can do the transfer if urgent. This is what happens at my trust if there is no appropriately trained paramedics.

God you poor woman.

You do indeed nee the on call manager or the site practitioner or on call surgical consultant.

Switchboard should just put you through. Very good luck. Right now, more than ever, the squeaky wheel gets the oil. Don’t worry about upsetting anyone. Just go for it. Advocate as best you can. Don’t be worried about upsetting people.

How terrible for you. We're always told that, whatever state it's in, when it comes to an emergency the NHS really steps up.

I hope you manage to speak to the people mentioned above. I was going to suggest Twitter too. And maybe one of the tabloids.

Sending positive thoughts to you and your dh.

Do you have another family member/friend who can come to the hospital to support you in this? Your mind must be in turmoil.

I’ve namechanged purely because I don’t want to be linked back to my trust because it could be outing!

It’ll be the receiving hospital that’s causing the issue.

My local hospital don’t have vascular, our patients get shipped out. But the receiving hospital have to agree. It’s a long standing joke that if we’d take ourselves over to the next trust because literally you’d have a better chance of survival.

I remember many moons ago, in a trust I worked for that again, didn’t have vascular, chatting to a lovely chap. Late 70s walked miles everyday. Fitter and healthier than all the staff. When I left that evening they were waiting for a decision from a vascular trust.

Came back the next morning and he’d passed away overnight. Other trust refused to take him. Had looked at the age and decided they wouldn’t even try. I was genuinely heartbroken at the unfairness of it. Our consultants and lead people had pleaded, but the answer from the next trust was just a No.

So so so wrong.

How horrendous. Please make the biggest fuss you can. Everything crossed for your dh.

He is in intensive care at the first hospital.

There's a place in intensive care at the second hospital - he was accepted for surgery immediately.

What I don't understand is how he needed this 'life saving' surgery last night and was on the ambulance trolley ready to go, then had to be transferred back to the resus bed and now he appears to be in limbo land.

How can life saving surgery be called off on the say so of a paramedic?

Since then I feel all we've heard are downright lies, back tracking and cover ups.

Surely the evidence from the scan yesterday and the significance of the rupture indicated emergency surgery - and now it doesn't?

Just doesn't make any sense.

Hope you’ve seen/spoken to a consultant, if not yet then as already said keep pushing firmly but politely and makes notes as suggested.

There is always someone 'in charge' of the hospital. During the weekend it is sometimes the hospital coordinator. The nurse in charge of the ED/ward will be able to contact them. They should be aware of this issue and trying to find a solution. Is he in ICU? Sounds like it's more a transport issue than a hospital accepting issue. We often accompany patients to a more appropriate hospital if they are on heparin drips. Surely if there is an ICU nurse looking after him they can go with him with the ambulance crew who are maybe not the most appropriate skill mix?

I agree about making a lot of noise and making it clear that you will be going to the media.

Fucking hell, your OP gave me chills. MAKE A LOT OF NOISE TO ANYONE WHO WILL LISTEN. Good luck

I have no suggestions OP just hope that your DH gets the operation he needs.
This is both shocking and down right disgraceful

I’m sorry I might have misunderstood - what exactly are they waiting for? For a transfer team to be available or for a response from the vascular/cardiothoracic team at the other hospital?

Please clarify this with them - not all dissections need surgery, even if the A&E team originally said he needed surgery they could have then been advised differently once the images reviewed by vascular.

If the vascular team agree he needs emergency surgery and they are waiting for a transfer team - it does NOT take over 24 hrs for a transfer team to be available and I would kick up an unholy fuss about this. If it is taking that long for a blue light transfer with an ambulance then the current hospital needs to be looking at releasing an anaesthetist/ODP/crit care nurse. To be honest if he needs emergency surgery then even a transfer with an ambulance technician crew is better than waiting as if things deteriorate in his current hospital the doctors there don’t have the capability to perform the necessary surgery anyway. In my experience in this situation the patient needs to be transferred for surgery and beds are found later/while surgery is happening. You do not wait for an ITU bed to be available.

If the vascular team have said he does not need surgery and this is to be managed with blood pressure control and other measures then he still needs transfer to be under their care but it’s not a blue light transfer as that care can be provided in any hospital in an ITU/HDU setting.

Please make sure you have the names of all the doctors you have spoken to and please also ask for the names of the specialist team members they have spoken to and the explicit advice given and when.

@MyOtherCarIsAPorsche
This sounds horrendous! Sadly it seems to common an experience recently.

If you’re still having issues, ring PALS (patient advice and liaison service). It probably saved my friend’s dad’s life when something similar happened to him. You’d be surprised how quickly your care when someone’s actually coordinating it.

I think the phone number changes by area, but I’m not 100% sure?

Best of luck OP!

He's only 59 - our daughter is expecting twins.

He's said to me last night that he was frightened and couldn't stop thinking about the twins he may never see.

I have never heard my husband say he is frightened before. He was reluctant to go to hospital in the first place because he thought he wasn't 'bad enough'. He thought the searing pain was a torn muscle.

We would rather he was treated somewhere else entirely - his father had a similar episode and had successful emergency surgery at a large teaching hospital (transferred from a local A&E). We were told we have no choice of hospital - but his father did?

OP Don't be very British about this, make a noise until they move him, do not move from the nurses station until the have the most senior staff member in the hospital today in front of you, if there is nobody senior enough demand they get on the phone and ring someone at home.

*too
*how quickly your care improves
I really should have proof-read that 🤦‍♀️

Here’s a link to find the PALS officers for your local area:
www.nhs.uk/service-search/other-services/Patient-advice-and-liaison-services-(PALS)/LocationSearch/363

@MyOtherCarIsAPorsche - it's unclear from your posts whether or not the aortic dissection has ruptured or not.
Initially you said it was an aortic dissection - yes. Didn't mention a rupture. In which case, surgery isn't necessarily required imminently.
But in your last post you said a rupture - have you been told that it has ruptured, specifically? This is a much more serious situation, if that is the case. But I cannot imagine they would not be doing everything in their power to get him into surgery, if it had actually ruptured.

Is it securing a transfer that is the issue? If the receiving hospital has accepted him for surgery and has an ITU bed it's crazy. I agree with others that sadly you need to make lots of noise, escalate up and up. It shouldn't be this way, and sadly I actually think if more was outsourced with financial penalties to service failures and the autonomy to offer staff better pay and working conditions things would be a lot better. Hoping it gets sorted soon.

I’m so sorry for you and your husband this sounds incredibly distressing. I don’t understand why a hospital would not have the same level of emergency staff all week long.